Shaare Zedek’s stroke fast track, it’s all about faster, faster and even faster…

In less than three years, the Helmsley Neurological Institute in Shaare Zedek, which opened in 2016, has become one of Israel’s leading centers for the diagnosis and treatment of strokes.

“Twenty years ago, when I first started to work in neurology, there were patients who died because we could not help them…Today, we are able to help these patients recover and live a normal life,” said Dr. Roni Eichel, Director of the Abraham & Lola Borg Stroke Unit and Neurological Intensive Care Unit at Shaare Zedek.

A stroke occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot or ruptures, obstructing blood flow to the brain. Eichel explained that time is the key factor in treating strokes, “Every minute that passes without treatment, two million brain cells die-treatment must be faster, faster and even faster.”

Shaare Zedek has a special “stroke fast track” where stroke patients are quickly diagnosed and treated. Dr. Eichel explained, “Instead of the patient waiting for the system, the system waits for the patient.” Shaare Zedek, in cooperation with מגן דוד אדום – Magen David Adom, developed an app that enables the hospital to obtain essential medical information while the patient is en route to the hospital. The patient is met in the hospital by a physician and nurse who take the patient for a CT scan to assess the situation. A senior stroke physician is also always available for video conferencing to manage cases and make quick decisions.

Prof. Natan Bornstein, Director of the Helmsley Neurological Institute, explained that people typically know certain symptoms and signs of heart attacks, such as chest pain, however, not everyone is aware that a heart attack can also cause brain dysfunction which can cause numbness or weakness in the face, arm or leg, confusion, difficulty understanding other people, and have trouble seeing with one or both eyes. Our emergency room staff have undergone intensive training to be able to quickly identify stroke symptoms.

If diagnosed quickly enough, many strokes can be treated by IV-TPA. In other cases, patients are treated via endovascular intervention, in which micro-catheters, thin tubes are inserted into the blood clot in the brain via the groin and used to remove the clot. Dr. Yaakov Amsalem, Corylee Jan Spiro Chair in Interventional Neuro-Radiology, is the director of our Lee and Anne Samson Interventional Neuro-Radiology Unit, which handles the complex specializations of brain catheterization strokes, aneurysms and other neurological episodes.

“It is amazing, in just three years, we have been able to develop a center that provides nearly all the neurological services – neurosurgery, neurology, neuroradiology, diagnostic neuroradiology and conventional radiology,” said Dr. Eichel. Shaare Zedek has 10 neurologists on staff and treats 1,200 stroke patients per year. According to the Israeli Health Ministry משרד הבריאות ירושלים, in 2017, Shaare Zedek performed more IV-TPA injections and endovascular procedures than any other hospital in Israel.

Stroke care at the Neurological Institute extends beyond the treatment for the stroke itself to preventive measures to evaluate the patient’s situation and prevent a second, more severe stroke. In addition, Dr. Eichel shared, “We are developing a center for headache treatment…Headaches are very common and are very underestimated in terms of how they can affect patients.”

Prof. Bornstein explained that the comprehensive neurological service at Shaare Zedek includes, the 20-bed David & Ann Kuppermann Neurology Department, the 24-bed Zvi Weinroth Department of Neurosurgery headed by Dr. Nevo Margalit, the Borg Stroke Unit, and the Lee & Anne Samson Interventional Neuroradiology Unit, which performs brain catheterization for removing blood clots from the brain, as well other neurosurgery catheter procedures.

Bornstein shared, “Our model for emergency room stroke care is now being followed by many hospitals…I’ve been in many countries…and I have taught around the world …Here, in Israel, neurology is a very advanced discipline in terms of knowledge, technology and treatment. A great deal of research is conducted here, and it is appreciated all over the world…In addition, the spirit of Shaare Zedek is something special.”

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