Diagnosis & Treatment

Diagnosis in the Neurovascular Medicine Program & Stroke Center

Patients with acute signs and symptoms of a stroke or transient ischemic attack (TIA) are first seen at the Emergency Department Stroke Center. They are then transferred to the Neurovascular Program for further care. Outpatients may also be referred to the Neurovascular Outpatient Clinic because they have had a previous stroke or transient ischemic attack, or because they have blood vessel malformations in the brain.

All patients who come to the Neurovascular Medicine Program and Stroke Center will have access to the latest imaging techniques, including advanced neuroimaging, for in-depth evaluation and diagnosis of their condition. This includes:

• Artificial intelligence (AI): AI-enhanced systems are used for faster and more accurate stroke diagnosis and evaluations.
• CT angiography and CT perfusion imaging: Advanced imaging techniques help visualize blood vessels and assess brain perfusion in stroke cases.
• Computed tomography (CT) angiogram: An imaging test that uses x-rays to create detailed pictures of the blood vessels in the brain.
• Magnetic resonance imaging (MRI): An imaging test that creates clear pictures of the brain using magnetic fields and radio waves.
• Catheter angiography: An interventional radiology technique that involves inserting a thin tube into an artery and uses X-rays to create very detailed, dynamic images of the blood vessels in the brain
• Carotid doppler: Ultrasound of the arteries in the neck.
• Transcranial doppler: Ultrasound of the interior brain arteries.
• Single-photon emission computed tomography (SPECT) scan: Nuclear medicine technique that uses imaging with radiotracers to make three dimensional images of the brain by measuring gamma rays.
• Positron emission tomography (PET) scan: Imaging technology that makes three dimensional images of the brain by using radiotracers and measuring energy produced by photons.

The care team may also order blood tests that screen for diabetes and high cholesterol, as well as blood tests that look for unusual stroke risk factors and assess the patient’s response to a medication. This thorough testing allows the program caregivers to most accurately diagnose the patient and design the treatment plan. Patients who need further testing may also be referred for cardiac testing, which may include echocardiography (ultrasound of the heart), cardiac telemetry (external heart monitoring that uses electrodes that stick to the skin) and implanted cardiac monitoring (heart monitoring that relies on a device inserted under the skin).

Treatment in the Neurovascular Medicine Program & Stroke Center

When a patient arrives at the Emergency Department with signs of an acute stroke, they are first treated by the Stroke Center emergency physicians. If a patient arrives within the first few hours with a blood clot blocking an artery (ischemic stroke), our highly specialized team can offer intravenous (IV) medication to dissolve the clot. In some cases, the team performs an emergency procedure to extract the clot. For patients with acute bleeding (hemorrhagic stroke), our highly skilled team of neurosurgeons and neuro-interventionists performs emergency neurosurgery to alleviate the bleeding.

After acute care the patient is then transferred to the expert team at the Neurovascular and Stroke Program within the Neurological Institute. There, caregivers order advanced scans to identify the type and cause of the stroke and conduct further follow-up.

Acute stroke inpatient admission and care

The majority of acute stroke patients who come to Cleveland Clinic Abu Dhabi’s Emergency Department will be seen at the Stroke Center and then admitted to the Neuro-intensive Care Unit. In less critical cases, patients are admitted to the Acute Neurology Ward. During their time at the hospital, patients will receive excellence in care provided by a multidisciplinary team consisting of neurologists, neuro-intensivists, neuro-interventionists, neurosurgeons, internists, vascular surgeons, cardiologists, neurorehabilitation physicians, and specialist nurses. Physical, occupational, and speech therapists, as well as dieticians may also be a part of the care team.

Outpatient management of stroke

Stroke patients who have already been discharged from the hospital, or who are referred to Cleveland Clinic Abu Dhabi after the acute stroke stage, are evaluated in the Neurovascular Outpatient Clinic. These patients have a comprehensive assessment with a team of neuro-interventionists, neurosurgeons and stroke neurologists. In order to ensure the best treatment course for complex conditions, the team discusses these patients’ cases in cerebrovascular case conferences. All patients are offered a comprehensive plan of condition management and treatment options, tailored to their specific needs.