Comprehensive treatment for stroke in Richmond

Stroke is the fifth leading cause of death in the U.S. and a leading cause of adult disability, per the National Stroke Association. Yet, research shows that too few people know what a stroke is and how to recognize when a stroke is happening.

A stroke happens when blood flow to an area of the brain is cut off. Brain cells are deprived of oxygen and begin to die. A stroke can cause you to permanently loose speech, movement and memory.

If you think you or a loved one might be experiencing symptoms of a stroke, call 911 immediately.


If you suspect a stroke, remember to act FAST to identify symptoms:

  • FACE: Ask the person to smile. Does one side of the face droop?
  • ARMS: Ask the person to raise both arms. Does one arm drift downward?
  • SPEECH: Ask the person to repeat a simple phrase. Is their speech slurred or strange?
  • TIME: If you observe any of these signs, call 911 immediately.

When you receive treatment at Chippenham Hospital, a Joint Commission-Certified Primary Stroke Center, you know you’re in good hands. The neurological care department at our hospital is a five-star recipient of stroke two years in a row (2016 to 2017) as awarded by Healthgrades™.

Stroke symptoms

If any of the below symptoms appear suddenly, dial 911 and seek emergency care:

  • Numbness or weakness in the face, arm or leg, especially on one side of the body
  • Confusion, trouble speaking or understanding
  • Trouble seeing in one or both eyes
  • Trouble walking, dizziness, loss of balance or coordination
  • Severe headache with no known cause

Types of stroke

Our stroke care specialists provide treatment for both types of stroke: hemorrhagic and ischemic.

Hemorrhagic stroke

Hemorrhagic strokes are the least common type of stroke. Only 15 percent of all strokes are hemorrhagic, but they are responsible for about 40 percent of all stroke deaths.

A hemorrhagic stroke is either a brain aneurysm burst or a weakened blood vessel leak. Blood spills into or around the brain and creates swelling and pressure, damaging cells and tissue in the brain.

There are two types of hemorrhagic stroke:

Intracerebral hemorrhage

An intracerebral hemorrhage is the most common hemorrhagic stroke, happening when a blood vessel inside the brain bursts and leaks blood into surrounding brain tissue. The bleeding causes brain cells to die and the affected part of the brain stops working correctly. High blood pressure and aging blood vessels are the most common causes of this type of stroke.

Sometimes, intracerebral hemorrhagic stroke can be caused by an arteriovenous malformation (AVM). AVM is a genetic condition of abnormal connection between arteries and veins and most often occurs in the brain or spine. If AVM occurs in the brain, vessels can break and bleed into the brain. The cause of AVM is unclear, but once diagnosed, it can be treated successfully.

Subarachnoid hemorrhage

A subarachnoid hemorrhage involves bleeding in the area between the brain and the tissue covering the brain, known as the subarachnoid space. This type of stroke is most often caused by a burst aneurysm. Other causes can include arteriovenous malformation (AVM), bleeding disorders, head injuries and blood thinners.

Ischemic stroke

Ischemic stroke occurs when a blood vessel carrying blood to the brain is blocked by a blood clot, causing blood not to reach the brain. High blood pressure is the most important risk factor for this type of stroke. Ischemic strokes account for about 87 percent of all strokes. An ischemic stroke can occur in two ways:

Embolic stroke

In an embolic stroke, a blood clot or plaque fragment forms somewhere in the body (usually the heart) and travels to the brain. Once in the brain, the clot travels to a blood vessel small enough to block its passage. The clot lodges there, blocking the blood vessel and causing a stroke. About 15 percent of embolic strokes occur in people with atrial fibrillation. The medical word for this type of blood clot is embolus.

Thrombotic stroke

A thrombotic stroke is caused by a blood clot that forms inside one of the arteries supplying blood to the brain. This type of stroke is usually seen in people with high cholesterol levels and atherosclerosis. The medical word for a clot that forms on a blood-vessel deposit is thrombus. Two types of blood clots can cause thrombotic stroke:

  • Large vessel thrombosis—As the most common form of thrombotic stroke, large vessel thrombosis occurs in the brain’s larger arteries. In most cases it is caused by long-term atherosclerosis in combination with rapid blood clot formation. High cholesterol is a common risk factor for this type of stroke.
  • Small vessel disease—This type of thrombotic stroke happens when blood flow is blocked to a very small arterial vessel (small vessel disease or lacunar infarction). Little is known about the causes of this type of stroke, but it is closely linked to high blood pressure.

Telemedicine and tPA administration

Telemedicine increases the quality and convenience of healthcare services. It can help provide patients with better, faster and more specialized care. Doctors can provide more convenient, real-time interactions with patients and improve communications with other medical staff.

Our expert doctors use on-site examinations and telemedicine capabilities to quickly access a neurologist at Johnston-Willis Hospital who can also evaluate the patient through a camera and microphone.

In addition, the patient can see and interact with the neurologist and see scans and reports of their tests, which can also be shared with a specialist. The neurologist can view head scans, prior reports and records in order to make an informed decision about care.

The most important decision for acute ischemic stroke is tPA (tissue plasminogen activators) administration. tPA is a clot-busting drug for blockages in the arteries in the brain. The sooner it is given, the more brain tissue is preserved. This is very important during a stroke because two million brain cells die every minute you're not treated.

This technology leads to faster administration of tPA, which can lead to improved outcomes in as little at six months. It is more convenient for the patient, as he or she can receive specialized care faster, no matter what time of the day or night.