Conditions

The Roxanna Todd Hodges Stroke and TIA care team offers expertise in the treatment of stroke, transient ischemic attacks and other neurovascular disorders. Symptoms of stroke and TIA may include sudden onset of one, some, or all of the following:

• Numbness or weakness in the face, arm or leg (usually unilateral)
• Confusion, trouble speaking or understanding
• Trouble seeing in one or both eyes
• Difficulty walking, dizziness or loss of balance and/or coordination
• Severe headache with no known cause

Transient ischemic attack (TIA) creates neurological symptoms because of inadequate blood flow to a part of the brain. Unlike a stroke, TIAs typically last only a few minutes and leave no permanent injury to the brain. Despite its transient nature, TIA is a warning sign of more serious impending stroke. The risk of stroke after a TIA can be as high as 25 percent in the first 90 days with the highest risk in the first week. Early diagnosis and treatment of TIA is effective in preventing stroke.

Ischemic stroke — occurs when the blood supply to the brain is interrupted. The obstruction could be a blood clot that has formed in the brain or one that has traveled to the brain from another part of the body. Nearly 85 percent of stroke patients have ischemic stroke — many of these preceded by TIA.

Hemorrhagic stroke — occurs when a weakened blood vessel ruptures, allowing bleeding into the brain. Blood vessels can be weakened by a vascular aneurysm, a malformation in the arteries or veins or, most commonly, by uncontrolled high blood pressure. As it accounts for up to 15 percent of all strokes, it is not advisable to take an aspirin after the onset of stroke symptoms; rather, call 9-1-1 immediately.

Vasculitis — An inflammatory condition of the blood vessel wall. Inflammation can narrow or completely close off an artery, reducing or eliminating blood flow to the brain and causing stroke symptoms.

Moyamoya — A rare disorder resulting in narrowing and closure of arteries at the base of the brain. Moyamoya can present with ischemic and hemorrhagic stroke.

Cerebral artery atherosclerosis — A condition resulting from hardening and thickening of artery walls in the brain. High blood pressure, smoking and high cholesterol are common causes of atherosclerosis.

Services

Urgent care management in a dedicated and specialized TIA program has been shown to reduce the risk of recurrent stroke by up to 80 percent. The Roxanna Todd Hodges Stroke Clinic and TIA Program at Keck Medicine of USC provides a multidisciplinary treatment approach to provide urgent evaluation and management of TIA and stroke patients.

Roxanna Todd Hodges Comprehensive Stroke Clinic and TIA Program:

• • Includes a seven-day-a-week stroke and TIA clinic, where a physician promptly evaluate patients following referral
  • Provides referring physicians with second opinions on complex cerebrovascular disorders
  • Accepts physician referrals or rapid evaluations and transfers of TIA patients through the Keck Medical Center of USC Evaluation and Treatment Clinic

Treatments

Acute ischemic stroke — Treatments include intravenous tissue plasminogen activator (tPA), a drug used to restore blood flow to the brain, and mechanical removal of blood clots

Cerebral aneurysm — Treatments include coil embolization, surgical clipping, and medical and endovascular treatment of vasospasm

Hemorrhagic stroke — Treatments include surgical removal of affected tissue and decompression, as well as other minimally invasive techniques

Vascular malformations — Treatments include endovascular embolization, surgical resection and advanced GammaKnife® radiosurgery

Patient Information

What to Expect

If you suddenly experience any warning signs of a stroke or TIA, call 911 immediately. Only non-urgent care is available by appointment at the Roxanna Todd Hodges Stroke Clinic and TIA Program, part of the Keck Medicine of USC neurology clinics.

All patients are evaluated by a board-certified vascular neurologist who initiates an immediate and individualized plan of care. This may include education, prevention therapy, advanced brain and vessel imaging, laboratory evaluation and heart function evaluation, and may prompt reports back to referring physicians.

Our stroke and TIA team also conduct clinical trials investigating new ways to identify, diagnose and treat TIA and stroke; patients may be able to participate in these research projects.

Resources

Keck Medicine of USC Stroke Support Group
The Keck Medicine of USC Stroke Support Group is an educational, interactive place allowing stroke survivors, their families and caregivers to connect with one another and with health care professionals. Support group meetings are held the second Thursday of every month from 1:30 p.m. to 3 p.m. at Keck Hospital of USC (3 North, Acute Rehab Unit Day Room, 3261A). Parking is validated and snacks are provided.

Roxanna Todd Hodges (RTH) Foundation
rthfoundation.org
The stroke clinic and TIA program at Keck Medicine at USC is supported by the RTH Foundation. This foundation also hosts informational seminars and support groups, offers free screenings, and provides a wide range of educational materials.

American Stroke Association
strokeassociation.org
This is the country’s largest organization for stroke awareness, treatment and prevention.

National Institute of Neurological Disorders and Stroke (NINDS)
ninds.nih.gov
Part of the U.S. National Institutes of Health, the NINDS provides comprehensive information on the latest stroke research and treatments, as well as access to nationwide clinical trials.

The National Stroke Association (NSA)
stroke.org
This national organization is focused on preventing, identifying and treating strokes and TIAs.

Clinical Trials
Biomarkers and TIA
Genetic changes and alterations in certain proteins circulating in the blood, known as biomarkers, could help predict stroke, its severity and the extent of recovery. Identifying these biomarkers may help in developing better stroke therapies. At Keck Medicine of USC, patients evaluated in the Roxanna Todd Hodges Stroke Clinic and TIA Program have the opportunity to participate in clinical research.

SUCCEED
Short for “Secondary stroke prevention by Uniting Community and Chronic care model teams Early to End Disparities,” this study aims to test how well a new community patient clinic and care interventions can control the risk of recurring stroke among stroke patients. Keck Medicine of USC is one of several participating medical centers in this study.