Froedtert & the Medical College of Wisconsin Stroke Program

The Froedtert & the Medical College of Wisconsin Stroke Program was established in 1995 and was the first program of its kind in eastern Wisconsin. Within the multidisciplinary environment of the Froedtert & MCW Neurosciences Research Center, the Stroke Program offers a comprehensive approach to care. Medical College of Wisconsin physicians and researchers are actively involved in seeking new and better ways to diagnose, treat and prevent stroke, and to assist the recovery of those who have been victimized by it.

Stroke programs provide comprehensive care to patients. From the emergency room to physical rehabilitation, stroke programs combine the skills of many different disciplines offering prevention, diagnosis, and treatment of stroke, and the rehabilitation of the patient.

Leading the way is a handful of comprehensive, multidisciplinary stroke programs located throughout the U.S. The Froedtert & MCW Stroke Program, established in 1995, was the first such comprehensive stroke program in Wisconsin. Within the Froedtert & MCW Stroke Program, nationally recognized neurologists, neurosurgeons, neuroradiologists, vascular surgeons, emergency physicians, physiatrists, and rehabilitation specialists work together toward a common goal: providing a comprehensive approach to the prevention, diagnosis, and treatment of stroke, and the rehabilitation of stroke patients.

Clinical services of the Stroke Program center around F.A.S.T., the Froedtert & MCW Acute Stroke Team. This emergency response team responds to any acute stroke call 24 hours a day, 7 days a week. F.A.S.T. provides immediate and experienced neurological expertise to carefully assess the needs and therapeutic options for a stroke patient. Effective and safe treatment of stroke requires patients and healthcare providers to "Think FAST" to access immediate expert emergency medical attention. As growing public awareness prompts patients to "Call 911-Stroke is a medical emergency!", F.A.S.T. guarantees an appropriate hospital response unique in the area.

The most widely known stroke therapy and the only FDA drug approved for treatment of stroke, intravenous tPA (tissue plasminogen activator), can reverse a stroke if given to carefully selected patients within three hours of stroke onset. However, this clot-busting drug can be dangerous if inappropriately given. The F.A.S.T. staff have been successfully using tPA since 1996 and have been active in teaching other hospitals how to safely administer this drug.

Other new advances in stroke therapy are emerging including neuroprotective medications, aneurysm coiling, carotid artery stenting and intra-arterial thrombolytic therapy. As future new F.D.A. approved emergency stroke therapies emerge, F.A.S.T. is prepared to respond if patients and doctors "Think FAST."

F.A.S.T. is led by a team of stroke neurologists, neurointensivists, and interventional neurologists. Dr. Jeffrey Binder established the Stroke Program in 1995 after training at Columbia-Presbyterian Hospital. Medical director Dr. Diane Book joined the program in 1996 after a stroke fellowship here to take over the clinical arm. The Stroke & Neurovascular Program has greatly expanded in depth and breadth, with neurocritical care services provided by neurointensivist Dr. Ann Helms, and advanced interventional neurology served by Dr Brian-Fred Fitzsimmons and Dr. John Lynch. The Stroke faculty all cover F.A.S.T. to aggressively reach patients for clinical treatment and research with hyperacute stroke therapies including neuroprotectants, existing and emerging revascularization therapies, and stroke diagnosis and prevention strategies. Other critical members of F.A.S.T. are the stroke program nurse coordinator, stroke clinical trials nurse coordinator, and physicians from emergency medicine. The program has become a regional resource for both urgent inpatient referral and elective outpatient care of challenging neurovascular patients.

Comprehensive Assessment and Recovery Education clinic for Stroke (CARES)

The Comprehensive Assessment and Recovery Education clinic for Stroke (CARES) clinic is a multidisciplinary clinic comprised of Neurology, Neuropsychology, and Social work. The CARES clinic offers patients and their families a comprehensive two-hour visit where they meet a team consisting of a stroke neurologist (Dr. Cierny), neuropsychologist (Dr. Pillay), and social worker (LeeAnn Lathrop).

Patients after stroke commonly experience deficits in multiple domains: physical, cognitive, emotional, and interpersonal. While assessment by therapies in the hospital and rehab provide insight, the effect on the dynamics of interpersonal functioning after return to their living environment varies by patient and their social network and resources, which are difficult to predict in the inpatient or rehab setting. This clinic aims to comprehensively assess the patient - caregiver support unit, evaluate symptoms and needs, predict their recovery, discuss treatment for secondary prevention of stroke, and provide recommendation on roles the patient can expect to have after stroke such as the ability to return to work, capacity to drive, degree of independence in living situation, addressing impulsivity or agitation, depression and anxiety, changes in thinking, language or memory, or other questions patients or caregiver may raise.

The interdisciplinary team aims to provide a comprehensive visit for patients who have more complex or persisting psychosocial or cognitive issues after stroke. This appointment also provides education around recovery trajectories and recommendations for additional rehabilitation and other resources if appropriate. The patient’s families and caregivers are a part of the appointment and have an opportunity to meet independently with social work during the appointment if needed.

learn more about the Froedtert & MCW Stroke and Neurovascular Program