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Mary Washington Hospital Primary Stroke Center

Certified as a Primary Stroke Center by the Joint Commission since 2009, Mary Washington Hospital provides stroke patients with the highest level of treatment and services according to national standards. We are dedicated to maintaining this quality stroke care with education and prevention programs and continuum of care from hospitalization through rehabilitation. You will be evaluated, treated and recover under the care of an interdisciplinary team of healthcare professionals trained to ensure that each stroke patient receives the highest level of care.

A Primary Stroke Center earns accreditation through intensive evaluations. Staff at a Primary Stroke Center continuously improve their efficiency and effectiveness in treating strokes from the initial emergency treatment through to recovery and rehabilitation.

The Certificate of Distinction for Primary Stroke Centers is awarded by the Joint Commission, an independent non-profit organization that accredits and certifies healthcare organizations and programs, to recognize centers that follow the best practices for stroke care. Programs applying for advanced certification must meet the requirements for Disease-Specific Care Certification plus additional, clinically specific requirements and expectations.

Certified Primary Stroke Centers:

  • Use a standardized method of delivering care based on the Brain Attack Coalition’s “Recommendations for Establishment of Primary Stroke Centers”
  • Support patient self-management activities
  • Tailor treatment and intervention to individual needs
  • Promote the flow of patient information across settings and providers, while protecting patient rights, security and privacy
  • Analyze and use standardized performance measure data to continually improve treatment plans
  • Demonstrate their application of and compliance with clinical practice guidelines published by the AHA/ASA or equivalent evidence-based guidelines

Source: Joint Commission

At Mary Washington Hospital, we’re committed to providing stroke care that aligns with the latest research-based treatment guidelines. Studies show patients can recover better when these guidelines are consistently followed.

Watch more videos about stroke:

What causes stroke?
Identifying signs and symptoms of stroke
What if I suspect someone is having a stroke?
What are the risk factors for stroke?
Mary Washington Hospital Primary Stroke Center

Stroke Facts

What is a stroke?

Stroke is a leading cause of disability in adults and the fourth leading cause of death. Eighty percent of strokes are preventable by managing risk factors. When a stroke occurs, quick recognition and treatment can give you or a loved one the best chance of a full recovery.

Also known as a cerebrovascular accident (CVA), stroke occurs when a blood clot blocks an artery that supplies blood flow to the brain or when a blood vessel breaks interrupting the flow of blood to an area of the brain.

Strokes are classified as ischemic, the most common, or hemorrhagic.

Ischemic stroke

About 87 percent of strokes are ischemic strokes. They are caused by blockage of an artery that impairs blood flow to part of the brain causing cells and tissues to die from lack of oxygen. The blockage can come from a blood clot in the blood vessels inside the brain (thrombotic stroke) or from a blood clot or plaque debris that develops elsewhere in the body and travels to one of the blood vessels in the brain (embolic stroke).

Hemorrhagic stroke

About 13 percent of strokes are caused when a blood vessel that supplies the brain ruptures and bleeds. This hemorrhagic stroke builds up pressure in surrounding tissues causing irritation and swelling.

When the bleeding is from blood vessels within the brain it is called an intracerebral hemorrhage. This is usually caused by high blood pressure and the bleeding occurs suddenly and often results in coma or death. When the bleeding is in the space between the brain and the membranes that cover the brain it is called a subarachnoid hemorrhage. This type of hemorrhage often results from bleeding due to an aneurysm or an arteriovenous malformation (AVM) (a disorder present at birth).

Stroke Symptoms and What to Do

You can save a loved one from death or disability by learning to recognize the symptoms of stroke."BEFAST” and call 9-1-1 immediately at any sign of a stroke.

Balance - see if the person is not walking straight or walking wobbly

Eyes - ask if the person has blurry vision or is experiencing double vision.

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 9-1-1 immediately!

Note the time that symptoms first appear. If given within three hours of the first symptoms, an FDA-approved clot-busting drug may reduce long-term disability for the most common form of stroke.

Common symptoms of stroke in men and women

  • SUDDEN numbness or weakness of face, arm or leg-especially on one side of the body
  • SUDDEN confusion, trouble speaking or understanding
  • SUDDEN trouble seeing in one or both eyes
  • SUDDEN trouble walking, dizziness, loss of balance or coordination
  • SUDDEN severe headache with no known cause

If you experience any of these symptoms call 9-1-1 immediately. Note the time, it may be important in determining treatment.

Stroke treatment

A stroke requires emergency medical treatment! The specific treatment for stroke depends on the type of stroke and the duration of your symptoms. Your age, overall medical status and tolerance for various treatments is also considered. Your caregiver will rapidly assess you and begin appropriate treatment. A combination of medications and surgical treatments may be used. The goals of treatment include:

  • Eliminate clotting
  • Reduce or eliminate swelling in the brain
  • Protect the brain from damage and lack of oxygen

Medications that may be used include:

Thrombolytics-Thrombolytic (fibrinolytic) drugs dissolve clots to restore blood flow to the brain. For greatest effectiveness, this treatment must be given as quickly as possible.

tPA-tPA is an enzyme that occurs naturally in the body. It converts or activates plasminogen into another enzyme to dissolve a blood clot. Your doctor might put it in an IV to speed up dissolving the clot. This treatment is typically only used within three hours of a stroke’s onset.

MERCI Retrieval System-This treatment is FDA approved for patients who are not eligible for IV-tPA or fail to respond to it. The system can be used for patients who present after the three-hour time window for IV-tPA. The innovative Merci Retriever, a tiny corkscrew device that wraps around the clot to trap it so it can be retrieved from the body, is proven to restore blood flow in the larger vessels of the brain by removing blood clots.

Penumbra System-This is another treatment option for patients up to eight hours after the onset of symptoms. The Penumbra Systems allows for safe revascularization of occluded (blocked) vessels after an ischemic stroke. It helps restore brain blood flow by using suction to “grab” blood clots in the brain.

Surgical treatment

In some cases, surgical treatment may be used to remove plaque and clots from the arteries to prevent stroke. A stent may also be placed in the carotid artery (in the neck). A craniotomy (brain surgery) may be performed to remove clots and repair bleeding in the brain. Other surgeries include repair of aneurysms and artery defects that could impact blood flow to the brain.

Preventing Stroke

Many people believe that stroke only occurs in the elderly and cannot be prevented. Both are myths! Stroke can occur at any age, and there are risk factors that you can control such as:

  • Control your blood pressure - Levels higher than 120/80 can put you at risk.
  • Maintain healthy cholesterol levels - An LDL of 100 or less is optimal and a total cholesterol of less than 200 is desirable.
  • Cease tobacco use - If you smoke, stop. Smoking nearly doubles your risk for stroke.
  • Maintain a healthy weight/diet - Choose a low salt, low fat diet with a balance of fruits, vegetables, whole grains, and proteins (lean meat, fish, eggs, beans, nuts, and low-fat milk).
  • Exercise-Aim for 30 minutes a day at least five days a week. Always check with your doctor before starting an exercise program.
  • Manage your diabetes - Manage diabetes closely to avoid complications that could result in a stroke.
  • Limit alcohol consumption - Excessive alcohol consumption can increase blood pressure so no more than two drinks per day!
  • Get treatment for atrial fibrillation - Tell your doctor if you experience heart palpitations. An irregular heartbeat, called atrial fibrillation (Afib), can lead to blood clot formation and increase your risk for stroke by nearly 500%!
  • Get treatment for TIA (Transient Ischemic Attacks) - TIA symptoms, “mini strokes” are just like a stroke but may come and go. Having a TIA can be a sign that something is wrong. Call your doctor immediately!

Source: National Stroke Association

Link to additional materials from the National Stroke Assocation.

Did you know?

  • Stroke is the third leading cause of death and a leading cause of disability in America.
  • About 795,000 Americans will suffer a stroke this year, yet most Americans cannot identify stroke symptoms or risk factors. Many strokes can be prevented through risk factor management.
  • Someone has a stroke every 40 seconds, on average.
  • Women are twice as likely to die from stroke than breast cancer annually.
  • There are many manageable risk factors for stroke, including: high blood pressure, weight control, alcohol consumption, smoking, diabetes, atrial fibrillation and transient ischemic attack (TIA).
  • It’s important to understand stroke symptoms and response. Time is a very urgent factor when it comes to stroke. Emergency treatment is available if a stroke is recognized fast and 9-1-1 is called. The faster a person having a stroke is taken to the hospital, the better chance of them receiving emergency treatment that can reduce or even reverse the symptoms of stroke.
  • Stroke will cost the United States an estimated $73.7 billion in 2010.
  • Stroke incidence rate in African Americans is almost double that of Caucasians.
  • Link to additional materials from the National Stroke Association.

Stroke Support Groups

Stroke Support Group

Mary Washington Healthcare’s Stroke Support Group has provided ongoing resource support for stroke survivors and their families or caregivers for over ten years. The Stroke Support Group meets on the first Monday of every month at:

John F. Fick, III Conference Center

1301 Sam Perry Boulevard
Fredericksburg, VA 22401

Click here for details

Aphasia Support Group

The Aphasia Support Group is for stroke survivors and people with brain injuries resulting in aphasia or apraxia. Family members, friends and caregivers who struggle to communicate with their loved ones are also invited.

Click here for details

For more information about either of our support groups, please contact Susan Halpin, RN, Stroke Coordinator, at 540.741.4815 or

Learn more about the stroke program at Mary Washington Healthcare and meet Jessica Boyce, a young stroke survivor who now volunteers as a stroke educator and is an active member of the stroke support group.

Stroke Survivor - Andrea McCauley

It wasn’t something that Andrea McCauley thought could happen to her. “I thought I did not have time to have a stroke. I was too busy to have a stroke. I have a full time job, I’m raising three children, I’m just too busy to have a stroke. A stroke happens to people who aren’t busy, people who are ill, people who are older. People who aren’t me.”

stroke specialistYet, in January 2012, Andrea had a massive stroke. She was swiftly transported to Mary Washington Hospital by ambulance. Andrea, a Stafford county prosecutor, had spent that morning at court and was about to go to an appointment when she collapsed. Her coworkers gathered around and immediately knew something was wrong. Andrea remembers a coworker, acting quickly saying, “We’re not going to ask her any more questions, we need an ambulance. Get an ambulance!”

Andrea was rushed by a Stafford County ambulance squad to the hospital. where many of her family and friends had gathered. She recalls, “As it was happening to me I can honestly say I had no idea what was going on. I never connected what was happening to me with the fact that I was having a stroke.”

Dr. Maha Alattar, a Mary Washington Healthcare neurologist, was ready and waiting for her when the ambulance arrived. Recognizing stroke symptoms, Dr. Alattar sent Andrea straight away to have a CAT scan. When the results came back, Andrea was administered tissue plasminogen activator (TPA), a drug that breaks up blood clots, a common cause of strokes.

Within thirty minutes, thanks to the rapid reactions of everyone involved and the Mary Washington Hospital Stroke Team, Andrea went from not being able to move at all on her right side or to speak, to being able to move her hands, feet, and legs. She bears no side effects from the stroke. Despite always living a healthy, active lifestyle, as a runner Andrea was and still is conscientious about what she eats, it was found that a congenital heart problem had triggered the stroke. In spite of her lifestyle, she experienced a stroke and, as is proved by her story, with strokes, immediate care is essential to improved recovery.

Andrea, has a special message for the Stroke Team and everyone at Mary Washington Hospital, “If it weren’t for you I would not be here. I would not be standing; I would not be speaking, if it were not for you. Thank you from the bottom of my heart.”

Watch Andrea's video here.

MWH Stroke Center Earns Prestigious Award

Mary Washington Hospital’s Primary Stroke Center Receives Get With The Guidelines-Stroke Gold Plus Quality Achievement Award

American Heart Association Award recognizes Mary Washington Hospital’s commitment to quality stroke care.

Mary Washington Hospital’s Primary Stroke Center has received the 2020 American Heart Association/American Stroke Association’s Get With The Guidelines®-Stroke Gold Plus Quality Achievement Award. The award recognizes the hospital’s commitment to ensuring stroke patients receive the most appropriate treatment according to nationally recognized, research-based guidelines based on the latest scientific evidence. MWH's award-winning Primary Stroke Center has over 10 years of experience and continues to improve its care for stroke patients in our community.

Mary Washington Hospital earned the award by meeting specific quality achievement measures for the diagnosis and treatment of stroke patients at a set level for a designated period. These measures include evaluation of the proper use of medications and other stroke treatments aligned with the most up-to-date, evidence-based guidelines with the goal of speeding recovery and reducing death and disability for stroke patients. Before discharge, patients also receive education on managing their health, get a follow-up visit scheduled, as well as other care transition interventions.

“We are dedicated to improving the quality of care for our stroke patients by implementing the American Heart Association’s Get with The Guidelines-Stroke initiative,” said Arun Chhabra, MD, Medical Director and Staff Neurologist, Mary Washington Hospital Primary Stroke Center. “The tools and resources provided help us track and measure our success in meeting evidenced-based clinical guidelines developed to improve patient outcomes.”

Mary Washington Hospital additionally received the Association’s Target: StrokeSM Honor Roll award. To qualify for this recognition, hospitals must meet quality measures developed to reduce the time between the patient’s arrival at the hospital and treatment with the clot-buster tissue plasminogen activator, or tPA, the only drug approved by the U.S. Food and Drug Administration to treat ischemic stroke.

Mary Washington Hospital has also met specific scientific guidelines as a Primary Stroke Center, featuring a comprehensive system for rapid diagnosis and treatment of stroke patients admitted to the emergency department.

“We are pleased to recognize Mary Washington Hospital for their commitment to stroke care,” said Lee H. Schwamm, M.D., national chairperson of the Quality Oversight Committee and Executive Vice Chair of Neurology, Director of Acute Stroke Services, Massachusetts General Hospital, Boston, Massachusetts. “Research has shown that hospitals adhering to clinical measures through the Get with The Guidelines quality improvement initiative can often see fewer readmissions and lower mortality rates.”

According to the American Heart Association/American Stroke Association, stroke is the No. 5 cause of death and a leading cause of adult disability in the United States. On average, someone in the U.S. suffers a stroke every 40 seconds and nearly 795,000 people suffer a new or recurrent stroke each year.

Community Education Opportunities

Community Education Opportunites

In addition to treating stroke patients within the hospital, the MWH Stroke team is dedicated to providing the communities we serve with valuable information on stroke education and prevention, including recognizing a stroke.

If you have a group or organization that’s interested in learning more about stroke, call Susan Halpin, RN, Stroke Coordinator, at 540.741.4815 or

To learn more about stroke, visit:

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