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Ask the Expert: Stroke warnings

 Vivek A. Gonugunta, M.D.
Vivekananda A. Gonugunta, M.D.
Endovascular Neurosurgeon
Sees patients at Marshfield Clinic Marshfield Center

​Question: If I’m having a stroke, how soon do I need to get treatment?​

In recent years, your only hope for stopping a stroke in its tracks was if you got to a properly equipped medical center within three hours of initial symptoms.

Recently, Marshfield Clinic introduced an “intra-arterial” approach that allows us to treat many stroke patients up to six hours after onset and in selected cases even up to 24 hours.

Most strokes are caused by a blockage in a blood vessel going to the brain, or by a rupture of an aneurysm, a bubble-like growth in a vessel.

The affected area is damaged and its functions are harmed or even lost.

About two million brain cells die each minute when such a blockage occurs, increasing the chances of severe neurological deficit like complete paralysis, coma or death.

With the intra-arterial approach, we route a microcatheter to the brain from the leg.

This device, as narrow as a few strands of hair, can pull a clot out of the blocked blood vessel in the brain to re-establish circulation.

Clot-busting medication can also be delivered directly into the clot via this microcatheter.

It’s a remarkable new treatment that can prevent the stroke from progressing and even potentially reverse the deficit in some patients.

Warning signs of a stroke include:

  • Weakness, tingling, or a loss of feeling on one side of your face or body.
  • Vision problems such as double vision or trouble seeing in one or both eyes.
  • Difficulty speaking, including slurred speech or problems understanding others.
  • A headache that is sudden and severe.
  • Movement problems such as dizziness, a spinning sensation, loss of balance, a feeling of falling, or blackouts.

If you have these potential stroke symptoms, don’t wait and don’t try to drive yourself. Call 911 immediately.


Marshfield Clinic's neurosciences​ experts provide care in a ​number of our centers. Your primary care doctor can refer you to the appropriate specialty and location.​​​