Certified Primary Stroke Center in Richmond

Advanced Primary Stroke Center


Parham Doctors' Hospital is a Joint Commission-Certified Primary Stroke Center. Our facility offers expert, fast care for stroke patients, meaning access to care is close by at any time of the day or night. According to the National Stroke Association, stroke is the fifth leading cause of death in America and the leading cause of adult disability.

If you suspect you or a love one is experiencing a stroke, don't wait. Call 911 immediately.

What is a stroke?

A stroke is an emergent medical condition that occurs when blood flow to an area of the brain is cut off. This causes brain cells to be deprived of oxygen, and they begin to die as a result. A stroke can result in permanent loss of speech, movement and memory. There are two 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 an intracerebral hemorrhagic stroke can be caused by an arteriovenous malformation (AVM). AVM is a genetic condition of abnormal connections 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 hemorrhagic stroke 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 (Afib). 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 is the most common form of thrombotic stroke, and it 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 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.

Signs of a stroke

If any of the below symptoms appear suddenly, seek emergency care immediately.

  • Numbness or weakness of 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

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

  • F(ace)—Ask the person to smile. Does one side of the face droop?
  • A(rms)—Ask the person to raise both arms. Does one arm drift downward?
  • S(peech)—As the person to repeat a simple phrase. Is their speech slurred or strange?
  • T(ime)—If you observe any of these signs, call 911 immediately.

Stroke care with telemedicine

Telemedicine is an innovative tool that increases the quality and convenience of healthcare services at Parham Doctors' Hospital. Telemedicine allows doctors to provide more convenient, real-time interactions with patients to improve communications with other medical staff.

Our expert doctors use on-site examinations and telemedicine technology to quickly contact a neurologist at our nearby, sister facility Henrico Doctors' Hospital who can evaluate patients through a camera and microphone. Additionally, patients are able to see and interact with the neurologist and view scans and reports of their tests, which can also be shared with a specialist.

The most important decision in stroke telemedicine is tissue plasminogen activator (tPA) administration for acute stroke patients. tPA is a clot-busting drug for blockages int the arteries of the brain. The sooner tPA is given after stroke onset, the more brain tissue can be preserved. This is extremely important during a stroke, as two million brain cells die every minute a patient does not receive treatment for a stroke.

Telemedicine leads to faster administration of tPA, which can lead to improved outcomes in as little as six months. It is more convenient for patients, as they can receive specialized care faster, no matter what time of the day or night. Neurologists at Parham Doctors' Hospital use this technology to provide continued care for stroke patients throughout their hospital stay.

Stroke rehabilitation

The Inpatient Physical Rehabilitation Center at Parham Doctors’ Hospital has long been recognized as a community leader in neurological rehabilitation of patients recovering from stroke and other neurological conditions. Our robust program offers unique therapies with a team solely dedicated to yours or your loved one's recovery.

If you believe that you or someone you know may benefit from the stroke rehabilitation services at Parham Doctors' Hospital, please call Rehabilitation Admissions at (804) 545-4908.

Stroke support group

The Stroke Survivor Group at Parham Doctor’s Hospital is comprised of stroke survivors, both inpatient and outpatient, and their families and caregivers. The group meets monthly to exchange information about recovery and resources.

Meetings also feature speakers from a variety of sources including authors, therapists and social connections. The group meets the last Thursday of each month with the exception of November and December. The goal of the group is to provide stroke education and information exchange.

Meetings are 3:30 p.m. to 4:30 p.m. at Parham Doctors Hospital 7700 E. Parham Rd. Richmond, fourth floor, Multipurpose Room.

If you are interested in being notified of future meetings, please email Dr. Barb Silverberg at barb.silverberg@hcahealthcare.com or call at (804) 747-5783.

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