Stroke Treatment

Time Is Brain: Understanding Stroke Emergency Care

Every minute counts when treating a stroke. For every minute a large vessel stroke goes untreated, approximately 1.9 million neurons are lost. This is why Santa Barbara Cottage Hospital's designation as a Comprehensive Stroke Center—the highest level of stroke care certification—is so critical for our community.

Having treated over 500 life-threatening ischemic strokes throughout my career, I understand the urgency and precision required in these situations. My training and experience allow me to provide rapid, expert intervention when it matters most.

Recognizing Stroke: BE FAST

Know the warning signs and act immediately:

• Balance – Sudden loss of balance or coordination
• Eyes – Sudden vision changes in one or both eyes
• Face – Facial drooping, especially on one side
• Arms – Arm weakness or numbness
• Speech – Slurred or difficult speech
• Time – Call 911 immediately

Mechanical Thrombectomy: Removing the Clot

Mechanical thrombectomy is a minimally invasive, image-guided procedure that physically removes blood clots from blocked brain arteries. This procedure has revolutionized stroke care and can dramatically improve outcomes when performed quickly.

How the Procedure Works

During mechanical thrombectomy, I guide a small catheter through an artery (typically in the leg or wrist) up to the blocked vessel in the brain. Using specialized devices, I can then capture and remove the clot, restoring blood flow to the affected brain tissue.

The procedure is performed under X-ray guidance in the angiography suite, allowing real-time visualization of the blood vessels and clot. Most patients are under general anesthesia for comfort and to ensure they remain still during this precise procedure.

Who Is a Candidate?

Mechanical thrombectomy is most effective for strokes caused by large vessel occlusions—blockages in the major arteries supplying the brain. Not all strokes are candidates for this procedure. The decision depends on:

• Location and size of the clot
• Time since symptom onset
• Amount of brain tissue that can still be saved
• Patient's overall health status

Comprehensive Stroke Center Care

Santa Barbara Cottage Hospital is the region's only Comprehensive Stroke Center, meaning we have:

• 24/7 availability of specialized stroke teams
• Advanced neuroimaging capabilities
• Dedicated neurocritical care unit
• Full range of medical and surgical treatments
• Rehabilitation services and ongoing care coordination

This designation reflects our commitment to providing the highest level of stroke care and ensures that patients have access to all treatment options, including mechanical thrombectomy.

Beyond Emergency Care: Stroke Prevention

While emergency stroke treatment is critical, preventing strokes in the first place is ideal. I also provide treatment for conditions that increase stroke risk:

• Carotid Stenosis: Narrowing of the carotid arteries in the neck
• Intracranial Stenosis: Narrowing of arteries within the brain
• Moyamoya Disease: Progressive narrowing requiring bypass surgery
• Atrial Fibrillation Management: Working with cardiologists to reduce clot formation

Why Choose Dr. Walcott for Stroke Care?

• Extensive Experience: Over 500 ischemic strokes treated
• Specialized Training: Fellowship-trained in endovascular neurosurgery at USC
• Comprehensive Stroke Center: Practice at Santa Barbara's highest-level stroke facility
• Full-Spectrum Care: Trained in both emergency intervention and preventive procedures
• Research Leadership: Actively involved in stroke treatment research and clinical trials