Mayo Clinic in Rochester, Minn., ranks No. 1 for neurology and neurosurgery in the U.S. News & World Report Best Hospitals rankings. Mayo Clinic in Phoenix/Scottsdale, Ariz., and Mayo Clinic in Jacksonville, Fla., are ranked among the Best Hospitals for neurology and neurosurgery by U.S. News & World Report. Mayo Clinic also ranks among the Best Children's Hospitals for neurology and neurosurgery.
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These documents have been provided to the American Heart Association by the below hospitals as examples of stroke best practices.  These documents are available only to give you an idea of how some hospitals might use discharge stroke best practices. By including this document on its Web site, the American Heart Association does not represent that these documents are complete, accurate or efficacious, or that it follows all of the American Heart Association guidelines for secondary and primary prevention of cardiovascular events or stroke. Hospitals should design their own stroke best practices based on their own procedures and professional experience.

Removing the clot with a stent retriever. Doctors may use a catheter to maneuver a device into the blocked blood vessel in your brain and trap and remove the clot. This procedure is particularly beneficial for people with large clots that can't be completely dissolved with tPA, though this procedure is often performed in combination with intravenous tPA.
Thank you for assisting our son get his life back under control. When he came out of the hospital I didn't know what to do with him. Your personal interest and that of all the staff and residents at Best Personal Care made him welcome and gave him structure and community he didn't have living on his own. Unlike other places our son has been, I have heard practically no complaints from him about the staff, the food or the other residents.
One relatively new service in the United States that can help keep older people in their homes longer is respite care.[18] This type of care allows caregivers the opportunity to go on vacation or a business trip and know that their family member has good quality temporary care, for without this help the elder might have to move permanently to an outside facility. Another unique type of care cropping in U.S. hospitals is called acute care of elder units, or ACE units, which provide "a homelike setting" within a medical center specifically for older adults.[19]
Thank you for assisting our son get his life back under control. When he came out of the hospital I didn't know what to do with him. Your personal interest and that of all the staff and residents at Best Personal Care made him welcome and gave him structure and community he didn't have living on his own. Unlike other places our son has been, I have heard practically no complaints from him about the staff, the food or the other residents.
The patient recovered from the stroke with limited damage resulting in a limp and nerve damage in one hand, but he is able to walk 2-3 miles several times a week. He attributes his successful outcome to having received tPA through access to the teleneurology system. He is thankful to the emergency physician, Dr. Gregory Driskell, for the critical care he received. 
To determine the most appropriate treatment for your stroke, your emergency team needs to evaluate the type of stroke you're having and the areas of your brain affected by the stroke. They also need to rule out other possible causes of your symptoms, such as a brain tumor or a drug reaction. Your doctor may use several tests to determine your risk of stroke, including:
You may have a transesophageal echocardiogram. In this test, your doctor inserts a flexible tube with a small device (transducer) attached into your throat and down into the tube that connects the back of your mouth to your stomach (esophagus). Because your esophagus is directly behind your heart, a transesophageal echocardiogram can create clear, detailed ultrasound images of your heart and any blood clots.
Posterior stroke: This type of stroke affects the back area of the brain, which includes the brain stem (controls breathing, blood pressure, and heart rhythm), the cerebellum (controls balance and coordination), and the occipital lobes (controls vision). Patients might experience any of the following ataxia, double vision, problems seeing to the left or right, or vertigo.
On both occasions I used their service, the caregivers either left minimal or no notes while visiting my elderly parents (no eating, sleeping or bathroom data). After the first visit, I contacted a supervisor at Around the Clock and asked specifically that the caregivers leave notes on eating, sleeping patterns, etc. Instead of improving, on the 2nd visit I only received notes from 1 of 3 caregivers...I paid for 16 hours of caregiving for people who may or may not have even showed up for all I know. Their medical staff is also hit and miss. On my father's post-hospital rehab, one of the 3 nurses missed appts at the house repeatedly...only making 1 of 5 scheduled appointments. After this, I contacted Around the Clock and asked them to send out a more reliable nurse. In the 5 weeks that have passed since, we have received 1 visit from a nurse...nobody makes their scheduled appointments. Is this the care you want for your elderly parents??
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