Comprehensive Stroke & Cerebrovascular Centre

The Comprehensive Stroke & Cerebrovascular Centre at SilverOak Health is a Joint Commission-designated comprehensive stroke centre, delivering hyper-acute stroke intervention, acute stroke unit care, and secondary stroke prevention within a fully integrated, multidisciplinary programme. Our vascular neurologists, interventional neuroradiologists, stroke nurses, and rehabilitation therapists work together in a model proven to reduce stroke-related mortality and disability by 20–30% compared to general medical ward care.

Hyper-acute management begins with rapid clinical assessment and CT/CT angiography within 15 minutes of arrival. Intravenous thrombolysis with alteplase is administered within 30 minutes for eligible patients, and mechanical thrombectomy for large vessel occlusion is initiated within 60 minutes of arrival — door-to-reperfusion times consistently among the best in the region. Our interventional team achieves successful recanalization in over 85% of thrombectomy procedures using modern aspiration catheters and stent retrievers, maximising neurological recovery.

Stroke rehabilitation commences within 24 hours of admission and is delivered using a goal-oriented, high-intensity model with a minimum of 45 minutes each of physiotherapy, occupational therapy, and speech therapy daily. Early supported discharge with community stroke team follow-up enables continuation of intensive rehabilitation at home. Our post-stroke prevention clinic addresses atrial fibrillation, hypertension, diabetes, dyslipidaemia, and carotid stenosis with interventions that reduce recurrent stroke risk by more than 50%.

Cerebrovascular surgery at our centre — performed by specialist neurovascular surgeons — addresses intracranial aneurysms by microsurgical clipping, arteriovenous malformation resection, cavernoma surgery, and extracranial-intracranial bypass for complex occlusive disease. Endovascular coiling, flow diversion, and intracranial angioplasty and stenting are performed by our interventional neuroradiology team for lesions better suited to catheter-based approaches. Every cerebrovascular case is reviewed in our weekly neurovascular MDT.

Carotid endarterectomy for symptomatic and asymptomatic significant carotid stenosis, carotid artery stenting as an alternative for high-risk surgical patients, and management of cerebral venous sinus thrombosis complete our cerebrovascular service. Our outcomes data — including 90-day modified Rankin scale scores, symptomatic intracranial haemorrhage rates, and door-to-needle and door-to-groin times — are submitted to national stroke audit programmes, enabling transparent benchmarking and continuous quality improvement.