Time is Brain: Swift Stroke Care Saves Lives at Intermountain Health St. James Hospital in Butte, Montana

cheryl herrera

Once a stroke begins, every minute counts. 

Studies consistently show that up to 2 million brain cells die every minute during a stroke, which increases the risk of permanent brain damage, disability, or death. 

The effects of a stroke depend on several factors including which part of the brain is affected and how quickly the stroke is treated. This is why you’ll often hear healthcare professionals use the phrase, “Time is Brain.” 

Intermountain Health St. James Hospital in Butte, Montana, is a Joint Commission Acute Stroke Ready facility with a team of emergency providers and specialists who can help shorten the amount of time it takes to diagnose and treat a stroke. 

"Intermountain St. James Hospital continues to be on the front line of comprehensive diagnostic stroke care and capabilities in Montana,” said Kelly Brock, stroke program coordinator at Intermountain St. James Hospital. 

Intermountain St. James Hospital consistently meets and exceeds “door-to-needle” times for stroke thrombolytic therapy, also known as clot busting medication, which restores blood flow and reduces damage to vital organs like the brain and heart. 

The treatment itself must be administered within 4½ hours of stroke onset to give a patient the highest odds of achieving a good outcome. 

Most strokes are caused by treatable risk factors and are therefore preventable. 

The treatment for stroke is most effective when patients quickly identify their symptoms and seek treatment. 

This was the case for Cheryl Herrera of Butte, when she experienced a stroke in February. Herrera was cooking dinner at her home when she suddenly lost strength in her right arm and had trouble speaking.  

“I realized I couldn’t speak. I kept trying to tell my husband something was wrong,” Herrera shared. “He called 911, and they were here in just a few minutes.” 

At Intermountain St. James Hospital, a neurologist evaluated Herrera via telemedicine and directed the team to treat her with the clot-busting medication. 

After receiving the medication, her speech and weakness symptoms resolved. She was admitted to the ICU for monitoring and later discharged home independently. Herrera and her husband’s quick recognition of stroke symptoms and calling 911 immediately to get her to the hospital were crucial in her recovery. 

Just a few months later, Herrera is back to normal and working with her primary care provider to manage lifestyle factors that could help prevent another stroke from happening. Reflecting on her experience, she was surprised how suddenly the symptoms came on.  

“There was absolutely no warning. There was nothing different during that day,” she said. “It just happened." 

In 2024, 116 people presented to Intermountain St. James with stroke-like symptoms, but unfortunately, nearly half of those patients were outside of the window to receive clot-busting treatment or be eligible to be transferred for thrombectomy or clot removal, which must occur in within 24 hours of symptom onset. 

Quick medical treatment during a stroke is one of the most important factors in determining a good outcome. If a stroke does occur, the treatments available to prevent long-term brain injury, but they are very time sensitive.  

Tegan Ake, MD, a neurologist with Intermountain Health, explained that a simple way to remember the signs of stroke is: BE FAST.  

• Balance: Sudden difficulty with balance or coordination 
• Eyes: Sudden blurred or double vision, or loss of vision in one or both eyes without pain 
• Face: Drooping or numbness on one side of the face. 
• Arm Weakness: Sudden weakness or numbness in one arm or leg. 
• Speech: Sudden difficulty, slurring, or inability to speak, or changes in swallow 
• Time: Know when the last time you or your loved one had normal symptoms. Call 911. The right treatment depends on what kind of stroke you are having. You need to get to the hospital very quickly to figure this out.  

Several risk factors contribute to the likelihood of experiencing a stroke. Some of these factors, such as age, gender, and family history, cannot be changed. However, many others are modifiable through lifestyle changes and medical interventions. 

“Modifiable risk factors include high blood pressure, high cholesterol, diabetes, obesity and physical inactivity, smoking, and a diet high in fat and sodium,” said Dr. Ake. “By identifying and addressing your risk factors, you can significantly reduce your stroke risk.” 

 Take a quiz to find out if you’re at a higher risk for stroke: https://connect.intermountainhealth.org/stroke-month