SAN ANTONIO – Hospitals in San Antonio are adjusting protocols as new statistics indicate that stroke deaths continue to rise among young patients.
“Both of my grandmothers had a stroke. One had an ischemic stroke. Then one had two hemorrhagic strokes, and she did fully recover, but it was quite extensive,” said University Health and UT Health San Antonio Vascular Neurology Doctor Sujani Bandela.
Bandela grew up hearing about her grandmother’s recoveries from her father.
“That was one of the reasons why I went into neurology to pursue stroke,” Bandela said.
Now, she is the co-medical director at University Hospital’s Comprehensive Stroke Center. It’s one of the most robust in the state and the main hospital for pediatric stroke in South Texas.
Bandela’s team is reacting quickly to the latest numbers from the American Heart Association and American Stroke Association.
The 2026 report showed stroke death numbers are down overall. Stroke was the underlying cause of death for 162,639 Americans in 2023, down from 165,393 in 2022.
However, there were sharp rises reported in younger people, including pediatrics, pregnancy and postpartum, and generally people under 50 years old.
“Cancer has gone up in the younger patient population, and that is the reason for developing clots and holes in the heart,” Bandela said, in part. “Substance abuse like methamphetamine and cocaine can play a role in major strokes too, and can cause high blood pressure that leads to strokes and brain hemorrhages.”
She said hypertension and pre-eclampsia are more common now during pregnancies, which increases the risk of a stroke.
The good news is that the American Stroke Association and the American Heart Association just released new guidelines on how to handle pediatric and pregnancy-related strokes.
“Which I was very excited about, because we so far did not have clear guidelines on what to do on pediatric stroke,” Bandela said. “They did say that it’s safe to do everything, and we should because we should be aggressive. We’re working with our OB-GYN and maternal fetal medicine on updating the protocols on this as well.”
What has not changed is the fact that every second counts during strokes, and getting to the right hospital could save a life.
“Coming to a comprehensive stroke center is unique because we always have somebody 24/7, an on-call stroke neurologist, an on-call endovascular neurosurgeon, and nurses,” Bandela said. “We see high volumes, and we have all the equipment and medications, the IV clot-busting medication. Not every hospital has the suites to do the thrombectomies, the procedures to remove clots. And those are the potentially life-threatening ones.”
Comprehensive Stroke Centers are the highest level of stroke care: Level One. There are only three in San Antonio, all three in the medical center, including University Hospital, Methodist Hospital and St. Luke’s Baptist Hospital.
The Southwest Texas Regional Advisory Council (STRAC) website has a stroke resource page that lists the status of many San Antonio hospitals.
Comprehensive care is provided by an advanced stroke center (Level 2), and the only San Antonio center listed at that level is Northeast Baptist Hospital.
The next level down is the primary stroke center (Level 3), and STRAC lists at least nine of those hospitals in San Antonio.
Then, there are a few centers labeled acute stroke ready, the lowest level of care.
Bandela said the most important thing is to know ahead of time what symptoms to look for that may signal a stroke.
The popularly used acronym is “BE FAST”:
- B: balance loss
- E: eyesight changes
- F: face drooping
- A: arm weakness
- S: speech difficulty
- T: time to call 911 immediately
To prevent stroke altogether, the American Heart Association recommends avoiding smoking, controlling blood pressure, controlling diabetes, limiting alcohol consumption, going to the doctor, exercising and eating less processed food by maintaining a healthy diet like the Mediterranean diet.