Stroke treatment, intervention, and recovery
4-minute read
You might have heard the saying "time is brain," and it
rings true in the case of stroke. Getting the proper stroke treatment as soon
as possible makes a difference in recovery and quality of life.
There are two main types of strokes: ischemic and
hemorrhagic. An ischemic stroke occurs when blood flow to the brain is blocked,
and a hemorrhagic stroke is sudden bleeding in the brain. During an ischemic
stroke, oxygen and nutrients can't reach the brain, and brain cells begin to
die off within minutes of an ischemic stroke's onset. During a hemorrhagic
stroke, the leaked blood puts pressure on the brain cells, causing damage. Just
fewer than 90% of strokes are ischemic, and the rest are hemorrhagic.
Know the Signs
An easy way to remember how to spot a stroke is with the acronym
F.A.S.T., from the American Stroke
Association:
F = Face. Ask
the person to smile so you can see if one side of the face droops. The smile
shouldn't be uneven.
A = Arm. When the person raises both their arms, are
they able to hold both up or does one drift down?
S = Speech. Ask
the person to repeat a sentence. Can they remember the words and repeat the
sentence clearly?
T = Time. A
stroke is a medical emergency, so call 911 to have the person taken to the
nearest hospital. Alert the medical team about the time symptoms started,
because some treatment options must begin within a few hours of onset.
Stroke Treatment
Because brain cells die every minute a stroke goes
untreated, it's critical to have a stroke diagnosed and treated as soon as
possible. Treatment begins in the ambulance, where emergency medical
professionals take your vital signs and alert the hospital's team a patient
with a life-threatening stroke is on the way. In many cases, the ambulance will
take you to a hospital with Primary
Stroke Center certification, such as Reid Health.
Once you arrive, the stroke team might take you immediately
to an imaging suite, where a brain scan will show what kind of stroke you
had. A vascular surgeon, a neurologist, or a neurosurgeon will likely make
a treatment plan.
Medications
If you experience an ischemic stroke, you might receive a medication
called a tissue plasminogen activator (tPA) that breaks up blood clots during an
ischemic stroke. tPA must be administered within 3 to 4.5 hours of when stroke
symptoms first appeared. Patients who aren't eligible for tPA might receive
blood-thinning medications.
If you have had a hemorrhagic stroke, you might need blood
pressure medications to reduce pressure on the brain's blood vessels.
Medical procedures
In some cases, you might need a surgery or minimally
invasive endovascular procedure to restore blood flow to the brain during an
ischemic stroke.
During a thrombectomy, a vascular surgeon uses a thin,
flexible tube called a catheter to remove the clot causing the stroke. The
catheter is inserted into an artery in your upper thigh and maneuvered to the
site of the blockage. A balloon on the end of the catheter expands to push the
clot to the side (angioplasty) and a thin mesh tube called a stent might be
placed to provide support to the artery.
In some cases, the vascular surgeon will use a stent
retriever — a wire mesh device within the catheter — to trap the clot, and
the clot and the stent retriever are all removed through the catheter. All
these procedures help restore blood flow within the brain.
To treat a hemorrhagic stroke, you might receive:
- Aneurysm clipping. This procedure uses a tiny clamp to stop the bleeding and prevent it from occurring again.
- Coil embolization. During this catheter-based procedure, the vascular surgeon inserts a tiny coil into the site of the bleeding to cause the blood to clot.
You might also have surgery to drain off excess fluid or
blood to reduce pressure, and the surgeon might remove part of the skull to
allow the brain tissue to swell without allowing additional pressure to build.
Preventing stroke
Finding the underlying cause of the stroke and treating it
helps to prevent a repeat. Heart
disease, high blood pressure, high cholesterol, diabetes, and atrial
fibrillation (AFib) are all risk factors for strokes that can be treated with
diet, lifestyle changes, and medication.
AFib increases your chances of stroke fivefold. If you have AFib, you ,might be a candidate for an implant called the WATCHMAN that helps control AFib without medication. Another preventive procedure is a carotid endarterectomy, which removes plaque from the carotid artery to thwart a stroke.
Make an appointment
with the Reid Health vascular team to learn more about your risk for stroke and
how to prevent it.