Stroke Treatment
Stroke treatment may
vary depending on whether the stroke is caused by a blood clot (ischemic
stroke) or a brain bleed (hemorrhagic stroke). It involves drugs, surgery, or
other therapies. Treatments for stroke will give to the patient as quickly as
possible to reduce the risk of permanent brain damage.
Treatment
for Ischemic Stroke
Ischemic strokes happen
when a blood clot in an artery blocks the flow of blood and oxygen to a portion
of the brain. With this type of stroke, the goal is to restore blood flow to
the brain as quickly as possible.
A number of medications
may be given at the hospital to help break up the clot and prevent the
formation of new clots.
These medications may
include:
Tissue plasminogen
activator (tPA, alteplase): Alteplase or tPA is a thrombolytic medication,
often referred to as a clot buster. These drugs must be started within a few
hours after stroke symptoms first appear. They will quickly break up or
dissolve blood clots that are blocking blood flow to the brain. This type of
medicine is given through a catheter or IV tube in the arm.
Aspirin: Aspirin won't
dissolve existing blood clots, but it will help to prevent new clots from
forming. Doctors may give aspirin within 48 hours of the start of stroke
symptoms.
Anticoagulants:
Anticoagulants, such as heparin, may be used to help prevent more blood clots
from forming.
Treatment
for Hemorrhagic Stroke
Hemorrhagic strokes
happen when blood vessels in or around the brain rupture or leak. This puts too
much pressure on the surrounding brain tissue, cutting off circulation and
starving the brain of oxygen.
Treatment for
hemorrhagic stroke will depend on the cause of the bleeding and what part of
the brain is affected.
Bleeding around the
brain is often caused by abnormally formed blood vessels, called aneurysms.
Bleeding in the brain
is often caused by high blood pressure.
Non-surgical treatments
for hemorrhagic stroke may include:
Controlling blood
pressure
Stopping any
medications that could increase bleeding (e.g., warfarin, aspirin)
Blood transfusions with
blood clotting factors to stop ongoing bleeding
Measuring pressure
within the brain using a device called a ventriculostomy tube that's inserted
in the skull
Surgical treatments for
hemorrhagic stroke may include:
Endovascular treatment:
A long tube is slid into a blood vessel in an arm or leg, and passed all the way up to the blood vessels
in the brain, where a coil or clip is placed to prevent further bleeding.
Revascularization
refers to procedures that restore blood flow through a blocked artery.
Aneurysm treatment:
This may involve removing a small piece of the skull to locate the aneurysm and
put a small clamp around it to stop the bleeding.
An aneurysm may also be
treated by placing a small tube or catheter into a blood vessel in the groin.
The catheter is then guided through the blood vessel to the location of the
aneurysm. A small coil may be placed within the aneurysm to block blood flow
and prevent it from rupturing again.
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