When a stroke attack occurs, the brain tissues begin to die due to a lack of oxygen, and sooner the medical intervention is provided, the more brain tissues can be saved. As an immediate course of action, some Doctors recommend giving an Aspirin to the patient as soon as possible, as Aspirin helps prevent further strokes by reducing blood clots. However, an Aspirin can be dangerous if the patient has had a prior episode of a stroke where the blood vessel had burst, also known as the hemorrhagic stroke.
Once at a hospital, the priority for the Doctors will be to restore blood flow to the brain, and the medical intervention is typically provided in the form of an intravenous drug known as TPA (Tissue Plasminogen Activator), also called alteplase, which breaks down the ischemia causing blood clots. That said, TPA has its limitation and is not always the best course of treatment. For one thing, it can cause bleeding in the brain; for another, it must be administered within 3 hours of the stroke, and that too in the presence of experienced doctors and specialist services. Also, the drug is effective only on the strokes that are caused by a blood clot (Ischemic strokes), and is not suitable for everyone, given certain risks, such as potential bleeding in the brain.
Doctors may sometimes also need to deliver medication directly to the brain. In order to do so, they will insert a long, thin tube (catheter) through an artery in the groin area, and posh it up to the brain to deliver the TPA into the affected region of the brain. This method, scientifically called Intra-arterial Thrombolysis, provides slightly longer, but essentially limited, window to deliver the TPA, as compared to the intravenous delivery of TPA. Doctors may also use a similar catheter to physically break up or grab and remove the clot by inserting a small device into the brain. This procedure is called Mechanical Thrombectomy.
In addition, in order to decrease the risk of having another stroke or a Transient Ischemic Attack, Doctors may also recommend opening up an artery that has been narrowed by fatty deposits. This is typically achieved by a procedure known as Carotid Endarterectomy, in which plaque is removed from the carotid arteries (the arteries running along each side of the neck to the brain) by making an incision along the front of the neck, opening the carotid artery, and removing the plaques. If the fatty deposit is too much to be removed, the Doctor may make a patch from a vein or artificial graft. If the patient has a heart disease or other medical conditions that make Carotid Endarterectomy too risky, the Doctor may opt for an Angioplasty, in which a balloon is inserted to expand the narrowed artery, and then a stent is inserted to keep the artery opened enough to restore blood flow.
In case of a Hemorrhagic stroke, the immediate concern for the Doctor would be to control the bleeding and reduce the intracranial pressure. This might involve blood transfusion, lowering the blood pressure, and preventing vasospasm and seizures. Once the bleeding has stopped, typically a supportive medical care is provided to the patient while the body absorbs the blood, but in some cases, a surgery might be needed to remove the blood. Surgery may also be needed if there are blood vessel abnormalities that may lead to a hemorrhagic stroke, or if there is a risk of an aneurysm or arteriovenous malformation (AVM) or another type of vascular malformation caused your hemorrhagic stroke.
Another treatment option available for Hemorrhagic stroke is called Endovascular Embolization, or Coiling, in which a catheter is inserted into the brain to guide tiny detachable coils into an aneurysm to block the flow of more blood and cause the blood to clot. The Doctor may also choose to perform intracranial Bypass or a Stereotactic Radiosurgery, which involves using beams of focused radiation to repair vascular malformations.
However, for any of the above-mentioned treatment options to be successful, it is important that the patient is given the medical intervention within 3 to 4 hours of suffering the stroke. To that end, the importance of performing the B.E.F.A.S.T. test (Balance loss; Eye-sight impairment; Face drooping; Arm weakness; Speech difficulty; Time to act) on a person who is showing the symptoms mentioned above, cannot be emphasized enough. If a loved one is high on the risk factors or has failed the B.E.F.A.S.T. test, contact us at 8008104199 immediately to properly diagnose the issue and evaluate treatment options available to you!