The medical community is working hard to get the message out to the public about recognizing the signs of stroke and getting timely treatment to limit damage. But what exactly are emergency stroke treatments? The appropriate treatment will depend on the type and severity of the stroke.
There are two types of strokes: ischemic, in which a blood clot blocks the flow of blood to the brain, and hemorrhagic, in which there is bleeding in or around the brain. In either case, the brain cells are being deprived of oxygen because oxygen is carried by blood, and within four minutes of a stroke, brain cells begin to die. After this point, it is estimated that two million brain cells die every two minutes.
Clearly, time is of the essence. The type of stroke must be determined quickly because different protocols are necessary for each type of stroke. A brain scan aids in the accurate identification of the type of stroke in order to administer the appropriate treatment.
Ischemic stroke causes and treatment
Ischemic strokes are caused by fatty deposits and cholesterol plaque that build up in the blood vessels. This may narrow the blood vessels, creating blood clots and potentially blocking the artery.
Ischemic strokes can be caused by a blood clot that forms in the brain (thrombotic stroke) or that breaks free from another part of the body and travels to the brain (embolic stroke). It can also occur from a clot in another part of the body that causes an interruption of the blood supply to the brain.
Risk factors for ischemic stroke include high blood pressure, diabetes, high cholesterol, obesity, a sedentary lifestyle, smoking, and an unhealthful diet.
Administering the right medications within four hours from the beginning of the stroke will increase the likelihood of effectiveness. Some of the medications that may be used include:
- Clot-busting medication such as alteplase, which dissolves blood clots
- Antiplatelets and anticoagulants, which reduce the risk of additional clots forming
- Blood pressure medications
- Statins to reduce blood cholesterol levels
Surgery is an option, as well, depending on the type of ischemic stroke. A thrombectomy removes blood clots in the brain by inserting a catheter into an artery and removing the clot. A carotid endarterectomy may be necessary if the carotid artery is severely blocked in order to open the artery and remove fatty deposit buildup.
Hemorrhagic stroke causes and treatment
Hemorrhagic strokes are caused by bleeding in the brain from a burst blood vessel or weakened brain tissue that begins to bleed. About 13% of strokes are hemorrhagic strokes.
Risk factors for hemorrhagic stroke include the same factors for ischemic stroke, but there are a number of others, as well: high stress or anxiety, family history, bleeding disorder, high alcohol consumption, recreational drugs, head injury, and a recent severe ischemic stroke, which could weaken the brain tissue.
Quick action is even more critical with a hemorrhagic stroke than with an ischemic stroke. Various forms of imaging are available to get a clear diagnosis; then often some form of surgery is necessary. Common treatment options include:
- Drugs to lower blood pressure in order to lessen pressure in the brain; medication to reverse the effects of anticoagulants and blood thinners the patient may have been taking
- Surgery to repair blood vessels or control the bleeding of an aneurysm, such as with surgical clipping or coiling
- A craniotomy to release pressure from swelling on the brain from the bleeding, opening a small part of the skull; this may also allow the surgeon to make repairs or drain fluids
- Treatment of hydrocephalus (cerebrospinal fluid buildup) by implanting a shunt in the brain to allow fluid to drain
Get help immediately
If you or a loved one has any signs of a stroke, call 911 immediately. The ambulance service can administer medical protocols right away, begin evaluating the stroke patient, and communicate this information to the hospital so a stroke team is ready.
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