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Brain Stroke Treatment

Care24 Administrator Neuro

Brain Stroke Treatment

The treatment for stroke will depend entirely on the type of stroke a patient has suffered from. A stroke is a medical emergency and the patient should be taken to the nearby medical facility immediately. In many cases, treatment will also depend on how much time has lapsed between the time the patient suffered the stroke and the time the treatment actually begins.

Here are a few treatment options that the doctors may go for.

  1. Treatment For Ischemic Stroke Or Transient Ischemic AttackIt is the type of stroke that occurs when the artery that supplies blood to the brain is blocked. A blood clot is the most common reason for an ischemic or transient ischemic stroke.
  • MedicationIf the stroke is caused by a blood clot, your doctor will first give a medicine that will help to dissolve the clot. Your doctor could also give you some other medications that will help to bust the clot, or inject it in the vein of your arm. These medicines can only be given within 4 hours of the first symptoms of stroke. Another type of medicine that the doctors may use is anti-platelet medicines that will stop the platelets from clotting up, or anti-coagulant medicines (blood thinners), that will prevent the already present blood clots from getting any bigger.
  • Medical ProceduresA carotid artery disease is a condition in which the carotid arteries get blocked due to plaque build-up. In that case, your doctor could ask you to go for a carotid endarterectomy, which is a type of surgery that will open up or clean the artery to avoid stroke or reduce the impact. Your doctor may also suggest a carotid artery angioplasty, which is a type of small surgical procedure to reduce the blockage.
  • Intra-Arterial ThrombolysisIt is a procedure in which your doctor will insert a long and flexible tube known as a catheter in your upper thigh area. The doctors will then thread it to the tiny arteries that are present in your brain. Your doctor can use the catheter to dissolve the blood clots that have formed in your brain.
  • Mechanical Clot Removal In Cerebral Ischemia (MERCI)Your doctor can also use a device known as MERCI to remove the blood clots that have formed in your artery. For the procedure, the doctor will thread the catheter through a carotid artery to reach the areas in your brain that are affected. The blood clot will be pulled out through the catheter.
  1. Treatment For Hemorrhagic StrokeIt is the type of stroke that occurs when there is an artery rupture in the brain, or an artery starts leaking blood.
  • MedicationIf you are on any type of anti-coagulant medicines (blood thinners) or antiplatelet medicines, your doctor will first get you off those, as it could increase the bleeding. If you suffered the bleeding due to high blood pressure, your doctor will first put you on medication that will help to bring down the level of blood pressure to normal. This will help to stop any further bleeding.
  • Aneurysm ClippingIn case you suffered a stroke due to an aneurysm, which is a balloon type of bulge in your artery, aneurysm clipping will create a block between the aneurysm and the blood vessels in your brain. It will help to stop any more bleeding and also prevent the aneurysm from bursting.
  • Coil EmbolizationFor this procedure, the surgeon will insert the catheter in your groin area and thread it to where the aneurysm is. They will push a tiny coil through the catheter and create a blood clot, which will prevent the aneurysm from bursting again.
  • Arteriovenous Malformation RepairThis is a condition in which you have a host of damaged veins and arteries that can burst in your brain. If that happens, your doctor will suggest an AVM repair procedure.

Is It Safe To Use Activase For Treating A Brain Stroke?

Activase is a type of drug, a tissue plasminogen activator (tPA) that helps to break down any unwanted blood clots in the body.

It is usually used to treat blood clots that appear in the lungs, and also help to improve the functioning of the heart. Many doctors also prescribe Activase to patients who have recently suffered a heart attack.

According to the American Heart Association/American Stroke Association (AHA/ASA), Activase should be the standard care procedure for any patient who suffers an acute ischemic stroke (AIS). The guidelines recommend that the drug should be administered within 3 hours of the symptoms.

Here are some of the things that the guideline recommends for patients who suffer from AIS and who should be administered Activase:

  • Intravenous Activase is recommended for those patients who are being treated within 3 hours of an ischemic stroke onset. The dosage should be 0.9mg/kg, maximum dosage 90 mg.
  • Using Activase will only have the desired effect if it is used well within the stipulated time. In those patients who require it, the treatment with Activase should begin immediately. The door to needle time, or DTN, should ideally be within 60 minutes of the patient arriving at the hospital.
  • Once a patient is suspected of suffering from AIS, the medical team should do a range of diagnostic tests to assess the patient’s situation. These tests include non-contrast brain CT scan or brain magnetic resonance imaging (MRI), oxygen saturation and blood glucose.

Safety Alert: When Not To Administer Activase

As per the guidelines by AHA/ASA, in case the patient has any of the following issues, the doctor should NOT administer Activase for treating AIS:

  • If the risk of bleeding in the patient is higher than the actual benefit of administering the drug
  • If the patient is suffering from a current intracranial haemorrhage (ICH)
  • If the patient is suffering from a subarachnoid haemorrhage
  • If there is active internal bleeding in the patient
  • If the patient has recently suffered a stroke
  • If the patient has had an intracranial or intraspinal surgery in the last 3 months
  • If the patient has suffered any serious injury to the head
  • If there are any signs of intracranial conditions in the patient that could increase the risk of bleeding
  • If there is any severe and uncontrolled hypertension
  • If there is bleeding diathesis

There are various ways to treat a stroke, but the main point to remember is that it requires immediate medical help. Each second is precious in saving a person who suffers a stroke.