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Treating Your Stroke

Stroke is an interruption of the blood supply to a part of the brain that lasts for more than 24 hours. Incidents that resolve more rapidly are referred to as Transient Ischemic Attacks or TIAs. A history of TIA may increase your risk factor for stroke by 10 times. Individuals suffering a TIA have a 25 percent likelihood of a heart attack or stroke within 90 days. Stroke or TIA is a medical emergency!

There are two types of stroke:

  • Ischemic stroke is caused by clotting within a vessel supplying blood to the brain; and

  • Hemorrhagic stroke occurs when there is bleeding in the brain caused either by excessively high blood pressure at a weakened point in a blood vessel or through a burst aneurysm (bubble in a blood vessel) within the brain.

Approximately 81 percent of all strokes are ischemic while the remainder are hemorrhagic.

Thrombolytic Therapy (tPA)

Because body tissues must receive a regular supply of oxygen, which is delivered through blood, time is critical, hence the saying: “Time is Brain.”

In 1996, the Food and Drug Administration approved the use of a clot-busting agent known as tissue Plasminogen Activator—or tPA—used for strokes caused by a blocked artery in the brain. The drug is administered intravenously during the first three hours after the stroke. By dissolving the blood clot, tPA restores blood flow to the brain and significantly improves a patient’s chance of recovery.

For stroke patients who are unable to take tPA, early treatment often involves intravenous heparin to reduce the risk of a stroke becoming worse or a second stroke from occurring. Once testing is completed and the type of stroke is determined, more specific therapy is started

Surgery

For patients diagnosed with a hemorrhagic stroke, surgery may be needed to repair the damaged blood vessel and to place a temporary drainage catheter within the brain to reduce intracranial pressure. If an aneurysm is found, it is clipped to prevent further trauma.

When blood flow throughout the carotid artery is reduced 60 percent or more, surgery (endarterectomy) is recommended to remove the plaque and restore blood flow to the vertebral arteries. Arteries within the brain may be treated surgically or with angioplasty and stenting. These procedures enlarge blocked blood arteries and blood flow.

General Treatment

General medical treatment varies according to the cause of the stroke and the length of time form the beginning of symptoms, and the overall health of the patient. Additional important health issues that must be attended to are as follows:

  • Blood pressure control
  • Fluid administration
  • Hyperthermia (fever control)
  • Glucose (blood sugar) control
  • Nutrition maintenance
  • Aspiration prevention
  • Deep venous thrombosis (blood clots in the legs) prevention