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Contents
Procedure description: Stroke Treatment
Patient preparation: Stroke Treatment
Recovery: Stroke Treatment
Note: Stroke Treatment
Conditions: Stroke Treatment
Common Synonyms: Stroke Treatment
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| Procedure description: Stroke Treatment |
A stroke is caused by oclusion of the brain vessel, this causes that the blood supply to part of the brain is suddenly interrupted, or, stroke can happen when a blood vessel in the brain bursts, spilling blood into the spaces surrounding brain cells. This other type of stroke is known as hemorrhagic stroke.
Brain cells are destroyed with lack of oxygen and nutrients from the blood or there is sudden bleeding into or around the brain.
The symptoms of a stroke include sudden numbness or weakness, especially on one side of the body; sudden confusion or trouble speaking or understanding speech; sudden trouble seeing in one or both eyes; sudden trouble with walking, dizziness, or loss of balance or coordination; or sudden severe headache with no known cause.
TWO MAIN STROKE FORMS
There are two forms of stroke:
1)ISHEMIC STROKE is caused by blockage of a blood vessel supplying the brain,
2)HEMORRAGIC STROKE is caused by bleeding into or around the brain.
STROKE TREATMENT
The initial treatment for stroke is supportive.
It is important to know that these two stroke types are treated quite differently, so it is highly important to distinguish these two pathophysiologically different events.
Generally there are three treatment stages for stroke:
1)prevention,
2)therapy immediately after the stroke, and
3)post-stroke rehabilitation
STROKE PREVENTION
Prevention therapy for first or recurrent stroke are based on treating an individual's underlying risk factors for stroke, such as hypertension, atrial fibrillation, and diabetes.
ACUTE STROKE TREATMENT
Acute stroke therapies try to stop a stroke while it is happening by quickly dissolving the blood clot causing an ischemic stroke or by stopping the bleeding of a hemorrhagic stroke.
AFTER STROKE REHABILITATION
Post-stroke rehabilitation helps individuals to overcome disabilities that result from stroke damage.
MEDICATIONS IN STROKE TREATMENT
Medications are the most common stroke treatment
The most popular type of drugs which are used to prevent or treat stroke are antithrombotics (antiplatelet agents and anticoagulants) and thrombolytics.
Patient will also be given intravenous fluids since very often these type of patients are dehydrated.
Oxygen may be given to be sure that the brain is getting the maximal amount.
In case of difficulty breathing, this will be assessed and treated.
Patient will not eat or drink until his or her ability to swallow is assessed.
BLOOD PRESSURE CONTROL
It is important not to lower the blood pressure too much so that the brain will get enough blood.
Many different medications can be used to lower the blood pressure including pills, nitroglycerin paste, or IV injections.
If the blood pressure is very high, it is treated with medications which are given through continuous IV flow.
Many people with stroke have very high blood pressure when they come to the emergency department.
This may be due to an underlying problem or in response to the stroke.
The doctor will assess the blood pressure and the type of stroke and decide if the blood pressure should be lowered.
In case of acute stroke, patient will be admitted to the hospital for monitoring and further testing to figure out the cause of the stroke and ways to prevent a future stroke.
Once the patient has had a stroke, it presents much greater risk than others of having an additional stroke.
STROKE MEDICATIONS
DRUGS USED IN ACUTE STROKE
Nowadays there is only one approved stroke medication to treat new strokes.
It is the clot-busting medication called tissue plasminogen activator (t-PA).
This medicine works with the body's own chemicals and helps dissolve the blockage in the blood vessel in the brain that may be causing the stroke.
This medication is also used in heart attack treatment but it is important to know that this drug has it's limitations and the first one is that it should be administered as soon as possible, since if it is given too late it doesn't work.
This is not a miracle drug, but studies of t-PA have shown that it can reduce disability from stroke by 30%.
It has potentially serious side effects that include bleeding within the brain. This usually occurs in people who have serious strokes or who were not going to do well regardless of treatment.
Not all people with stroke can receive the clot-busting drug t-PA.
For t-PA to work, it must be given within 3 hours of the onset of symptoms. The earlier the drug is given within those 3 hours, the better it works. Symptom onset is defined as the time you were last known to be OK. If you awaken with symptoms, the symptom onset time is set back to the hour you went to sleep. This criterion alone may exclude many people from receiving this drug. This is also why it is so important to get to a stroke team for evaluation.
You must not have any evidence of bleeding on the CT scan of the head. The clot-busting medication is not used for anyone having a hemorrhagic stroke. That is why it is critical to know what kind of stroke you are having.
The doctor evaluates whether you should receive treatment with this drug and discuss the risks and benefits of giving it. Some doctors may believe that the drug is less effective. If given, strict guidelines must be met for the administration of this drug to prevent bad side effects.
Other treatments for acute stroke are being tested. At some hospitals, clot-busting drugs are given through a small catheter that, through an IV, is threaded up into the neck and into the artery where there is a blockage. This treatment can potentially be used up to 6 hours after onset of stroke symptoms. Many other new treatments for stroke are being developed. It may be possible to participate in a study of a new stroke drug or other acute treatment.
STROKE PREVENTION
Strokes are preventable! The most important thing you can do is to get your blood pressure checked and treated if it is high.
Have your blood pressure checked and monitored by a doctor. Even moderately high blood pressure over years can lead to a stroke.
Treat high cholesterol with diet and exercise and then medication to reduce the risk of stroke.
High levels of blood cholesterol known as LDL (low-density lipoprotein) increase risk for stroke and may cause the formation of artery-narrowing plaque.
In people with certain irregular heart rhythms, such as atrial fibrillation, the use of blood thinners such as warfarin (Coumadin) has been shown to reduce the risk of stroke.
For the general population, aspirin has not been shown to reduce stroke risk. It may be useful if prescribed by a doctor for people who have an increased risk of stroke.
It is important to control diabetes and to stop with smoking if you are a smoker.
It is also crucial to act quickly when someone exhibits the signs of a stroke. Stroke is a medical emergency.
STROKE REHABILITATION
Please find more informations about stroke rehabilitation amoung treatments in category Physical Therapy And Rehabilitation. |
| Patient preparation: Stroke Treatment |
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| Recovery: Stroke Treatment |
People who survive a stroke should begin stroke rehabilitation as soon as possible to regain as many lost functions (e.g., lack of coordination, strength) as possible.
Most recovery occurs during the first few months following a stroke.
However, new intensive rehabilitation techniques are offering new hope for recovery even a year or so following a debilitating stroke.
The risk of a recurrent stroke is very real, and patients are usually advised to take a number of steps to reduce their risk for another stroke. These steps might include eating a heart-healthy diet and taking aspirin or other antiplatelet agents. For patients with severe blockage of a carotid artery, a physician might also recommend a surgery called carotid endarterectomy or the placement of a carotid artery stent.
(Please see "STROKE REHABILITATION")
Although stroke is a disease of the brain, it can affect the entire body. A common disability that results from stroke is complete paralysis on one side of the body, called hemiplegia. A related disability that is not as debilitating as paralysis is one-sided weakness or hemiparesis.
Stroke may cause problems with thinking, awareness, attention, learning, judgment, and memory.
Stroke survivors often have problems understanding or forming speech.
A stroke can lead to emotional problems.
Stroke patients may have difficulty controlling their emotions or may express inappropriate emotions. Many stroke patients experience depression. Stroke survivors may also have numbness or strange sensations.
The pain is often worse in the hands and feet and is made worse by movement and temperature changes, especially cold temperatures.
Recurrent stroke is frequent; about 25 percent of people who recover from their first stroke will have another stroke within 5 years |
| Note: Stroke Treatment |
Strokes are preventable! The most important thing you can do is to get your blood pressure checked and treated if it is high.
Have your blood pressure checked and monitored by a doctor. Even moderately high blood pressure over years can lead to a stroke.
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| Conditions: Stroke Treatment |
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| Common Synonyms: Stroke Treatment |
| stroke, ischemic stroke, hemorrhagic stroke, intracerebral hemorrhage, brain attack, cerebrovascular accident, CVA, prevention of stroke, acute therapy following stroke, subacute/chronic therapy following stroke, cerebral ischemia, medical treatment of CVA, antiplatelet therapy, transitory ishaemic attack (TIA), TIA, Acute Stroke Treatment, Antithrombotics, Antiplatelet agents, Anticoagulants, Thrombolytics, tPA, Tissue Plasmnogen Activator, After Stroke Rehabilitation, Post Stroke Rehabilitation, Stroke Rehabilitation, Acute Stroke Treatment, Stroke Prevention, Prevention of Stroke |
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