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Ischemic Stroke Treatment - Oren Zarif - Ischemic Stroke


An ischemic stroke occurs when a blood clot obstructs an artery supplying blood to the brain. As a result, brain cells are deprived of oxygen and blood for at least 4.5 hours. Depending on the type of stroke, treatment may include drugs that break up blood clots, procedures to remove the clot, or rehabilitation. Preventive measures include controlling risk factors and removing the blockage.

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The first steps in the treatment of an ischemic stroke are based on the patient's medical and psychological history. The initial evaluation should include monitoring of the airway, circulation, and vital signs. The physician may want to perform an endotracheal intubation or a fingerstick glucose test to rule out hypoglycemia. Once these steps are complete, a thorough evaluation will follow. In addition, a patient's condition may require thrombolytic therapy.

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The most important aspect of the patient's history is the time of symptom onset. This is based on the last time the patient was symptom-free before the stroke. Unless the patient is experiencing other symptoms, he or she is unlikely to have been awake during the stroke. Fortunately, the onset of symptoms is often painless. In most cases, the patient does not even feel the stroke. During the treatment process, the goal is to reduce the pressure in the brain and restore the patient to normal function.

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The first step in diagnosing an ischemic stroke is to find the cause. The underlying cause of the disease is determined by an electrocardiogram. Other tests can include blood testing and a cardiac catheterization. In some cases, a patient will not even experience chest pain, although the condition can be accompanied by other symptoms. An ECG is an important first step because it can help diagnose heart problems before they can cause a stroke.

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Thrombotic strokes can be preceded by transient ischemic attacks, or TIAs. These attacks may last anywhere from a few minutes to 24 hours and are considered a warning sign of a full-blown stroke. The symptoms of TIAs are often similar to those of a stroke. Another risk factor is an abnormal opening between the right and left upper chambers of the heart. In these cases, the clot may bypass the lungs and travel to the brain.

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In ischemic stroke, the artery supplying blood to the brain becomes blocked. Clots usually form in the heart and travel through the circulatory system. Sometimes they break up on their own, but sometimes they stay lodged in an artery. Because the brain arteries do not get enough oxygen and blood, brain cells begin to die. In addition, plaque can obstruct the arteries, narrowing them. Patients should seek medical attention immediately if these symptoms are noticed.

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After a diagnosis of ischemic stroke, treatment will vary depending on the type of clot and the severity of the symptoms. Some treatments focus on preventing blood clots, such as anticoagulants and antiplatelet drugs. While these medications are useful for people with acute ischemic stroke, it is important to note that they will not dissolve existing clots. In addition to aspirin, some people with ischemic stroke may benefit from short-term dual antiplatelet therapy (DAPT).

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Although intra-arterial administration of a specific thrombolytic agent may benefit a small percentage of patients, these treatments are not widely available. There are also logistical challenges, such as implementing the necessary resources. Also, the time it takes to transport patients from one hospital to another can affect treatment, and this can have a negative impact on outcomes. Therefore, if intra-arterial thrombolysis is offered, it should be considered carefully.

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In the case of patients with severe acute ischemic stroke, immediate treatment is essential. In this case, urgent anticoagulation is not recommended. However, it is important to treat the patient as if it were a life-threatening emergency. Using an organized stroke care program can improve outcomes and reduce the number of emergency department visits. In the emergency department, an evaluation is urgent, and treatment should include measures to protect the airway, breathing, and circulation of the patient.

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