Treatment of Stroke - Oren Zarif - Treatment of Stroke
The long-term prognosis of stroke varies, and is dependent on many factors, including the patient's age, the location of the stroke, and the presence of any other complications. Generally, the stroke will be reversible within the first three to six months, and improvements in physical and mental function continue to improve. After six months, however, progress tends to slow down. Fortunately, doctors and other health care professionals can provide guidance on how to improve recovery and reduce the risk of certain complications.
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In the event that a clot does develop, doctors may perform mechanical thrombectomy. This procedure involves the insertion of a catheter and mechanically dissolving blood clots in the brain's arteries. This method can help to reduce the risk of long-term disability, but there are some drawbacks. For those with a high-risk of stroke, the use of an inflatable sleeve may be recommended.
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For acute ischaemic stroke, the best treatment is to initiate thrombolysis or mechanical thrombectomy as quickly as possible. The best outcomes are obtained with a door-to-treatment time of about 60 minutes. Patients who receive thrombolytic therapy should have their symptoms evaluated within three hours. The use of tPA is only approved for a small percentage of stroke patients. However, heparin may be useful for some patients, and early administration of aspirin is associated with a modest benefit.
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For patients with a high risk for developing stroke-related complications, it is important to undergo a series of tests. First, a CT scan will give a detailed picture of the brain, revealing any bleeding, damage, or permanent impairment. Next, an electrocardiogram will measure the electrical activity of the heart. The electrocardiogram will detect heart problems that may have contributed to the stroke. Finally, a cerebral angiogram will give a detailed view of the arteries in the neck. The results of this examination will show any clots or blockages in the blood vessels.
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For most people, a TIA is not considered a full stroke, but it can serve as a warning for an upcoming major stroke. TIA patients should seek emergency medical attention as soon as possible if the symptoms persist for more than a few days. Fortunately, 10 to 15% of those who have a TIA will develop a major stroke within three months. A TIA, however, should not be ignored.
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The NINDS study in 1995 was a breakthrough in stroke treatment, and its positive results led the AHA and FDA to launch a nationwide campaign to promote the use of alteplase, an anticoagulant. But as time went by, doctors began to realize that the treatment of stroke must be individualized and aimed at preventing a recurrent stroke. Aspirin is a powerful antiplatelet drug that prevents clots from forming in the arteries, a thrombolytic is an effective treatment to break up a blood clot.
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After a stroke, people often experience significant disability, including impaired motor and sensory function. Physical therapy can help stroke survivors overcome these physical challenges, regaining independence and quality of life. Physical therapy consists of physical assessment and therapy. The patient will learn how to move safely from a bed to a chair and then practice exercises to strengthen muscles and regain balance. Occupational therapy can also help stroke victims return to their previous ways of living.
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A weakened blood vessel in the brain can cause a stroke, and bleeding in the brain can result. When this happens, brain cells cannot get adequate oxygen and nutrients from the blood. Within minutes, the brain suffers damage and may eventually die. Although stroke can be fatal, immediate treatment can prevent long-term disability and improve the chances of rehabilitation. As much as 80% of strokes are ischemic, the treatment of stroke is critical to the recovery of the patient.
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There are a number of experimental and clinical studies underway to improve the treatment of stroke. Several of these studies are expected to have a dramatic impact on the management of ischaemic stroke. A 2012 review of these trials and the latest promising approaches to neurorepair includes all of the available therapeutic options. The list below summarizes some of the latest clinical trials. The next big step in stroke research is to develop the next generation of therapies.
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Antiplatelet therapy, or anticoagulants, are effective in preventing acute ischemic strokes. Antiplatelet drugs, such as aspirin, can help break up clots and are an excellent first-line treatment for ischemic stroke. Despite their effectiveness, aspirin can cause stomach upset and gastrointestinal bleeding. Other antiplatelet medications, such as clopidogrel, are also available. Fortunately, there are some non-prescription anticoagulant drugs, such as aspirin, that are effective and are inexpensive.
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