Stroke Treatment
Studies show that hospitals designated as Comprehensive Stroke Centers
offer patients the best chance for survival and return to normal life.
Stroke victims receive better treatment and recover with fewer disabilities.
For instance, Comprehensive Stroke Center recommendations require round-the-clock
neurosurgical staff and the latest technology to swiftly and accurately
diagnose and treat acute stroke victims on an emergency basis. They offer
access to advanced neuroradiological imaging and therapeutic techniques,
which provides the widest range of interventional options to stop and
minimize potential damage from a stroke.
Ischemic Stroke
Ischemic stroke happens when a clot blocks a vessel supplying blood to
the brain. It's the most common type, accounting for 87% of all strokes.
The treatment goal is to bust or remove the clot.
Treatment
Considered the gold standard, tissue plasminogen activator (or Alteplase
IV r-tPA) is an FDA-approved treatment for ischemic strokes. When promptly
administered, it can save lives and reduce the long-term effects of stroke.
Many people miss this key brain-saving treatment because they don't
arrive at the hospital in time, which is why it's so important to
identify a stroke and seek treatment immediately for the best possible
chance at a full recovery.
Thrombectomy
Physical removal of a large blood clot, called an endovascular procedure
or a mechanical thrombectomy, is another strongly recommended treatment
option. Thrombectomy allows trained doctors to use a wire-cage device
called a stent retriever to remove a large blood clot. Thrombectomy should
be done within six hours of onset of acute stroke symptoms. For selected
patients under certain conditions, the procedure can be beneficial if
done even within 24 hours of onset. Patients who are eligible for IV alteplase
should receive the drug, even if the clot removal procedure is considered.
Patients must meet certain criteria to be eligible for this procedure.
Hemorrhagic Stroke
Hemorrhagic stroke is caused by a rupture in a blood vessel within the
brain. Fewer strokes happen as the result of a rupture. The treatment
goal is to stop the bleeding.
When a weakened blood vessel ruptures and spills blood into brain tissue,
it’s called a hemorrhagic stroke. The most common cause for the
rupture is uncontrolled hypertension (high blood pressure). There are
two other types of weakened blood vessels that can also cause hemorrhagic
stroke: aneurysms (swellings within vessels) and arteriovenous malformations
or AVMs (abnormal tangles of blood vessels). Fewer strokes happen as the
result of a rupture. The treatment goal is to stop the bleeding.
Treatment
A small tube called a catheter can sometimes be threaded up through a major
artery in an arm or leg and guided into the brain tissue, allowing the
surgeon to use camera technology to help fix the problem. Once the catheter
is guided to the source of the bleeding, it deposits a mechanical agent,
such as a coil, to prevent further rupture.
This type of procedure is endovascular, meaning that the surgeon gains
access via the vascular system, making it less invasive than conventional
surgical treatment. Sometimes surgery is required to secure a blood vessel
at the base of the aneurysm.