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Treatments for stroke12,13
As the two main different kinds of stroke, ischemic and hemorrhagic, are caused by different factors, both require different forms of treatment. It is not only important that the type of stroke is diagnosed quickly to reduce the damage done to the brain, but also because treatment suitable for one kind of stroke can be harmful to someone who has had a different kind.
Ischemic strokes are caused by arteries being blocked or narrowed and so treatment focuses on restoring an adequate flow of blood to the brain.
Treatment can begin with drugs to break down clots and prevent further ones from forming. Aspirin can be given, as can an injection of a tissue plasminogen activator (TPA). TPA is very effective at dissolving clots but needs to be injected within 4.5 hours of stroke symptoms manifesting themselves.
Surgeons are able to remove plaque and any other obstructions from the carotid artery through surgery.
Emergency procedures include administering TPA via catheter directly into an artery in the brain or using a catheter to physically remove the clot from its obstructive position. Recent studies have cast doubt as to the effectiveness of these methods, and so research is still ongoing as to how beneficial these procedures are.
There are other procedures that can be carried out to decrease the risk of future strokes or TIAs. A carotid endarterectomy involves a surgeon opening the carotid artery and removing any plaque that might be blocking it.
Alternatively, an angioplasty involves a surgeon inflating a small balloon in a narrowed artery via catheter and then inserting a stent (a mesh tube) into the opening in order to prevent the artery from narrowing again.
Hemorrhagic strokes are caused by bleeding into the brain and so treatment focuses on controlling the bleeding and reducing the pressure on the brain that it is causing.
Treatment can begin with drugs being given to reduce the pressure in the brain, overall blood pressure, prevent seizures and prevent sudden constrictions of blood vessels. If the patient is taking anti-coagulant or anti-platelet medication like Warfarin or Clopidogrel, they can be given drugs or blood transfusions to counter the medication's effects.
Surgery can be used to repair any problems with blood vessels that have led or could lead to hemorrhagic strokes. Surgeons can place small clamps at the base of aneurysms or fill them with detachable coils to stop blood flow to them and prevent rupture.
Surgery can also be used to remove small arteriovenous malformations (AVMs) if they are not too big and not too deep within the brain. AVMs are tangled connections between arteries and veins that are weaker and burst more easily than other normal blood vessels.14
Strokes are life-changing events that can affect a person both physically and emotionally, temporarily or permanently. After a stroke, successful recovery will often involve specific rehabilitative activities such as:
- Speech therapy - to help with problems producing or understanding speech. Practice, relaxation and changing communication style, using gestures or different tones for example, all help
- Physical therapy - to help a person relearn movement and co-ordination. It is important to get out and about, even if it is difficult at first
- Occupational therapy - to help a person to improve their ability to carry out routine daily activities, such as bathing, cooking, dressing, eating, reading and writing
- Joining a support group - to help with common mental health problems such as depression that can occur after a stroke. Many find it useful to share common experiences and exchange information
- Support from friends and family - to provide practical support and comfort. Letting friends and family know what can be done to help is very important.
Preventing a stroke16
The best way to prevent a stroke is to address the underlying causes. This is best done by living healthily, which means:
- Eating a healthy diet
- Maintaining a healthy weight
- Exercise regularly
- Not smoking
- Avoiding alcohol or moderating consumption.
Eating a healthy diet means getting plenty of fruits, vegetables and healthy whole grains, nuts, seeds and legumes; eating little or no red or processed meat; limiting intake of cholesterol and saturated fat (typically found in foods of animal origin); and minimizing salt intake so as to support healthy blood pressure.
Other measures taken to help reduce the risk of stroke include:
- Keeping blood pressure under control
- Managing diabetes well
- Treating obstructive sleep apnea (if present).
As well as these lifestyle changes, a health care provider can help to reduce the risk of future strokes through prescribing anti-coagulant and anti-platelet medication. In addition to this, the arterial surgery previously mentioned can also be used to lower the risk of repeat strokes.
Recent developments on stroke treatment and prevention from MNT news
A new study suggests that using nanocapsules to precisely target activated clotting platelets with clot-busting drugs could revolutionize the treatment of stroke and heart attack.
There is growing evidence that drugs used to treat depression and Alzheimer's disease also can help patients recover from strokes, according to new research published in the journal Drugs and Aging.
Stroke is the leading cause of serious long-term disability in adults because of the damage it inflicts on the brain. Now, a new study suggests it may be possible to stimulate brain tissue to repair itself following a stroke.
New research provides further evidence of the health benefits of fruit consumption, after finding that eating fresh fruits daily may lower the risks of heart attack, stroke and cardiovascular death.