Stroke treatment

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Your treatment will depend on the type of stroke:

Treatment of ischaemic stroke consists of two different stages:

  • Initially, the primary goal is to re-establish blood flow as soon as possible and minimise the extent of brain damage (in colloquial terms, the priority in the acute phase is to «put out the fire»).
  • The objective of the second stage is to prevent a recurrent stroke, prevention treatment adapted to the cause of the stroke is provided.

Time is a crucial factor in the first few hours of a stroke (acute phase) as an average of 2 million neurons die every minute. Treatments aimed at recovering blood flow should be used in the acute phase. These treatments are:

  • Intravenous thrombolysis. A medicine which dissolves blood clots is injected into a vein.
  • Mechanical thrombectomy. A technique used when the blood clot has blocked one of the major arteries carrying blood to the brain. A catheter is introduced into an artery in the groin until it reaches and unblocks the obstructed cerebral artery.

Once the patient has been admitted, and while tests are being carried out to discover the cause, general treatment includes different strategies: prevent another stroke in the following days; control blood pressure and blood glucose levels; maintain adequate blood oxygenation; provide fluids and nutrition; and prevent and treat any stroke-associated complications.

Green and blue antiplatelet drug

Antiplatelet agents, which limit platelet activity (the blood cells that initiate the coagulation process), or anticoagulants, which interrupt some of the later steps in the coagulation cascade system are prescribed to prevent recurrent strokes.

heart rate, high blood pressure

Blood pressure is managed with either intravenously or orally administered medicines, according to the patient’s blood pressure at any given moment. The ideal blood pressure range varies in function of the extent of the stroke and whether the artery causing the problem remains blocked or has been unobstructed.

Testing the sugar through a glutometer

High blood sugar levels are associated with a poor recovery from a stroke. For this reason, efforts are made to maintain normal values and avoid low sugar levels, which are also harmful. To control blood sugar, medicines such as insulin sometimes have to be used during hospitalisation, even in patients who have never used it before suffering a stroke.

Pill

The most common complications associated with stroke are infections, either respiratory or urinary. Infections must be treated with the appropriate antibiotics as soon as they are diagnosed.

Some cases of haemorrhagic stroke in which bleeding is close to the surface can undergo surgery to remove the blood or treat the bleeding lesion, as in the case vascular malformations. The patient may also require an angiography to repair the damaged blood vessel.

This applies to aneurysms which can be protected with some small coils that take the damaged vessel wall out of circulation and so prevent further bleeding.

Substantiated information by:
Ángel ChamorroNeurologist — Neurology DepartmentArturo RenúNeurologist — Neurology DepartmentAntonia FernándezNurse — Neurology DepartmentXabier UrraNeurologist — Neurology Department

Published: 20 February 2018
Updated: 20 February 2018

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