By Dr Ananya Mandal, MD
Stroke management involves identifying and treating the condition quickly, as time is a crucial element in preventing the long lasting consequences of stroke.
Treatment of stroke
Treatment of stroke includes the following:
Immediate transfer of the patient to hospital as soon as symptoms are detected.
Once a patient has reached the hospital, a brain scan is performed using a computerised tomography (CT) scan or magnetic resonance imaging (MRI) scan to provide clues about the cause and type of stroke. There are two types of stroke - ischemic stroke and hemorrhagic stroke.
Ischemic stroke occurs due to a clot blocking a blood vessel and preventing the supply of blood to a part of the brain. Ischemic stroke makes up 80% of all strokes. Hemorrhagic stroke describes stroke caused by a blood vessel that has ruptured in the brain. Treatment depends on the type of stroke.
The patient is then admitted to a well equipped stroke unit.
In the case of an ischemic stroke, treatment involves:
Disintegrating the clot that is obstructing the blood vessel. This is achieved with the use of thrombolytic medications such as alteplase and reteplase. However, these agents only work if they are started during the first 4.5 hours after stroke onset.
After the clot is broken up, anticoagulant or antiplatelet agents are administered to prevent any further formation of clots. Examples include aspirin, clopidogrel, warfarin and heparin.
Blood pressure is controlled using medications such as thiazide diuretics, angiotensin converting enzyme (ACE) inhibitors, calcium channel blockers and beta-blockers.
Blood cholesterol is controlled using statins and an angioplasty procedure can be used to widen a narrowed blood vessel using a stent.
In the case of hemorrhagic stroke, treatment involves:
Emergency surgery to remove blood that has accumulated due to the ruptured blood vessel in the brain. The skull is cut open in a procedure called a craniotomy and the blood is collected and removed. This relieves any compression of surrounding brain tissue.
Blood pressure is controlled using medications such as thiazide diuretics, angiotensin converting enzyme (ACE) inhibitors, calcium channel blockers and beta-blockers. This helps to prevent the recurrence of stroke.
Rehabilitation, physiotherapy and good nursing care are other important aspects in managing and treating stroke patients.
Reviewed by Sally Robertson, BSc