Stroke Management

Stroke is an emergency condition that needs immediate treatment depending upon the type of the stroke. Quick treatment improves chances of survival and reduces complications.
Ischemic stroke: In cases of ischemic stroke, treatment is done to quickly restore blood flow to the brain.
Emergency medication for Ischemic stroke: Emergency treatment includes clot-busting drugs that dissolve blood clot. Drugs include:
1)Aspirin
2)Intravenous injection of recombinant tissue plasminogen activator (TPA)

Emergency procedures: Depending upon the features of bold clot, surgeon may decide to perform following procedure in patients of ischemic stroke:
1)Medications delivered directly to the brain through a long, thin tube called catheter to deliver TPA directly into the area of stroke.
2)Mechanical clot removal is done using a catheter to maneuver a tiny device into the brain that will physically break up or grab and remove the clot.
Other procedures:Following procedures are recommended by the surgeon to decrease the risk future stroke:
1)Carotid endarterectomy is a surgical procedure that removes plaques from carotid arteries to reduce the risk of ischemic stroke.
2)Angioplasty and stents is a procedure in which surgeon gains access to the carotid artery through an artery in the groin and expands the narrowed artery by using a balloon. Now a stent is inserted to support the opened artery.
Hemorrhagic stroke: In case of hemorrhagic stroke, treatment is done to control bleeding and reduce pressure in the brain.
Emergency medication for hemorrhagic stroke: Patients taking warfarin (coumadin) or other anti-platelet drugs such as clopidogrel (Plavix) to prevent blood clots are given drugs to counteract their blood thinners’ effects. In addition to this, drugs to lower pressure in brain (intracranial pressure), lower blood pressure, prevent vasospasm or prevent seizures. After bleeding stops in brain, supportive medical care is given to absorb blood and fasten healing.
Genetic Predisposition: There is evidence to suggest that some individuals may have a genetic predisposition to develop Trigeminal Neuralgia.
Surgical blood vessel repair: Any of the following procedures is done to repair blood vessel abnormalities associated with hemorrhagic stroke:
1) Surgical clipping to stop blood flow, prevent bursting of aneurysm or to prevent re-bleeding of an aneurysm.
2) Coiling (endo vascular embolization) is a procedure to insert a catheter into an artery to attach tiny detachable coils into the aneurysm. This will block the blood flow into the aneurysm.
3) Surgical removal of accessible AVM to eliminate the risk of rupture and lower the risk of hemorrhagic stroke.
4) Intracranial bypass is the procedure of bypassing intracranial blood vessels to treat poor blood flow to a region of the brain or complex vascular lesions.
5) Stereotactic radiosurgery is an advanced minimally invasive treatment used to repair vascular malformations.

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