Strokes can be treated several different ways. Good treatment depends upon good tests and a proper diagnosis. Emergency physicians that specialize in caring for patients who are having a stroke will determine the best standard of care and the appropriate stroke treatments.
Tests and diagnosis come first. If a stroke is suspected, the emergency team will assess the situation. Tests such as a physical exam, an echocardiograph, a CT exam (computerized tomography), an MRI (magnetic resonance imaging) and carotid ultrasound may be performed to facilitate the correct diagnosis. Once the suspected cause of stroke is understood, the treatment approach will vary.
Treating most strokes involves restoring blood flow. The continual supply of the proper amount of blood is crucial to the health of the brain. Oxygen and nutrients are supplied to the brain constantly — a block or slow in blood flow can damage and kill brain cells within minutes. According to the Mayo Clinic, clot-busting medication must be started within four and a half hours for survival and complication minimization. Some of these medications include aspirin (the most common), intravenous tissue plasminogen activator (TPA), Coumadin (warfarin), Heparin and Plavix (clopidogrel).
Procedures are sometimes implemented to treat stroke. Strokes of all types can be treated with specialized procedures. Time is of the essence, so these measures must be taken as soon as practicable:
- TPA can be delivered directly to the brain through a catheter.
- Clots may be removed via a catheter.
- A carotid endarterectomy may be performed to remove plaque from the carotid arteries.
- An angioplasty may be performed to widen narrow-plaque ridden arteries and a stent inserted with a balloon-tipped catheter to keep the artery open.
- Hemorrhagic stroke treatments focus on hemorrhagic control and may require surgery to manage the bleeding and future risk of bleeding.
- Surgical blood vessel repair may be necessary with blood vessel abnormalities associated with hemorrhagic strokes. Types of repair are aneurysm clipping, embolization or removal of the malformation altogether.