Treatments To Reduce The Risk Of Another Stroke
Most people who have an ischaemic stroke will be given bloodthinning medication to help prevent clots from forming. For most people this will be a daily dose of aspirin followed by clopidogrel. If you receive thrombolysis, you normally have to wait at least 24 hours before you can begin taking aspirin.
How long will I need to take blood thinning medication?
Most people will need to take blood-thinning medication for life. There are two main types of blood-thinning medication, known as antiplatelets and anticoagulants. Many people need antiplatelets such as aspirin and clopidogrel People with heart conditions like atrial fibrillation are more likely to have an anticoagulant such apixaban, dabigatran, edoxaban, rivaroxaban or warfarin. Find out more about blood-thinning medications on our dedicated webpage.
Surgery for narrowed arteries in the neck
Around 15% of ischaemic strokes are due to narrowed arteries in the neck, known as carotid artery disease. This is diagnosed using specialist ultrasound scans of your neck. Carotid artery disease is due to atherosclerosis, the build-up of fatty materials in your arteries.
Carotid artery disease is sometimes treated using a surgical procedure. This means either removing the artery lining, or inserting a mesh cylinder to keep the artery open. Youll be assessed to decide on the best treatment to help reduce your risk of a stroke, which might include medication instead of surgery.
How Does The Covid
The effects of the pandemic may mean that some people in hospital for a stroke may leave earlier than usual. They may also have problems accessing care acutely or after leaving the hospital. This may affect services such as rehabilitation resources, such as physiotherapy and neurorehabilitation therapy.
However, they should still get the support and treatment they need from their healthcare team or stroke center, with a detailed care plan. Some treatments may need to happen at home, while appointments may happen over phone or video calls.
Stroke survivors are vulnerable to severe COVID-19. That means survivors, and those who care for them, should take extra precautions and care in maintaining hygiene and physical distancing. Washing hands and cleaning surfaces and items that others have touched is important. A stroke survivor may also wish to get a COVID-19 vaccine.
Health experts also advise staying at home whenever possible. Stroke survivors may wish to ask a family member or friend to undertake essential tasks outside the home, such as grocery shopping or pharmacy trips. They should also work from home where possible and avoid situations in which physical distancing is difficult to maintain.
Wearing a mask helps to protect you and others around you. Stroke survivors should wear a mask when venturing outdoors and avoid anyone not wearing one.
What Can I Expect If I Have An Ischemic Stroke
If you have a stroke, many factors affect what you can expect. These include, but arent limited to, the size of the stroke and the specific areas of the brain it affects. In general, the larger the stroke, the more severe the symptoms. Larger strokes also have a higher risk of an unfavorable outcome. Some strokes can be smaller, but can still be severe if they affect a critical area of your brain. An example of this is a stroke that affects areas of your brain that control your ability to speak. These can severely disrupt your life, but are less likely to be life-threatening.
The more severe an ischemic stroke is, the more likely that youll lose at least temporarily certain abilities. Larger strokes are also more likely to cause permanent damage or death. Thats why getting medical attention quickly is so important. The faster you get medical attention for stroke symptoms, the better your chances that these effects will be temporary or less severe.
Strokes can happen in very different ways from person to person. While there are many similarities in how strokes happen and the symptoms unfold, not all cases are the same. Because of that, your healthcare provider is the best person to tell you what you can and should expect.
How long does an ischemic stroke last, and when I can I return to school, work or my usual routine?
Whats the outlook for this condition?
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When Specific Areas Of The Brain Are Damaged
Different areas of the brain control specific functions. Consequently, where the brain is damaged determines which function is lost.
Computed tomography is usually done first. CT helps distinguish an ischemic stroke from a hemorrhagic stroke, a brain tumor, an abscess, and other structural abnormalities.
Doctors also measure the blood sugar level to rule out a low blood sugar level , which can cause similar symptoms.
If available, diffusion-weighted magnetic resonance imaging Diffusion-weighted MRI In magnetic resonance imaging , a strong magnetic field and very high frequency radio waves are used to produce highly detailed images. MRI does not use x-rays and is usually very safe… read more , which can detect ischemic strokes within minutes of their start, may be done next.
Measures to support vital functions, such as breathing
Drugs to break up blood clots or make blood less likely to clot
Sometimes surgery to remove a blockage or angioplasty with a stent
Measures to manage problems that stroke can cause, such as difficulty swallowing
Measures to prevent blood clots in the legs
Another priority is to restore the persons breathing, heart rate, blood pressure , and temperature to normal. An intravenous line is inserted to provide drugs and fluids when needed. If the person has a fever, it may be lowered using acetaminophen, ibuprofen, or a cooling blanket because brain damage is worse when body temperature is elevated.
Hemiplegia On The Left Side
Hemiplegia is paralysis on one side of the body. A right-sided stroke can cause hemiplegia of the whole left side of the body.
More commonly, this type of stroke causes left-side hemiparesis, which is diminished strength, without total paralysis. It usually affects only the face, arm, or legnot necessarily the whole left side.
Sometimes, months or years after the stroke, spasticity can develop in the weak muscles. This occurs when a stroke affects the right motor strip of the cerebral cortex or the right internal capsule .
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Which Ischemic Stroke Treatment Options Are Available
The aim of the treatment is to remove the blood clot from the artery. This can be either done by medical treatment and/or endovascular approach . Treatment options are varying from each case. Factors such as: location, size, and condition play a major role for the chosen treatment.
The endovascular approach is a treatment from within the vessel. It is a minimally invasive procedure which typically only requires a puncture of the groin. Small catheters are navigated through the artery towards the blockage. Treatment devices can be delivered through these catheters.
What Will My Recovery From Stroke Be Like
A stroke affects people in different ways. Youre likely to see the most improvement in the first few weeks of your recovery, usually while you’re still in hospital. However, it can take months or sometimes years.
Your rehabilitation will begin in hospital where specialists, such as nurses, physiotherapists and occupational therapists will discuss what help youll need. The aim of rehabilitation is to help return you as close as possible to how you were before the stroke. They also support you to live as independently as you can.
If youve had a stroke, you may be at risk of developing vascular dementia. This happens when a stroke damages part of your brain, leading to symptoms such as concentration problems and personality changes. If you have any concerns you should speak to your GP.
Stroke is sudden and can be devastating, but many people continue to improve and there is help and support available.
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New Procedure Removes Blood Clot In 10 Minutes A Worlds First
A patient at London Health Sciences Centre is the worlds first to benefit from a new medical device developed to treat stroke by rapidly removing the offending blood clot in 10 minutes, ultimately reversing the symptoms of stroke and preventing permanent damage to the brain.
As a research-intensive teaching hospital, LHSC is committed to finding and developing innovative health care solutions to treat patients for a variety of emergency conditions, including stroke. On June 24, 2022, Dr. Michael Mayich and his team used a new device called a balloon distal access catheter to successfully remove a blood clot from an artery in the brain of Wilene Leyen. The procedure was performed through a tiny incision over the right hip and took less than 10 minutes, reconstituting blood flow to a large part of the brain and restoring Ms. Leyens movement and speech almost immediately.
Mechanical thrombectomy is a new minimally invasive treatment for strokes caused by blood clots which block blood flow to the brain. It is performed by a specialized team which includes neuroradiologists, stroke neurologists, neurosurgeons, imaging technologists and anesthesiologists who are on-call 24-7 to provide this emergency service. LHSC was the first hospital in the world to use the BDAC to treat a patient experiencing a stroke.
Treatment Options To Consider
In addition to the treatment options discussed above, in the emergency treatment section, there are other treatment options that are available. For instance, in the case of ischemic stroke, your doctor might recommend procedures to prevent a stroke from recurring. Carotid endarterectomy is one of the recommended medical procedures. In this process, plaque is removed from carotid arteries through an incision and then completed with stitching. This procedure is risky for people who have certain medical conditions or who are suffering from heart problems. Another option is using angioplasty and stents.
In hemorrhagic stroke, there are additional treatment options that are available if AVM or any type of vascular malformation has caused the stroke. Endovascular embolization is an option that helps the blood to clot. Another option is stereotactic radiosurgery which helps to treat vascular malformations. Surgical clipping might be recommended by your doctor.This procedure prevents an aneurysm from bursting It can also help prevent further bleeding. Another medical procedure that is an option, is surgical AVM removal. This is only possible if the AVM is small and it can be easily accessed in your brain.
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How Is An Ischaemic Stroke Diagnosed
If someone has any signs of a stroke, its time to call 999 immediately.
Ambulance paramedics are trained in stroke. They assess the person and take them to the right type of hospital for the treatment they need. This could be a hospital with a specialist stroke unit or a hyper-acute stroke unit. A stroke unit has an inter-disciplinary team of trained professionals who are experienced in stroke care.
The important thing when a stroke happens is time. The faster someone can get to a specialist stroke unit, the better their chances of reducing damage to the brain.
Once youre admitted to hospital, you have tests and checks to confirm if you have had a stroke, and what type of stroke it is.
If you have a suspected stroke, a brain scan should be carried out urgently, and if possible within one hour of arriving at hospital. A brain scan can help doctors decide if you are suitable for an emergency treatment such as clot-busting treatment and mechanical clot removal .
A computed tomography scan or a magnetic resonance imaging scan is used to produce pictures of your brain. Doctors use scans to rule out other causes of your symptoms, and see how much of your brain has been affected. It also helps them decide how best to treat you, as treatments are different depending on the cause and timing of your stroke.
Lower Your Risk Of Stroke
Some risk factors for stroke, like age, race, and family history, can’t be controlled. But you can make changes to lower your risk of stroke. Talk to your doctor about what you can do. Even if you’re in perfect health, follow these suggestions:
- Control your blood pressure. Have your blood pressure checked often. If it is high, follow your doctor’s advice to lower it. Treating high blood pressure lowers the risk of both stroke and heart disease.
- Stop smoking.Smoking increases your risk for stroke. It’s never too late to quit.
- Control your cholesterol. If you have high cholesterol, work with your doctor to lower it. Cholesterol, a type of fat in the blood, can build up on the walls of your arteries. In time, this can block blood flow and lead to a stroke.
- Control your diabetes. Untreated diabetes can damage blood vessels and also leads to narrowed arteries and stroke. Follow your doctor’s suggestions for keeping diabetes under control.
- Eat healthy foods. Eat foods that are low in cholesterol and saturated fats. Include a variety of fruits and vegetables every day.
- Exercise regularly. Try to make physical activity a part of your everyday life. Do things you like for example, take a brisk walk, ride a bicycle, or go swimming. Talk with your health care provider if you haven’t been exercising and you want to start a vigorous program or increase your physical activity.
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Will I Be Able To Make A Full Recovery
Everyone recovers differently. Some people recover fully. Other people will have health problems or a disability. The fastest recovery takes place in the first few months. After that progress can be slower, but people can continue to improve for months or years after a stroke.
You should receive rehabilitation soon after your stroke. It may begin in hospital and should carry on at home if you need it. Rehabilitation is part of your recovery. It means trying to restore function to as near normal as possible, and helping you adapt to disability.
During rehabilitation, the therapist assesses you and designs treatment tailored to your needs. Depending on the type of therapy, you may have exercises to practise. You may work towards building up stamina, or learn new ways of doing things.
Although brain cells that have been severely damaged or have died cant grow back, the brain can re-wire itself, allowing you to relearn things like walking, speech and swallowing. This is called neuroplasticity. Neuroplasticity is the process that happens in the brain when you do rehabilitation therapy. By repeating the therapy activities, your brain starts to form new connections, allowing you to improve.
Tpa Benefits And Risks
Clot-dissolving drugs are not for everyone and the stroke team at Sinai-Grace is trained to quickly identify those patients who are the best candidates.
Because tPA increases the risk of bleeding, patients who have a history of bleeding problems, recent surgery or trauma, uncontrolled high blood pressure or recent head injury may not be able to receive it. Some strokes are caused by a ruptured blood vessel, not a blocked blood vessel, so a CT scan is used to rule out these types of strokes.
While the risks of tPA should be considered, the benefits of prompt treatment of the clot far outweigh the risks for most patients. If you or your family is faced with the decision to use tPA, listen carefully to the risks and benefits.
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How Soon After Treatment Will I Feel Better
How long it takes to feel better after treatment and the time to recover after a stroke can vary from person to person. Thats because many factors play a part in how you feel over time. If you have questions about the likely timeline for your treatment and recovery, your healthcare provider is the best person to answer that question and give you information that is most accurate for your situation.
What Causes Stroke In Younger People
Some of the risk factors for stroke in younger adults are different than those found in older adults, but many are the samesmoking, heavy drinking, diabetes, high blood pressure and high cholesterol. Bad health habits are not the only causes of strokes in young people, however. Other conditions can bring about strokes before age 45, including several that are inherited.
Even when inherited conditions raise your chances of having a stroke, there may be actions you can take to reduce your risk.
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How Are Ischemic Strokes Treated
The highest priority with ischemic stroke is restoring circulation to the affected brain areas. Thats because restoring circulation quickly can limit the damage and preserve brain tissue. The less permanent brain damage you have, the more likely youll keep all or most of the abilities you had before the stroke.
How Atherosclerotic Plaque Causes Damage
Stroke and atherosclerosis
There are two types of ischemic stroke caused by blood clots, narrowing of blood vessels to the brain caused by atherosclerosis or other particles.
Atherothrombotic stroke is the most common. It occurs when a blood clot forms on an atherosclerotic plaque within a blood vessel in the brain and blocks blood flow to that part of the brain.
A cerebral embolism happens when a wandering clot or some other particle, called an embolus, is carried by the bloodstream. It lodges in an artery leading to or in the brain and blocks the flow of blood. The embolism could be due to a piece of clot or plaque that broke off from an atherosclerotic plaque. However, most embolic strokes are due to blood clots that form in people with atrial fibrillation and enter the bloodstream.
Written by American Heart Association editorial staff and reviewed by science and medicine advisers. See our editorial policies and staff.
Last Reviewed: Jun 17, 2021
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