Acute strokes occur in the brain without much warning. According to the Centers for Disease Control and Prevention, nearly more than 795,000 Americans suffer from strokes annually. Of these patients, up to 30 percent remain permanently disabled. Clots prevent oxygen-rich blood from reaching the brain causing an ischemic stroke. Bleeding in the brain causes an acute hemorrhagic stroke, often due to a ruptured blood vessel. Immediate medical treatment is necessary to minimize and prevent stroke related complications, reports MayoClinic.com.
Stabilization
Medical personnel initially stabilize a stroke victim's vital signs including respiration and pulse, according to the Merck Manual. A patient may be placed onto a ventilator to improve breathing. An elevated body temperature, or fever, increases complications of an acute stroke. Administering ibuprofen or aspirin decreases a person's fever. Alternatively, placing a cooling blanket onto the patient may also reduce high body temperatures. Blood pressure remains untreated unless reaching over 220/120 mm Hg. Slightly high blood pressure is necessary to pump blood through restricted or narrow arteries often present in stroke victims.
Medications
Ischemic stroke victims must use clot reducing drugs within three hours of a stroke. Medications include aspirin; however, hemorrhagic stroke victims should not take aspirin because bleeding will increase. Injecting tissue plasminogen activator often decreases blood clots in ischemic stroke patients, yet medical professionals must be certain the medication will not cause further brain bleeding. A CT scan takes images of the brain to ensure bleeding is not present. Administration of the drug within three hours of having a stroke is required. After three hours, and up to 18 hours after the stroke, tissue plasminogen activator administration occurs via a catheter commonly inserted into a groin artery and threaded to the location of the blocked artery. According to the Merck Manual, specialized stroke centers commonly perform the procedure and injection of the medication.
Ischemic Stroke Surgery Options
Surgeons clear blocked carotid arteries by performing carotid endarterectomy. The surgery reduces the risk of ensuing ischemic strokes. Patients must have a blocked carotid artery with 70 percent or more narrowing, functioning brain tissue supplied by the artery and a life expectancy of 5 years or more, according to the Merck Manual. During the surgery, patients remain awake. The surgeon creates an incision into the neck and removes the blocked portion of the artery. The Merck Manual warns the procedure may cause a stroke; the lodged clot may become loose and severely block an artery. The surgery cannot be performed in smaller arteries. An alternative treatment includes angioplasty which includes threading a catheter and attached balloon into a blocked artery and expanding the artery by filling the balloon with air. A wire mesh tube is inserted into the artery to prevent the artery from narrowing.
Hemorrhagic Stroke Surgery Options
Aneurysm clipping and arteriovenous malformation are the two most common procedures to treat hemorrhagic stroke victims. Placing a small clip at the base of the bleeding artery prevents continuous bleeding. The procedure, known as aneurysm clipping, is permanent. Arteriovenous malformation occurs when the bleeding artery is located deep in the brain and remains unreachable. A connecting, smaller artery is removed, which lowers the risk of additional strokes.
