brain, spinal cord, and nerve disorders
Overview of Stroke
Treatment of Stroke
If needed, measures to support vital functions such as breathing Various medications to break up clots or to make blood less likely to clot Various procedures to treat blocked or narrowed arteries, surgery to remove a clot, or insertion of a coil to block an aneurysm Rehabilitation to regain as much normal function as possible Treatment of problems after a stroke Anyone with symptoms of a stroke should seek medical attention immediately. The earlier the treatment, the better the chances for recovery. Thus, emergency medical services and hospitals are continuously developing new and better ways to treat people who have had a stroke as soon as possible after symptoms begin. Doctors check the person’s vital functions, such as heart rate, breathing, temperature, and blood pressure, to make sure they are adequate. If they are not, measures to correct them are taken immediately. For example, if people are in a coma or unresponsive (as may result from Brain Herniation ), Other treatments used during the first hours and first days depend on the type of stroke. Treatment may include the following: Medications (such as antiplatelet medications, anticoagulants, medications to break up clots, and medications to control high blood pressure) Insertion of a thin, flexible tube (catheter) into an artery, usually in the groin, and then through the aorta to an artery in the neck, followed by injection of a medication through the catheter to dissolve a clot (intra-arterial Thrombolytic therapy ) Use of instruments threaded through the catheter (called endovascular procedures) to remove a clot ( Mechanical thrombectomy ), to widen a narrowed artery (angioplasty), and/or to place a stent to widen a narrowed artery Surgery ( Carotid artery surgery ) to remove fatty deposits blocking blood flow in an artery in the neck Treatment may include the following: If needed, treatments that help blood clot (such as vitamin K and transfusions of fresh frozen plasma or platelets) If blood pressure is very high, medications to control it Occasionally, surgery to remove large areas of accumulated blood or to place a shunt to relieve the increased pressure within the skull Insertion of small coils or stents through a catheter to the affected area to treat a ruptured Brain Aneurysms (the most common cause of a Later and ongoing treatments focus on Preventing subsequent strokes Treating and preventing problems that strokes can cause Helping people regain as much function as possible (rehabilitation) Intensive Rehabilitation After a Brain Injury can help many people overcome disabilities. The exercises and training of rehabilitation encourage unaffected areas of the brain to learn to perform functions that were done by the damaged area. Also, people are taught new ways to use muscles unaffected by the stroke to compensate for losses in function. The goals of rehabilitation are the following: To regain as much normal function in doing daily activities as possible To maintain and improve physical condition and to improve walking To help people relearn old skills and learn new ones as needed Success depends on the area of the brain damaged and the person’s general physical condition, functional and cognitive abilities before the stroke, social situation, learning ability, and attitude. Patience and perseverance are crucial. Participating actively in the rehabilitation program can help people avoid or lessen depression. Rehabilitation is started in the hospital as soon as people are physically able—usually within 1 or 2 days of admission. Moving the affected limbs is an important part of rehabilitation. Regularly moving the limbs helps prevent muscles from shortening and becoming tight (called spasticity). It also helps maintain muscle tone and strength. If people cannot move their muscles themselves, a therapist moves their limbs for them. People are encouraged to practice other activities, such as moving in bed, turning, changing position, and sitting up. Some problems due to stroke require specific therapies—for example, to help with walking (gait or ambulation training), to improve coordination and balance, to reduce spasticity (involuntary tightening of muscles), or to compensate for vision or speech problems. After discharge from the hospital, rehabilitation can be continued on an outpatient basis, in a nursing home, in a rehabilitation center, or at home. Occupational and physical therapists can suggest ways to make life easier and the home safer for people with disabilities. Family members and friends can contribute to a person’s rehabilitation by keeping in mind what effects a stroke can have, so that they can better understand and support the person. Support groups can provide emotional encouragement and practical advice for people who have had a stroke and for those who care for them. 