Treatment
for Stroke
Specific
treatment for stroke will be determined by your
physician based on:
- your age, overall health,
and medical history
- severity of the stroke
- location of the stroke
- cause of the stroke
- your tolerance for
specific medications, procedures, or therapies
- type of stroke
- your opinion or preference
Although
there is no cure for stroke, advanced medical
and surgical treatments are now available, giving
many stroke victims hope for optimal recovery.
Treatment
is most effective when started immediately. Emergency
treatment following a stroke may include the following:
- medications used to
the dissolve blood clot(s) that cause an ischemic
stroke
Medications that dissolve clots are called thrombolytics
or fibrinolytics, and are commonly known as
"clot busters." These drugs have the ability
to help reduce the damage to brain cells caused
by the stroke. In order to be most effective,
these agents must be given within several hours
of a stroke's onset.
- medications and therapy
to reduce or control brain swelling
Corticosteroids and special types of intravenous
(IV) fluids are often used to help reduce or
control brain swelling, especially after a hemorrhagic
stroke (a stroke caused by bleeding into the
brain).
- medications that help
protect the brain from damage and ischemia (lack
of oxygen)
Medications of this type are called neuroprotective
agents, with some still under investigation
in clinical trials.
- life support measures
including such treatments as ventilators (machines
to assist with breathing), IV fluids, adequate
nutrition, blood pressure control, and prevention
of complications
Other
medications that may help with recovery following
a stroke, or may help to prevent a stroke from
occurring, include the following:
- medications to help
prevent more blood clots from forming
Medications that help to prevent additional
blood clots from forming are called anticoagulants,
as they prevent the coagulation of the blood.
Medications of this type include, for example,
heparin and warfarin (Coumadin®).
- medications that reduce
the chance of blood clots by preventing platelets
(a type of blood cell) from sticking together
Examples of this type of medication include
aspirin, clopidogrel (Plavix®), dipyridamole
(Aggrenox®), or ticlopidine (Ticlid®).
- medications to treat
existing medical conditions such as diabetes,
heart, or blood pressure problems
Several
types of surgery may be performed to help treat
a stroke, or help to prevent a stroke from occurring,
including the following:
- carotid endarterectomy
Carotid endarterectomy is a procedure used to
remove plaque and clots from the carotid arteries,
located in the neck. These arteries supply the
brain with blood from the heart. Endarterectomy
may help prevent a stroke from occurring.
- craniotomy
A craniotomy is a type of surgery in the brain
itself to remove blood clots or repair bleeding
in the brain.
- surgery to repair
aneurysms and arteriovenous malformations (AVMs)
An aneurysm is a weakened, ballooned area on
an artery wall that has a risk for rupturing
and bleeding into the brain. An AVM is a congenital
(present at birth) or acquired disorder that
consists of a disorderly, tangled web of arteries
and veins. An AVM also has a risk for rupturing
and bleeding into the brain. Surgery may be
helpful, in this case, to help prevent a stroke
from occurring.
Many
individuals who have a stroke are left with paralysis
of the upper extremities. CIT is a treatment that
encourages the use of the stroke-affected limb
by constraining the non-affected limb in a mitt,
sling, splint or glove. Intense exercises are
done using the stroke-affected arm or hand.
- CIT restraints are
worn for up to 90 percent of the waking hours.
- Restraints can be removed
for activities such as bathing.
- Small steps are used
to break down complex tasks such as making a
phone call.
- Verbal and written
feedback is used to help motivate and inform
persons undergoing CIT.
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