Stroke | Stroke Symptoms | Ischemic Stroke | Treatment

What is a Stroke?

What are the symptoms and treatment methods?

Stroke | Stroke Symptoms | Ischemic Stroke
Stroke Diagram

Stroke is a BRAIN CRISIS where the vital blood and oxygen flow to the brain are suddenly interrupted or reduced. Cells in the region where the blood flow is interrupted begin to die rapidly. The functions carried out from the area where the it occurs also cause temporary or permanent losses.

 

Types of stroke

Symptoms

Risk factors 

Emergency treatment 

Intravascular clot-dissolving drug treatment (Thrombolysis)

Angiographic clot removal treatment (Thrombectomy)

Prevention of a new stroke that can recur

Drug treatments for the source of the clot

Surgical treatment

Interventional treatments

Types of stroke

Ischemic Stroke:

Ischemic stroke occurs when vessels are blocked by blood clots or plaques and fat deposits over time. 85% of all strokes are ischemic strokes.

 

Bleeding Stroke:

A bleeding stroke occurs when blood leaks from a blood vessel in the brain to the brain. Its incidence is much less than ischemic stroke. However, it is responsible for 30% of deaths due to stroke.

 

Stroke symptoms

Sudden numbness and weakness in the arm or leg, especially on only one side of the body.

Confusion, difficulty speaking, and understanding.

Loss of vision in one or both eyes

Sudden and severe headache of unknown cause

Walking difficulties, dizziness, loss of balance and coordination

 

Risk factors that cause stroke
Medical Risk Factors

 

High blood pressure, Diabetes, High cholesterol level, and heart rhythm disorder are known as Atrial Fibrillation.

 

Lifestyle Risk Factors

 

Smoking, sedentary lifestyle, excess weight, bad eating habits.

 

Unmodified Risk Factors

 

Age; 75% of patients who have had a stroke are around 60 years old—doubles every ten years after the age of 60.

Gender; It is more common in men over 55 years old than women. As age progresses, the rate of stroke increases in women.

The risk of a new stroke after a previous ischemic stroke and a short-stroke is quite high.

 

High blood pressure, high cholesterol, and smoking are the most critical risk factors for stroke. Approximately half of the Turkish people carry at least one of these three risk factors.

Stroke | Stroke Symptoms | Ischemic Stroke
Stroke Brain Blood Circulation

 

Emergency treatment of stroke

Its treatment should be done as soon as possible. When the brain vessel is blocked, damage to the brain tissue begins to occur. This damage expands as you wait. When the clogged vessel is large and the time is longer brain damage increases.

Opening the vein as soon as possible prevents all of them from expanding the damage to the brain tissue. In the brain tissue, the less restricted the damage caused by the stroke, the sooner and faster we can recover. Therefore, rapid treatment means early and quick recovery when it comes .

 

Intravascular clot-dissolving drug treatment (Thrombolysis)

It is the intravascular clot-dissolving drug application that can be performed within the first 4.5 hours at the latest after stroke symptoms begin. Its ideal is to do it as soon as possible. This treatment dissolves the clot and helps the blood flow to recover quickly and effectively, thereby improving the stroke.

 

If the patient’s condition is not suitable for the application of this treatment or if the period since the occurrence of stroke has been prolonged, intravenous anticoagulant therapy cannot be performed. Your doctor will resort to other medications and methods in treatment.

 

Angiographic clot removal treatment (Thrombectomy)

If the main vessels feeding the brain are clogged with a clot, clot-dissolving medication, intravenous thrombolysis, which is applied through a vein, is not sufficient to dissolve the clot mass in these large vessels. In this case, the primary purpose of the treatment is to find the brain vessel clogged with angio method and remove the clot with select devices. The ‘angiographic clot removal treatment’ applied in the first 6 hours is so useful that 1 out of 3 patients who are treated ultimately return to their former lives.

One of these two treatment applications is not used as an alternative to the other. On the contrary, it is used as complementary and success enhancing.

Stroke | Stroke Symptoms | Ischemic Stroke
Brain Inflammation Stroke

 

Prevention of a new stroke that can recur

It is essential to prevent  recurrence by applying all the necessary research about the cause of the patient’s stroke after emergency its treatment.

 

Drug treatments for the source of the clot

Antithrombotic drugs prevent clot formation that can cause  in the brain vessels and prevent the growth of blood clots that form. There are two different drug subgroups in this drug group.

 

Antiplatelet drugs

These are drugs called plaques in arteries that prevent clots from forming on uneven surfaces that cause stenosis. Aspirin is a drug that belongs to this group.

 

Anticoagulant drugs

They are drugs that prevent the formation of a clot in the blood vessels, the growth of the formed clot and its breaking into the circulation (embolism). Especially atrial fibrillation, aIt is used in the prevention of clots that may occur due to the blood buried in the chambers of the heart due to the deterioration of the contraction pattern of the heart in the given rhythm of the heart.

Stroke | Stroke Symptoms | Ischemic Stroke
Two Kinds of Stroke

 

Surgical treatment

Endarterectomy Treatment

The carotid arteries are the vessels on both sides of the neck that provide blood flow to the brain. It is a treatment method in which the plaques that cause narrowing in this vein are removed from the vessel wall by reaching the carotid artery through an incision. Opened from the front of the neck when there is stenosis or obstruction.

 

Interventional treatments

Angioplasty application

Entering from the groin with a special catheter is advanced to the region where the vein is narrowed due to plaque in the brain. When the vein’s narrow part is reached, the balloon at the end of the catheter is inflated to open the narrowed part of the thread and expand the vein diameter. Thus, there will be an improvement in blood flow to the brain.

 

STENTING TREATMENT

With a special catheter entered through the groin, the vein’s narrowed area in the brain due to plaque is reached. If necessary, the balloon on the catheter is inflated, and the narrow part is expanded. Then, a stent (mini cage made of openable steel) is placed in the small area of ​​the vein to expand the thin section of the vain. The blood flow to the brain is improved.

Video Courtesy: Mechanisms in Medicine

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