Treatment for  Stroke

Medical 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. 

Emergency treatments for stroke: 
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 used to treat or  prevent a stroke: 

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®) and enoxaparin (Lovenox®). 
• 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®) or dipyridamole (Aggrenox®). 
• medications  to treat existing medical conditions such as diabetes, heart, or  blood pressure problems 

Types of surgery  to treat or prevent  a stroke: 

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. 
• Patent foramen ovale (PFO) closure  the foramen ovale is an opening  that occurs in  the wall between  the two upper chambers  of a baby's heart before birth. It functions  to provide oxygen-rich  blood to  the baby from  the mother's placenta  while in the womb. This opening normally closes soon after birth. If  the flap does not close, blood flows from  the right atrium  directly to the left atrium. It then flows out  to the central circulation  of the body. If this blood contains any clots  or air bubbles, they  can pass  into the brain circulation causing  a stroke or transient ischemic attack (TIA). PFO closure procedure  can be performed  through a percutaneous (through  the skin) approach. Signs  and symptoms  of a PFO  may not occur until early or middle adulthood  and may even go undetected. 

Constraint-Induced Therapy (CIT) for arm  and hand paralysis after stroke: 

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. 

Notes: DrJMinor

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EditText of this page (last edited December 24, 2009)