Stroke

Alternate Names : Brain Attack, Cerebrovascular Accident, CVA

What are the treatments for the condition?

Most people with strokes are treated right away with only aspirin if they do not have bleeding into the brain. This only serves to help prevent further strokes. In cases when a stroke is caught in the first few hours, a clot-busting medication may be used to reverse a stroke. This is why early recognition of a stroke can be important.

If someone has the early warning signs of stroke, the emergency medical system should be contacted immediately.

These signs include a sudden onset of:

Specific types of medication may be needed in special cases. For instance, those with a heart infection may be given antibiotics. Those with arteritis are often given corticosteroids, such as prednisone, to reduce inflammation in the brain.

If an individual has significant narrowing of the carotid arteries, a carotid endarterectomy may be recommended to widen them. This surgical procedure removes the cholesterol plaques and may prevent future strokes. The decision to perform surgery will depend on the person's neurological status, the type of plaque clogging the artery, and whether the plaque has a break in it, known as a rupture.

Supportive therapy may also be needed with some strokes. This may include an artificial breathing machine, or ventilator, and an artificial feeding tube if the person cannot swallow.

Rehabilitation services can help to improve a person's function after a stroke. Physical therapy and other therapy, such as speech therapy or occupational therapy, may be used to maximize recovery.

What are the side effects of the treatments?

Side effects depend on the treatments used. For instance, aspirin may cause allergic reactions, stomach upset, or bleeding. Clot-busting medications can cause excessive bleeding. A ventilator may sometimes cause damage to the lungs or an infection.

A carotid artery endarterectomy can cause bleeding, infections, and allergic reactions to the anesthesia. On rare occasions, carotid endarterectomy can cause a stroke or heart attack to occur.

What happens after treatment for the condition?

After the person is stable, treatment of the risk factors for stroke, as well as the cause of the stroke, is important to prevent further strokes. For instance, stopping smoking and controlling high blood pressure, diabetes, and high cholesterol are advised for most people.

Those with arteritis are often maintained on medications to reduce inflammation for long periods. Those with clots in the heart are often put on medications to thin the blood, such as warfarin.

Many people need assistance of one form or another after a stroke. This may range from using a walking cane to needing 24-hour-a-day skilled nursing care. Ongoing therapy to improve function is usually advised for at least 6 months if the person is able.

How is the condition monitored?

People having a stroke are often admitted to the hospital for close monitoring. Once the person is stable, he or she can often be sent home or to a skilled nursing facility or rehabilitation center for further therapy.

Other monitoring is related to the cause. For instance, those with clots in their heart need repeat blood tests, such as a PT test, to monitor the effects of medications used to thin the blood. Any new or worsening symptoms should be reported to the healthcare provider.