Stroke – Diagnosis and Treatment

Stroke – Diagnosis and Treatment

Stroke (brain stroke or cerebrovascular stroke) is a condition which occurs due to reduced supply of blood to the brain because of a blockage or bleeding of the blood vessels. In this condition, the brain cells start to die due to lack of oxygen.

It can be classified into two types based on the underlying cause. If the stroke occurs due to a blockage or clot, then it is called ischemic stroke and if it is due to or leakage bleeding, then the condition is called hemorrhagic stroke.

Diagnosis

As soon as you enter the emergency department, assessment of symptoms is done and an imaging test such as CT or MRI scan is performed to determine the type of stroke you have. It also helps to rule out other possible causes of the stroke such as brain tumor.

Treatment

Ischemic stroke

In case of ischemic stroke, doctors must quickly restore blood flow to your brain. In these cases, emergency IV medication can be given to dissolve the clot within 4.5 hours of the onset of symptoms. This helps in reduction of symptoms as well as prevention of complications.

Emergency endovascular procedures (mechanical thrombectomy) help to treat ischemic stroke directly by opening the blocked blood vessel. It can be done in cath lab under local anesthesia or at times general anesthesia. It is not an open surgery. In this procedure, clot in brain artery can be removed using a stent retriever/ suction catheter. This procedure is beneficial in patients with large vessel occlusion. It can be done even after tPA.

Hemorragic stroke

Hemorrhagic stroke can be treated by controlling the bleeding and reducing pressure in your brain. Surgery is performed to decrease the intracranial pressure and remove causes such as an aneurysm or arteriovenous malformation (AVM).

Surgical clipping is a procedure in which a tiny clamp is placed at the base of the aneurysm to stop the haemorrhage.

In endovascular embolization (coiling) without open surgery, a catheter is inserted into the artery in your groin and guided to the brain. Using the catheter, tiny detachable coils are placed into the aneurysm to fill it. Intracranial bleeding secondary to arteriovenous malformation (AVM) or arteriovenous (AV) fistula can also be treated by endovascular embolization.