STROKE TREATMENT
ACUTE STROKE
The stroke response team at UCI Medical Center acts swiftly to stabilize vital signs, definitively diagnose the stroke, locate the precise site of the blood vessel blockage or breakage, and if appropriate, administer highly specialized clot dissolving drugs.
- Management of ischemic and hemorrhagic stroke
There are a number of principles that guide management of acute stroke, whether ischemic or hemorrhagic in nature. Examples include careful attention to blood pressure, temperature, swallowing function, cardiac status, and physical and occupational therapy.
- Clot-busters for acute ischemic stroke
An important new treatment for reducing disability after ischemic stroke is the FDA-approved clot-busting drug tPA, which must be administered through a vein within a three-hour window from the onset of stroke symptoms. Generally, only 2-3 % of U.S. stroke patients reach the hospital in time to be considered for this treatment.
For patients who arrive at the hospital too late for clot-busters through the vein, the still experimental intra-arterial (IA) tPA treatment, which uses a catheter to deliver tPA directly to the spot in the brain where the artery is blocked, extends the treatment window to six hours. However, this therapy requires the skills of a highly trained neurointerventional physician.
PREVENTATIVE TREATMENT
- Antiplatelet/Anticoagulant Drugs
Antiplatelet agents such as aspirin and anticoagulants such as coumadin interfere with the blood's ability to form new blood clots. These drugs can play an important role in preventing an ischemic stroke.
- Carotid Endarterectomy
Carotid endarterectomy is a procedure in which a blockage in an internal carotid artery is surgically removed to improve blood flow to the brain and to decrease the risk of stroke.
- Angioplasty/Stents
Doctors sometimes repair narrowed arteries with a procedure known as balloon angioplasty, which is sometimes accompanied by implantation of a mesh tube called a stent.
REHABILITATION
- After a patient with acute stroke is stabilized, an appropriate rehabilitation strategy is formulated by a team of experts.
HEMORRHAGIC STROKE
- Surgical Intervention
For hemorrhagic stroke due to a rupture of an aneurysm, treatment is generally recommended to avoid further hemorrhage. Treatment can include neurosurgical placement of a metal clip at the base of the aneurysm, or minimally invasive neurointerventional placement of material, such as coils, to clog the aneurysm from within. For an arteriovenous malformation (AVM), removal of the abnormal vessels may be necessary, via either/both approaches.