Stop a Stroke from Striking you Paralytic

Atherosclerosis (narrowing of blood vessels) is a disease that affects any vessel in the body. A heart starved of blood supply cries of pain (heart attack). On the other hand, reduced blood supply to the brain just manifests as a stroke. There are certain warning signs of stroke. These include temporary loss of power in hand or leg, loss of vision for a few moments, temporary speech loss, giddiness, etc.

Every second counts

Once a patient is brought to the hospital, he is scanned to locate the narrowed blood vessels. These are picked up by either Doppler studies or with CT or MR angiographies. The narrowed blood vessels once detected will lead to a catastrophic stroke, and hence need to be treated. Traditionally narrowed blood vessels in the neck are treated by open surgery. Now the same block can be treated through pinhole surgeries. Blocks anywhere in the neck or brain blood vessel can be accessed with a catheter followed by dilatation with balloon and stent placement.

Using the arterial highway

Navigating the balloons and stents through the arteries, from the groin requires a sophisticated digital cathlab with facilities for 3D angiography, subtraction angiography and road mapping. The availability of better quality stents, good guide wires and sophisticated equipments with a well-trained team have made these procedures more popular with fewer complications. Prevention is better than cure any day and identification of critical blocks in the blood vessels to brain and treating them with angioplasty and stenting would help in stroke prevention. After stenting patients need to be on antiplatelet medication.

What if a stroke occurs?

It is very important that the patient is rushed to hospital within 3 hours. If there is a block it can be treated by administration of thrombolytic agents either intravenously or intra arterially to dissolve the clots. In fact initiation of therapy within the first 3- 6 hours is critical for restoration of neurological function. Other interventional procedures performed in brain blood vessels, include:

(1) Aneurysm in Brain: Aneurysm is a bulge in brain blood vessels that may rupture and cause bleeding with devastating effects. These aneurysms need to be treated before they rupture once again. For these conditions a catheter can be taken from the groin and coils deposited into the aneurysm preventing bleeding. There is no need for opening up of the skull to do these procedures.

(2) AVM of brain: Can treated by injecting a liquid agent into an AV malformation and blocking it.

(3) Treatment of carotid cavernous fistula: This condition leads to painful bulging of eyes. These can also be treated by embolisation (blocking) with balloons or coils.

(4) Thrombolysis of venous thrombosis: Blocks in the veins of brain can be tackled by taking a catheter directly into thrombi and using thrombolytic agents.