Time Saves Brain-Treating Brain Hemorrgages

Strokes are treated differently depending on the underlying reasons. Treatment depends on the type of stroke. In the case of Ischemic strokes that are strokes caused due to blocked blood vessels, the blocks need to be removed as early as possible.

Emergency Treatment

Therapy with clot-busting drugs must start within three hours. Quick treatment not only improves chances of survival, but may also reduce the amount of disability resulting from the stroke. TPA (Tissue Plasminogen Activator) is a very potent drug which can be given intravenously within 3 hours. The Interventional Radiologist can give the same drug directly into the blocked artery by taking a small catheter from the groin into brain. Alternatively he can also give Pro Urokinase directly into the blocked vessel within 6 hours.

Regular Treatment

A patient lands up after 6 hours he is put on regular anti platelet and anticoagulant medications along with physiotherapy and rehabilitation. Stroke Prevention Surgeries: This includes surgical and other procedures to open up an artery that’s moderate to severely narrow by plaques: The first is the Carotid Angioplasty and Stenting: In this procedure, a balloon-tipped catheter is maneuverer into the obstructed area of the artery. The balloon is inflated, compressing the plaques against the artery walls. A metallic mesh tube (stent) is usually left in the artery to prevent recurrent narrowing. Distal protection devices also may be used with angioplasty. The second is the Carotid Endarterectomy is a surgical procedure where the surgeon opens up the blocked blood vessel through open surgery.

What are the Preventive Medications for Stroke?

Preventive medications: It’s important to determine why the stroke occurred and to prevent another. There are recommended medications to help reduce the risk of having a TIA or stroke. These include:

Anti-platelet drugs: Platelets are cells in blood that initiate clots. Anti-platelet drugs make the platelets less sticky and less likely to clot. The most frequently used anti-platelet medication is aspirin. The other anti-platelet drugs include clopidogrel (Plavix) or ticlopidine (Ticlid).

Anticoagulants: These drugs include heparin and warfarin (Coumadin). They affect the clotting mechanism in a different manner than do anti-platelet medications. Heparin is fast acting and is used over the short term in the hospital. Slower acting warfarin is used over a longer term. These drugs have a profound effect on blood clotting and require that you work with your doctor to monitor them closely.

How to Treat Brain Hemorrgages?

Hypertensive bleeds: Are usually treated conservatively. In case the bleed is very large patient need surgical intervention. Subarachnoid bleeds due to aneurysm Aneurysms are bulges in brain blood vessels which rupture and spill into the coverings of the brain to cause a subarachnoid bleed. Patients have a sudden, severe “thunderclap” headache. After subarachnoid haemorrhage, vessels may go into vasospasm, a condition in which arteries near the haemorrhage constrict erratically, causing brain cell damage by further restricting or blocking blood flow to portions of the brain. Aneurysms need early intervention to prevent re-bleeding. The procedures which are done include aneurysm clipping. A tiny clamp is placed at the base of the aneurysm, isolating it from the circulation of the artery to which it’s attached. This can keep the aneurysm from bursting, or it can prevent re-bleeding of an aneurysm that has recently haemorrhaged. In an embolization procedure, a catheter is maneuverer from the groin into the aneurysm. A tiny platinum coil is pushed through the catheter and positioned inside the aneurysm. The coil fills the aneurysm and seals the aneurysm off from connecting arteries. In this procedure there is no need for opening the skull. The procedure is safer as well.

How is AVM Treated?

It’s not always possible to remove an AVM if it’s too large or if it’s located deep within the brain. Surgical removal of a smaller AVM from a more accessible portion of the brain, though, can eliminate the risk of rupture, lowering the overall risk of haemorrhagic stroke. Other treatment options for AVMs include embolization, in which the small arteries supplying the blood to the AVM are blocked, shrinking the AVM. Radiosurgery or Gamma Knife therapy is another alternative option for treating small AVMs.