Guide To Ischemic Stroke Treatment And Recovery

October 8, 2023

An ischemic stroke is a life-threatening medical emergency where a part of the brain is deprived of its blood supply due to a blockage in the feeding blood vessel. This blockage can be caused by a piece of fatty substance that travels to the affected vessel in the brain and becomes lodged. The blockage may also be caused by a clump of clotted blood that travels to the affected vessel and becomes lodged. Plaque buildup inside of the affected blood vessel in the brain can also result in or exacerbate an impending ischemic stroke. The brain cells are extremely demanding cells when it comes to blood, nutrients, and oxygen. When the brain cells become deprived of these elements, they become damaged and die within minutes. A stroke results in brain function loss that affects numerous organ systems and body parts. Various impairments caused by a stroke make treatment and recovery a lengthy process.

Emergency Medication

A patient who has an ischemic stroke requires immediate medical treatment, which may include the use of certain types of medications to help dissolve the blood clot that caused the stroke. This type of treatment is only effective if the patient reaches the hospital within three hours of the onset of their symptoms. The medicine given is called a thrombolytic medication, and it works through a mechanism where it activates plasminogen, a substance that produces plasmin. Blood clots are made of fibrin molecules, and plasmin can break the links that hold these fibrin molecules together. Thrombolytic medications work more effectively on a patient who has a stroke caused by a recently formed blood clot, as older blood clots have more links between the fibrin molecules the drug must break down. Because the medication is not specific to blood clots, it can cause side effects related to increased and prolonged bleeding.

Surgery To Remove Clot

A patient who has a stroke caused by a substance that cannot be dissolved or is resistant to the use of medication may need to undergo surgery to remove the stroke-causing clot or embolus. This treatment is typically needed in cases when the patient arrives at the hospital over three hours following the onset of their symptoms. Two different surgery types can be used on ischemic stroke patients. A mechanical embolectomy is a procedure where the surgeon uses a microcatheter through the groin to reach the artery in the patient's brain that has become blocked. A small tool is threaded through the microcatheter to the site of the clot that either breaks it up and sucks it out or removes it as a whole. The surgeon uses x-ray guidance to accurately reach the blocked vessel in the patient's brain. Another method used on ischemic stroke patients is called cerebral revascularization, and it works by connecting a graft or artificial vessel to the carotid artery at a point before and after the blockage to create a bypass route for the patient's blood supply.

Long-Term Medication

When an ischemic stroke is the result of certain medical conditions that cause the individual's blood to clot inappropriately or when many blood vessels around the body are affected by atherosclerosis, they may need to be on long-term medication to prevent the recurrence of a stroke. Blood pressure medications may need to be taken in the long-term by patients who have had an ischemic stroke to help prevent further damage to the blood vessels. Medications known to help decrease cholesterol may be needed for the long-term if the stroke is the result of plaque buildup in the blood vessels. Medications considered to be antiplatelet therapy may be necessary for the long-term for patients who have blood that clots excessively and inappropriately. These medications may also be used in conjunction with cholesterol-lowering drugs to help the blood flow through the vessels easier. Antiplatelet therapy may include the use of drugs such as acetylsalicylic acid, dipyridamole, and clopidogrel. Anticoagulants may also be used in the long-term to help reduce hypercoagulability in a patient's blood for the same purposes.

Speech Therapy

Many patients who have an ischemic stroke tend to experience problems with their speech during and after the event if the part of the brain where speech is formed or where speech is interpreted has become damaged. Damage to the nerves responsible for moving the muscles that control the movement of the mouth and tongue to produce sounds can also cause patients to have a communication barrier. Approximately thirty-three percent of all stroke patients experience communication difficulties or aphasia following the event. Speech therapy is useful in the treatment of patients affected by a stroke when they need help with forming sounds and words, cannot swallow properly, are unable to write or read words, and or have difficulty finding the right words to use to convey what they want to say. Speech therapy involves helping the patient regain speech and communication function and helping them adapt to or overcome related functions that are permanently lost. Speech therapy may involve learning to use tools such as gestures, communication charts, drawing, writing, or a letter board to communicate with others.

Physical And Occupational Therapy

Physical and occupational therapy are essential components to the treatment of a patient who experienced an ischemic stroke that has affected their ability to move properly or perform their everyday activities. Physical therapy is needed in cases where a patient experiences weak muscles and is unable to mobilize as they should. Physical therapy focuses on regaining function, strengthening muscles, and maximizing mobility. Occupational therapy is a type of therapy where the patient can learn different ways to overcome any challenges they are faced with as a result of their stroke. Many patients who have an ischemic stroke have to cope with and adjust to some form of permanent function loss. The affected part of the body varies widely from one patient to the next because it is dependent on the part of their brain the stroke damaged. The amount and duration of physical and occupational therapy are also dependent on how severe or how much damage the patient's brain has experienced from the ischemic stroke.

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