Stroke Treatments

Time is a Critical Factor

Since over 80 percent of strokes are the result of a blocked artery (ischemic stroke) getting to the Emergency Department as soon as possible can allow some patients to receive clot-dissolving treatments that attempt to lessen the severity of the stroke and brain damage. These treatments can help if given within the first 3 hours of stroke. There are many factors involved when determining the best treatment. A stroke patient may or may not qualify for, or benefit from, clot-dissolving medicines or procedures.

Comprehensive Treatment for Stroke at St. Charles

At St. Charles, comprehensive diagnosis and treatment of each type of stroke is something we take very seriously. Our multi-disciplined team of stroke specialists works quickly in an extremely coordinated, systematic way to increase your chances for recovery and prevent stroke reoccurrence and complications.

Treatment of stroke has evolved in recent decades. Over the past 20 years, stroke pioneers have developed better ways to control stroke risk factors, lessen stroke severity and damage, and keep strokes from reoccurring. Therapies and strategies have also been developed to reduce complications and improve rehabilitation after stroke.  For example, leg clots (deep veinous thrombosis) and lung clots (pulmonary emboli), once common after stroke, are now prevented with blood thinning medications. 

In general, we use cutting-edge medicine, procedures and technology to:

• Identify the type of stroke
• Determine the best treatment for each type of stroke and individual patient
• Reduce the stroke’s size and severity of a stroke in an attempt to lessen brain damage
• Prevent stroke and stroke reoccurrence
• Rehabilitate for improved function after the damaging effects of a stroke

We offer a wide array of modern treatment options, including clot-dissolving medications, surgical and non-surgical procedures and other therapies to treat and prevent strokes, including:

Testing is a critical part of stroke care and must be performed very quickly and thoroughly since every minute counts when treating a stroke patient. Testing also helps us to identify the causes for stroke in an effort to prevent them from happening, reoccurring or developing complications.

Tests can include some of the following:

• Complete blood count (CBC ): measures the number of red and white blood cells, the total amount of hemoglobin in the blood, the fraction of the blood composed of red blood cells and the size of the red blood cells
• Platelet count: measures how many blood cells (platelets) are in your blood. Platelets help the blood clot
• Bleeding time: tests how fast small blood vessels close to stop you from bleeding
• Prothrombin time (PT): measures the time it takes for the liquid part (plasma) of your blood to clot
• Liver function tests: measures and monitors liver function
• Kidney function tests: measures how the kidneys are functioning
• Head CT scan: Computed tomography (CT), also referred to as a computed axial tomography CAT scan, uses x-rays to create cross-sectional pictures of the head
• Head MRI : Magnetic resonance imaging (MRI ) uses powerful magnets and radio waves to produce clear, detailed pictures of brain tissue
• Cerebral angiography or spiral CT scan angiography: taken of the head to evaluate brain blood vessels

Medications that we use for stroke may include blood thinners and anti-platelets to prevent stroke recurrence and leg clots (DVTs), corticosteroids or diuretics to reduce swelling, and anticonvulsants to control seizures. Blood, blood products, and intravenous fluids may also be needed.

In general, the three groups of different types of medications we use to treat stroke are:

• Thrombolytics are clot-dissolving medications that can optimize the degree of recovery in some patients. However, these medications must be injected within the first 3 hours of the stroke; in fact, the sooner the better.
• Anticoagulants are also called blood thinners and may be given to a patient following a stroke to reduce the ability of the blood to clot. In some causes of stroke, such as atrial fibrillation(irregular heartbeat), anticoagulants can help to prevent strokes from happening or reoccurring by preventing clots from forming.
• Antiplatelet medications can be given during or immediately after a stroke to prevent stroke recurrence. While these medications thin blood like anticoagulants, they work differently to prevent platelets from forming clots.

Surgery and other therapies are used when medications cannot provide the entire solution for a stroke condition. Common surgeries and procedures our specialized physicians perform include:

• Carotid endarterectomy is a surgical procedure to remove plaque buildup from arteries in the neck (carotid).
• Revascularization (Bypass) is asurgical procedure to create a new route for blood to reach the brain, usually by grafting another blood vessel.
• Interventional Neuroradiology offers procedures for the treatment of complex problems that affect the blood vessels within the brain. State-of-the-art equipment is used to treat or prevent stroke, brain aneurysms, arterio-venous malformations and tumors in the brain.

Endovascular therapy is one kind of interventional neuroradiology treatment that uses catheters to deliver medications and deploy devices into specific arteries. For example, angioplasty is a surgical procedure that widens the inside of an artery. A balloon-tipped catheter inserted into the clotted artery, then inflated to compress the plaque against the artery walls. A metal mesh tube (stent) is usually left in the artery to prevent recurrent narrowing.