Treatments and Prevention of Stroke

Stroke: Treatments and Prevention

Treatments for stroke

As the two main different kinds of stroke, ischemic and hemorrhagic, are caused by different factors, both require different forms of treatment. It is not only important that the type of stroke is diagnosed quickly to reduce the damage done to the brain, but also because treatment suitable for one kind of stroke can be harmful to someone who has had a different kind.
Ischemic stroke

Ischemic strokes are caused by arteries being blocked or narrowed and so treatment focuses on restoring an adequate flow of blood to the brain.

Treatment can begin with drugs to break down clots and prevent further ones from forming. Aspirin can be given, as can an injection of a tissue plasminogen activator (TPA). TPA is very effective at dissolving clots but needs to be injected within 4.5 hours of stroke symptoms manifesting themselves.
Carotid endarterectomy
Surgeons are able to remove plaque and any other obstructions from the carotid artery through surgery.

Emergency procedures include administering TPA via catheter directly into an artery in the brain or using a catheter to physically remove the clot from its obstructive position. Recent studies have cast doubt as to the effectiveness of these methods, and so research is still ongoing as to how beneficial these procedures are.

There are other procedures that can be carried out to decrease the risk of future strokes or TIAs. A carotid endarterectomy involves a surgeon opening the carotid artery and removing any plaque that might be blocking it.

Alternatively, an angioplasty involves a surgeon inflating a small balloon in a narrowed artery via catheter and then inserting a stent (a mesh tube) into the opening in order to prevent the artery from narrowing again.
Hemorrhagic stroke

Hemorrhagic strokes are caused by bleeding into the brain and so treatment focuses on controlling the bleeding and reducing the pressure on the brain that it is causing.

Treatment can begin with drugs being given to reduce the pressure in the brain, overall blood pressure, prevent seizures and prevent sudden constrictions of blood vessels. If the patient is taking anti-coagulant or anti-platelet medication like Warfarin or Clopidogrel, they can be given drugs or blood transfusions to counter the medication's effects.

Surgery can be used to repair any problems with blood vessels that have led or could lead to hemorrhagic strokes. Surgeons can place small clamps at the base of aneurysms or fill them with detachable coils to stop blood flow to them and prevent rupture.

Surgery can also be used to remove small arteriovenous malformations (AVMs) if they are not too big and not too deep within the brain. AVMs are tangled connections between arteries and veins that are weaker and burst more easily than other normal blood vessels.14
Rehabilitation

Strokes are life-changing events that can affect a person both physically and emotionally, temporarily or permanently. After a stroke, successful recovery will often involve specific rehabilitative activities such as:

Speech therapy - to help with problems producing or understanding speech. Practice, relaxation and changing communication style, using gestures or different tones for example, all help
Physical therapy - to help a person relearn movement and co-ordination. It is important to get out and about, even if it is difficult at first
Occupational therapy - to help a person to improve their ability to carry out routine daily activities, such as bathing, cooking, dressing, eating, reading and writing
Joining a support group - to help with common mental health problems such as depression that can occur after a stroke. Many find it useful to share common experiences and exchange information
Support from friends and family - to provide practical support and comfort. Letting friends and family know what can be done to help is very important.

7 things you can do to prevent a stroke
Regardless of your age or family history, a stroke doesn't have to be inevitable. Here are some ways to protect yourself starting today.

             prevent stroke

Age makes us more susceptible to having a stroke, as does having a mother, father, or other close relative who has had a stroke.

You can't reverse the years or change your family history, but there are many other stroke risk factors that you can control—provided that you're aware of them. "Knowledge is power," . "If you know that a particular risk factor is sabotaging your health and predisposing you to a higher risk of stroke, you can take steps to alleviate the effects of that risk."

Here are seven ways to start reining in your risks today, before a stroke has the chance to strike.

1. Lower blood pressure

High blood pressure is a huge factor, doubling or even quadrupling your stroke risk if it is not controlled. "High blood pressure is the biggest contributor to the risk of stroke in both men and women," . "Monitoring blood pressure and, if it is elevated, treating it, is probably the biggest difference women can make to their vascular health."

Your ideal goal: Maintain a blood pressure of less than 120/80. But for some, a less aggressive goal (such as 140/90) may be more appropriate.

How to achieve it:

Reduce the salt in your diet to no more than 1,500 milligrams a day (about a half teaspoon).
Avoid high-cholesterol foods, such as burgers, cheese, and ice cream.
Eat 4 to 5 cups of fruits and vegetables every day, one serving of fish two to three times a week, and several daily servings of whole grains and low-fat dairy.
Get more exercise — at least 30 minutes of activity a day, and more, if possible.
Quit smoking, if you smoke.

If needed, take blood pressure medicines.

1. Lose weight

Obesity, as well as the complications linked to it (including high blood pressure and diabetes), raises your odds of having a stroke. If you're overweight, losing as little as 10 pounds can have a real impact on your stroke risk.

Your goal: Keep your body mass index (BMI) at 25 or less.

How to achieve it:

Try to eat no more than 1,500 to 2,000 calories a day (depending on your activity level and your current BMI).
Increase the amount of exercise you do with activities like walking, golfing, or playing tennis, and by making activity part of every single day.

1. Exercise more

Exercise contributes to losing weight and lowering blood pressure, but it also stands on its own as an independent stroke reducer.

Your goal: Exercise at a moderate intensity at least five days a week.

How to achieve it:

Take a walk around your neighborhood every morning after breakfast.
Start a fitness club with friends.
When you exercise, reach the level at which you're breathing hard, but you can still talk.
Take the stairs instead of an elevator when you can.
If you don't have 30 consecutive minutes to exercise, break it up into 10- to 15-minute sessions a few times each day.

1. Drink — in moderation

What you've heard is true. Drinking can make you less likely to have a stroke — up to a point. "Studies show that if you have about one drink per day, your risk may be lower," . "Once you start drinking more than two drinks per day, your risk goes up very sharply."

Your goal: Drink alcohol in moderation.

How to achieve it:

Have one glass of alcohol a day.
Make red wine your first choice, because it contains resveratrol, which is thought to protect the heart and brain.
Watch your portion sizes. A standard-sized drink is a 5-ounce glass of wine, 12-ounce beer, or 1.5-ounce glass of hard liquor.

1. Treat atrial fibrillation

Atrial fibrillation is a form of irregular heartbeat that causes clots to form in the heart. Those clots can then travel to the brain, producing a stroke. "Atrial fibrillation carries almost a fivefold risk of stroke, and should be taken seriously," .

Your goal: If you have atrial fibrillation, get it treated.

How to achieve it:

If you have symptoms such as heart palpitations or shortness of breath, see your doctor for an exam.
You may need to take blood thinners such as high-dose aspirin or warfarin (Coumadin) to reduce your stroke risk from atrial fibrillation. Your doctors can guide you through this treatment.

1. Treat diabetes

Having high blood sugar damages blood vessels over time, making clots more likely to form inside them.

Your goal: Keep your blood sugar under control.

How to achieve it:

Monitor your blood sugar as directed by your doctor.
Use diet, exercise, and medicines to keep your blood sugar within the recommended range.

1. Quit smoking

Smoking accelerates clot formation in a couple of different ways. It thickens your blood, and it increases the amount of plaque buildup in the arteries. "Along with a healthy diet and regular exercise, smoking cessation is one of the most powerful lifestyle changes that will help you reduce your stroke risk significantly," .

Your goal: Quit smoking.

How to achieve it:

Ask your doctor for advice on the most appropriate way for you to quit.
Use quit-smoking aids, such as nicotine pills or patches, counseling, or medicine.
Don't give up. Most smokers need several tries to quit. See each attempt as bringing you one step closer to successfully beating the habit.