If you or a person you are with could be having a stroke, call 911. When you are connected, state that you or the person you are with is having a stroke and that you need to go to the closest Stroke Treatment Center.
A stroke is a life-threatening, potentially disabling medical emergency that requires immediate medical evaluation and treatment. Call 911 if you or someone with you experiences these symptoms:
- A feeling of numbness or weakness in the face, arm or leg. You might notice it on one side of the body more than the other.
- Vision problems in one or both eyes
- Dizziness or loss of balance
- Difficulty with walking
- Problems with speaking or understanding what other people are saying
- Severe headaches without warning or explanation
Women may experience the same stroke symptoms as men, but they have also reported a few other symptoms that may come on suddenly or unexpectedly.
- Pain in the face or legs
- Feeling week all over
- Chest pain
- Shortness of breath
- Rapid heartbeat
Timing is everything when it comes to surviving and recovering from a stroke because time is brain. Every second that passes could mean the loss of more brain function, which affects your ability to think, walk and talk.
What to Expect at the Hospital
After you call 911 and help arrives, the emergency response team in the ambulance and at the hospital or clinic will work to stabilize and monitor your blood pressure, temperature, heart rate and breathing. Next, physicians and other members of the healthcare team will order tests, such as a CT scan or MRI make the diagnosis.
If your doctor determines that you had a stroke, he or she must quickly determine if the stroke was ischemic or hemorrhagic.The treatment will be different depending on the type as stroke as well as your unique circumstances, such as your age and other risk factors.
Treatment for Ischemic Stroke
An ischemic stroke happens when blood flow to the brain is restricted or blocked. Once the cause of the ischemic stroke is determined, the doctor may give a dose of aspirin or other drugs to thin the blood. Even if you think that you are having a stroke, do not take aspirin before coming to the emergency room. If you are having a hemorrhagic stroke, aspirin could increase bleeding.
Opening Blocked Arteries
If a patient who has an ischemic stroke arrives at the hospital in time, he or she may be given a clot-dissolving medicine called t-PA (tissue plasminogen activator). Patients who receive t-PA within the first three hours after their first symptoms of stroke seem to have a better chance of recovering and have fewer complications.
Unfortunately, fewer than 5 percent of patients who have ischemic strokes receive this treatment because they don’t make it to the hospital in time or they are they are not diagnosed quickly enough after they arrive.
That’s why it’s important to go to a primary or comprehensive stroke treatment center. These centers are certified as meeting certain requirements, for example, having testing equipment, such as CT scanners and MRI machines available on a 24-hour emergency basis and keeping doctors close at hand to read and interpret the results. Stroke treatment centers also have physicians and other healthcare professionals who specialize in recognizing and treating stroke.
Other treatments for ischemic stroke include:
- Surgery—A carotid endarterectomy is a surgical procedure that removes blockages from arteries in the neck that supply blood to the brain.
- Interventional procedures—Physicians also use balloon angioplasty and stenting to open up the artery blocked or narrowed by the build-up of fatty deposits, or plaque.
Carotid Artery Stenting
Carotid artery stenting involves inserting a small plastic tube (catheter) through an artery in the leg and threading it through the blood vessels to the blockage in the neck arteries. A thin wire (guidewire), which has a collapsible umbrella-like filter device attached to its end, is advanced via the catheter to a point just beyond the blockage.
When opened, the “umbrella” filters the blood flowing to the brain, preventing bits of plaque or blood clot from passing to the brain and causing stroke. The blocked artery is widened by inflating a tiny balloon inside vessel. This pushes the plaque against the artery’s walls and makes way for the stent, a small metal tube that is inserted to prop open the artery. Once the stent is in place, the umbrella filter and catheter are removed.
Treatment of Hemorrhagic Stroke
A hemorrhagic stroke occurs when a blood vessel in the brain bursts or weakens, allowing blood to leak into the brain. With this type of stroke, it is very important to control the bleeding. This is why it is very important to NOT take aspirin or any other blood-thinning medication before going to the emergency room for a possible stroke.
Like ischemic stroke, hemorrhagic stroke can be treated with surgery or interventional procedures. Depending on the stroke’s cause, your doctor may choose one of the following procedures:
- Aneurysm clipping. If your stroke results from an aneurysm in the brain, your doctor may place a clamp at the base of the aneurysm. This separates the aneurysm from the artery to which it is attached to prevent it from bursting or re-bleeding if it has already leaked blood.
- Coiling (aneurysm embolization). In this procedure, a small thin tube (catheter) is used to deliver a tiny coil to fill an aneurysm. This seals the aneurysm off from connecting arteries, and reduced the risk of rupture.
- Surgical removal of malformed arteries in the brain (AVM). Surgical removal of malformed vessels in the brain may be possible if they are not too large and are accessible. Removal eliminates the possibility of their rupture and lowers the risks of hemorrhagic stroke.
Stroke care has come a long way. Physicians have learned a lot from treating heart disease with angioplasty and stenting, and they have transferred that knowledge to treating strokes. Neuro-rescue stroke treatments are revolutionizing stroke care. Emergency medical responders, hospitals and clinics are establishing and improving systems to help patients get the help they need as quickly as they need it.
Treatment of Patent Foramen Ovale (PFO)
A hole in the heart called a PFO (patent foramen ovale) is a type ofheart defectthat may increase the risk of stroke and migraine headaches. We are all born with a trap-door-like opening between the upper left and upper right chambers (atria) of the heart. For most of us, the hole closes soon after birth. For the other 20 percent, the hole never closes on its own. The PFO can be closed during open-heart surgery or with less invasive interventional procedures.
Ongoing Care After a Stroke
During the first few hours and days after a stroke the patient is at great risk of having another stroke. Stroke patients are also very susceptible to serious complications that can include seizures, brain swelling and infections, such as pneumonia. It will take time to assess how much damage was done by the stroke. Although the brain will begin to adapt and change its way of functioning to accommodate the loss of some of its parts, it can take a long time.