There are two major categories of stroke:
- Ischemic is the most common form of stroke and is caused by a blockage in the blood vessel that prevents oxygen and nutrients from getting to the brain.
- Hemorrhagic stroke is when blood vessel(s) burst and bleed into the brain.
Gundersen offers many treatment options to restore blood flow to the brain and reverse the debilitating effects of ischemic stroke:
- t-PA which stands for tissue plasminogen activator, Activaseâ is the drug (read move in depth below)
- Clot extraction (thrombectomy) is a treatment to remove the blood clot(s) from arteries leading to, or in, the brain. A thin tube called a catheter is placed into an artery and guided to the location of the clot. Then a tiny retrieval device is maneuvered to that area and collects the blood clot(s) and removes them through the catheter.
- Angioplasty and stenting of the carotid, veterbral and intracranial arteries. This allows the surgeon to open an artery that has narrowed to allow for more blood flow and reduce the risk for stroke. A stent (a wire mesh tube) is placed in the artery where the narrowing existed to help keep the artery open.
- Carotid endarterectomy is a surgery to remove plaque or debris from the major neck artery called the carotid. The goal of this surgery is to improve blood flow to your brain and reduce your risk of stroke.
- The procedure choice depends on multiple medical factors and often patients receive a combination of treatments.
With ischemic stroke, doctors can give patients a clot dissolver called t-PA that can minimize the severity of a stroke. tPA is a medication that dissolves blood clots. It is called a thrombolytic agent or more commonly referred to as the "clot buster." It is an intravenous or IV medication usually given through a catheter inserted into a vein in the arm.
tPA has been approved to treat brain attacks in the first three hours following the onset of symptoms. If given promptly, 1 in 3 patients who receive tPA resolve their symptoms or have major improvement in their stroke symptoms.
Waiting until morning, the end of a golf game or meeting may be too late. Every minute that goes by without blood flow to the brain can mean more damage to brain cells.
People who have experienced an ischemic stroke will be seen in Gundersen Neurosciences department for follow-up care.
Transient ischemic attack (TIA)
A transient ischemic attack (TIA) is a "mini stroke." The symptoms are the same as a stroke, but only last a few minutes or hours. If someone suffers these symptoms, they should present to the emergency room for immediate evaluation. These symptoms could be a warning sign of a stroke. About 15% of strokes are preceded by TIAs, so it's important for people to see a doctor immediately.
Gundersen takes mini strokes very seriously. When someone is seen in the emergency room for a mini stroke, staff provides a full evaluation right in the ER. This is not true in all emergency rooms. Gundersen believes it's important to know a patient's risk as soon as possible so a more serious stroke could potentially be prevented.
Depending on the results of the tests done in the emergency room, the patient may be admitted into the hospital or sent home with an appointment scheduled in the Vascular Institute. Our vascular specialists offer treatments to help prevent a more serious stroke.
A hemorrhagic (hehm-or-AA-jik) stroke happens when there is bleeding into the brain. The bleeding comes from a leak in a blood vessel. This can be caused by high blood pressure or a defect in the blood vessel.
The cause and location of the bleeding must be found first. Treatments may be used together or by themselves. Those treatments include:
- Medicines may be used to:
- Help control blood pressure
- Control bleeding
- Keep brain swelling down
- Manage seizures (if needed)
- Embolization (em-BO-lie-ZAY-shun)
- A treatment to close off the leaking blood vessels. A thin plastic tube (catheter) is threaded through a blood vessel into the brain. The tube injects tiny coils or special glue to close off the harmful vessels. This helps prevent more bleeding into the brain.
People who have experienced a hemorrhagic stroke will be seen in Gundersen Neurosciences department for follow-up care