There are two major categories of stroke:
- Ischemic is the most common form of stroke and is caused by a blockage in a blood vessel in the brain. The blockage prevents blood, oxygen and nutrients from getting to the brain.
- Hemorrhagic stroke is when blood vessel(s) burst (subarachnoid hemorrhage) or leak blood into the brain (intracerebral hemorrhage).
Gundersen offers many treatment options to restore blood flow to the brain which can minimize the debilitating effects of ischemic stroke. Treatment depends on multiple medical factors and a combination of options may be used:
- Tissue plasminogen activator (t-PA) is a medication that dissolves a clot. This "clot-buster" has been approved to treat ischemic strokes in the first three hours following the onset of symptoms. When t-PA is given promptly, a person's functional outcome is better compared to those who did not receive the t-PA.
- Certain patients can be treated with t-PA up to four-and-a-half hours following the onset of symptoms.
- In some cases, we can perform a thrombectomy which is a procedure to remove the blood clot(s) from arteries leading to, or in, the brain from inside the vessel using a special clot-removal device.
- Plaque or debris can clog the carotid (the major neck artery) resulting in stroke. Plaque removal can happen via a minimally invasive technique called carotid stenting, or via surgery known as carotid endarterectomy. Both procedures improve blood flow to the brain and reduce the risk of future stroke.
People who have experienced an ischemic stroke will be seen in Gundersen Neurosciences for follow-up care.
Transient ischemic attack
A transient ischemic attack (TIA) is sometimes called a "mini stroke," but is considered a major warning sign that a stroke could be pending. TIA is a medical emergency. The symptoms are the same as a stroke, but only last a few minutes or hours. If someone suffers these symptoms, it is essential that they call 911 right away!
Patients seen for a TIA are given a full evaluation right in our Emergency Services. Knowing a patient's risk and potential cause of a pending stroke provides the opportunity to prevent a 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 (intracerebral hemorrhage), or an aneurysm that bursts (subarachnoid hemorrhage). 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 include:
- Medicines to:
- Help control blood pressure
- Control bleeding
- Keep brain swelling down
- Manage seizures (if needed)
- Coiling is a minimally invasive surgical treatment to repair a vessel that has an aneurysm
- Surgical clot removal
People who have experienced a hemorrhagic stroke will be seen in Gundersen Neurosciences for follow-up care.