Stroke Diagnosis & Treatment

Diagnosis

The physicians will determine the most appropriate treatment for stroke, depending on the type of stroke suffered as well as the affected area of the brain. Several tests may be used to determine stroke, including:

  • Physical examination
  • Blood tests
  • Computerized axial tomography (CT)
  • Carotid ultrasound
  • Magnetic resonance imaging (MRI)
  • Cerebral angiogram
  • Echocardiogram

Treatment

Emergency treatment for stroke depends on whether the patient is suffering from an ischemic stroke, the most common stroke in which an artery becomes blocked, or a hemorrhagic stroke, which creates bleeding into the brain.

Treatment for ischemic stroke

The goal of treatment for an ischemic stroke is to restore blood flow to the brain as quickly as possible.

Emergency treatment options

Emergency medications used to treat ischemic stroke include:

  • Aspirin which reduces likelihood of another stroke occurring by thinning the blood and preventing clots from forming in the blood stream.
  • Intravenous injection of tissue plasminogen activator (tPA) which is a drug given to stroke patients through a vein in the arm to dissolve blood clots that must be injected in less than 4.5 hours after stroke symptoms occur.

Physicians may decide to treat an ischemic stroke with emergency procedures depending on the location of the blood clot. Emergency procedures to treat ischemic stroke include:

  • Medications delivered directly to the brain using a catheter inserted through an artery in the groin that travels up to the brain to administer tissue plasminogen activator (tPA) to the location of the stroke.
  • Mechanical clot removal using a catheter to insert a small device into the brain to break up or remove the blood clot causing the stroke.

Carotid endarterectomy

During a carotid endarterectomy procedure, plaque is surgically removed from the carotid artery to reduce the risk of a ischemic stroke. Angioplasty and stents During an angioplasty procedure, a balloon is used to inflate the narrowed artery, followed by a stent implantation to support the expanded artery.

Treatment for hemorrhagic stroke

The goal of treating a hemorrhagic stroke is to control excessive bleeding and reduce pressure on the brain. A stroke patient may be given drugs to lower blood pressure and intracranial pressure, and to prevent an additional seizure. The following procedures may be performed to repair abnormalities often associated with stroke.

  • Surgical clipping – a small clamp is placed at the base of an aneurysm to stop blood flow and keep the aneurysm from re-bleeding or bursting.
  • Surgical arteriovenous malformation (AVM) removal – an AVM, an abnormal connection between arteries and veins, is removed from the brain to reduce the risk of a rupture and lower the risk of a hemorrhagic stroke.
  • Stereotactic radiosurgery – a minimally invasive procedure administering beams of radiation to repair a vascular malformation.
  • Coiling – a catheter is inserted into an artery in the groin and directed up to the brain. Small coils are then placed into the aneurysm to block blood flow into the aneurysm.
  • Intracranial bypass – surgical bypass of an intracranial blood vessel increases blood flow to an area of the brain or to repair an aneurysm.