Stroke: New treatment guidelines

Stroke: New treatment guidelines mean more people can be treated

For many diseases, doctors follow guidelines established by national or international medical societies to help them deliver the best and most current treatment. Just this month, the American Heart Association released new, updated guidelines. This change will make more stroke victims eligible to receive the latest and best treatments—removal of the clot via a catheter, and clot dissolving intravenous medications.

What is a stroke?

The new treatment guidelines apply to people who suffer an “ischemic” stroke. In this type of stroke, a blood vessel in the brain is blocked by a blood clot. If not treated, the brain tissue normally fed by this vessel will stop working. Depending on the area of the brain affected, this could produce paralysis, or problems speaking, or numbness, among other possibilities. Ischemic strokes are the most common type, occurring in about 87% of stroke victims. The less common type of stroke (“hemorrhagic”) is caused by breakage of a blood vessel in the brain, but the new guidelines don’t affect treatment for this type of stroke.

The current best treatments

The most aggressive treatments, and ones that can produce the most dramatic improvements, is use of a clot dissolving drug and/or removal of the clot via a catheter inserted into the blocked artery. When a patient comes to the hospital with a suspected stroke, he will have a CT or MRI scan, and perhaps other tests, to determine if the patient had a stroke, and its location and type. Depending on what is found, the best treatment may include one or both of those therapies. But in some cases the risks of those treatments are considered higher than the risk of more conservative treatments, so the more aggressive treatments are not carried out. Each person needs to have his treatment individualized.

The guidelines, up to now, advised that 1) people who had suffered a stroke more than 6 hours previously should not have the clot removed via catheter; and 2) only people with more serious strokes should receive the clot dissolving drugs. These guidelines exclude many people, but recent research has shown that the treatments should be offered to more people, as it has now been determined that for more patients, the benefits outweigh the risks as well.

New guidelines for stroke treatment

The new guidelines say that that the window of time to offer clot removal should be expanded from 6 hours to 16 hours; even 24 hours in some cases. Removing the clot in many of these people has shown to give a better recovery. The second change is that the clot dissolving injections should be offered to people with lesser strokes as well as those with more severe strokes.

What to do

If you suspect you, or someone you are with, is having a stroke, go to a hospital as soon as possible. The sooner you get there and the quicker treatment is started, the better the outcome. And while it may be hard in the moment to figure this out, you should try to get to a hospital or center that offers the latest stroke treatments, or will transfer a patient to a more sophisticated center if needed. (Particularly if you are at higher stroke risk, it may be good to research this in advance.)

How to recognize a stroke

The most common symptoms: drooping of one side of the face (ask the person to smile); weakness in an arm or leg (ask the person to raise both arms); slurred speech (ask the person to repeat a simple sentence like “the sky is blue”). If you notice any of these things, don’t delay in getting medical care.

To find a doctor, of any specialty, anywhere in Brazil, check out our website: www.Procuramed.com.

See also in ProcuraMed:

Seven habits that are harmful for your brain

Sexual activity and brain function in older people

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