The success of stroke treatment depends largely on one very simple factor - how soon the patient seeks medical treatment.
More than 80 percent of strokes are ischemic strokes caused by a blood clot or plaque that blocks a blood vessel in the brain. The faster that our physicians can dissolve or remove this blockage, the less damage is done to the brain tissue.
The other main type of stroke is hemorrhagic stroke that occurs when a blood vessel bursts in the brain. Prompt treatment is also important for hemorrhagic strokes.
Because there are two kinds of stroke, the treatment can vary. Specific treatment of a stroke will be determined by your physician based on:
- how soon you seek medical treatment after symptoms arise
- your age
type of stroke
- overall health and medical history
- severity of the stroke
- location of the stroke
- your tolerance for specific medications, procedures, or therapies
- your opinion or preference
Although there is no cure for stroke, advanced medical and surgical treatments are now available, giving many stroke victims hope for optimal recovery.
At Beaumont, the treatment of a stroke is a multidisciplinary endeavor. Throughout the treatment process, we emphasize a unified effort among neurologists, neurosurgeons and interventional neuroradiologists to provide the most advanced care possible.
Treatment of a stroke often involves endovascular therapy - minimally invasive procedures guided by advanced imaging equipment. Neurosurgeons and neurointerventionalists work side-by-side in a state-of-the-art Heart & Vascular Center, occasionally using hybrid approaches that combine both endovascular and conventional surgical techniques.
Hemorrhagic Stroke Treatment
A physician may prescribe medications and therapy to reduce or control brain swelling and help protect the brain from damage and ischemia (lack of oxygen). They may also reverse blood thinners that you may have been taking before arrival. Special types of intravenous (IV) fluids are often used to help control vasospasm, a condition in which blood vessels spasm, leading to vasoconstriction. This can lead to further tissue ischemia and death of brain tissue.
Surgical Treatment of a Stroke
At Beaumont, we offer minimally invasive surgical procedures to control bleeding from a hemorrhagic stroke.
Beaumont specialists can use a new minimally invasive procedure called endovascular coiling to treat an aneurysm before it ruptures and causes a hemorrhagic stroke.
Surgery to repair aneurysms and arteriovenous malformations (AVMs)
An aneurysm is a weakened, ballooned area on an artery wall that has a risk for rupturing and bleeding into the brain. An AVM is a congenital (present at birth) or acquired disorder that consists of a disorderly, tangled web of arteries and veins. An AVM also has a risk for rupturing and bleeding into the brain. Surgery or treatment using Gamma Knife may be helpful, in this case, to help prevent a stroke from occurring.
Treatment of Vasospasm
Approximately one-third of patients that arrive at Beaumont Hospitals with a subarachnoid hemorrhage experience vasospasm. This can lead to stroke if blood flow to the brain is significantly impaired.
Ongoing stroke treatment is tailored to the needs of each patient, depending upon the type and severity of the stroke, as well as factors such as age and co-existing medical conditions. Our patients benefit from being cared for by specialized experts who can recommend an optimal plan to help prevent a new stroke.
Ischemic Stroke Treatment
Today's standard of treatment for stroke patients who have a blood clot is the clot-dissolving drug t-PA. To be effective, t-PA must be given intravenously within three hours of the onset of stroke symptoms. Unfortunately, many patients do not seek medical care in that time period. For these patients, Beaumont provides an important treatment option that can expand this window up to eight hours for many patients: We can administer t-PA directly into the clot through the arteries. This is called intra-arterial thrombolysis.
Carotid endarterectomy is a surgical procedure to remove plaque buildup in an artery. It is performed on patients with over 50 percent stenosis, or narrowing of an artery, and with symptoms of stroke or trans-ischemic attack. The goal of the procedure is to prevent a major stroke.
A craniotomy is a type of brain surgery to remove blood clots or repair bleeding in the brain.
A physician may prescribe medications and therapy to reduce or control brain swelling and help protect the brain from damage and ischemia (lack of oxygen). Life support measures may be needed, including such stroke treatments as ventilators (machines to assist with breathing), IV fluids, adequate nutrition and blood pressure control.
The medical team will also work to:
- lower blood cholesterol levels
- prescribe aspirin or other blood thinners as indicated
- control blood sugar levels in diabetics
- prevent other blood clots, such as deep vein thrombosis
- prevent aspiration pneumonia, a common side effect during stroke recovery
- reduce other possible complications
- provide education to empower you to prevent future strokes
Emergency Treatment for Stroke
Beaumont Health can provide the most advanced care of a Primary Stroke Center. Because of our staff of interventional specialists, we offer emergency stroke treatment options that can improve outcomes for stroke patients.
Care for most stroke patients begins when they arrive the Emergency Center. Emergency physicians are specially trained to quickly identify stroke symptoms and begin treatment.
Our stroke emergency protocols call for CT testing to be completed and read by a physician within 25 minutes of being ordered. Our CT equipment is also capable of performing angiogram images if requested.
If the stroke is ischemic, or caused by a blood clot, the stroke emergency team's goal is to begin intravenous t-PA dosing within 60 minutes of the patient's arrival at the Emergency Center.
Beaumont Health also has neurologists on staff and they work closely with the Emergency Center to treat acute stroke patients with IV t-PA. Severely ill patients may be transferred to the Beaumont Health - Royal Oak hospital if more-advanced treatment is needed. The majority of stroke patients are cared for at facilities in their local community, with consultation to experts at tertiary care facilities.
At Beaumont Health, the stroke emergency team is available to respond to all in-hospital strokes, so that patients receive the same urgent assessment as they would in the Emergency Center.