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.
Endovascular Coiling of Aneurysm
An aneurysm is a weakened, ballooned area on an artery wall that has a risk for rupturing and bleeding into the brain called subarachnoid hemorrhage. Beaumont specialists can perform a minimally invasive procedure called endovascular coiling to treat an aneurysm.
Surgery clipping of Aneurysm
Beaumont specialists can perform neurosurgical procedure called clipping to treat an aneurysm.
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.
Surgery to repair arteriovenous malformations (AVM)
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.
A craniotomy is a neurosurgical procedure to remove blood clots and/or reduce effects of swelling after a stroke.
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 and meet the required criteria, is the clot-dissolving drug t-PA. To be effective, t-PA must be given intravenously within four and a half hours of the onset of stroke symptoms.
Mechanical thrombectomy or endovascular reperfusion may be an option for stroke patients who present within 24 hours of symptom onset with evidence of an occlusion or blockage in one of the large arteries in the brain. Mechanical thrombectomy devices are designed to remove blood clots from these large vessels within the brain. During the procedure, a catheter is inserted into the groin and into the blocked artery where the clot can be removed.
Carotid revascularization involves one of two surgical procedures aimed at improving blood flow within the carotid arteries. The carotid arteries are located in the neck and are the primary blood supply for the brain. Narrowing, or stenosis, within the carotid arteries is a known risk factor for stroke.
Carotid endarterectomy is a surgical procedure to remove plaque buildup in an artery. It is performed on patients with significant stenosis, or narrowing of an artery, and with symptoms of stroke or transient ischemic attack. The goal of the procedure is to prevent a major stroke.
Carotid stenting, like carotid endarterectomy, is a procedure performed to prevent a major stroke due to narrowing within the carotid arteries. Unlike carotid endarterectomy, carotid stenting is an endovascular (catheter-guided) procedure where a mesh stent is placed within the narrowed artery to help open the vessel and improve blood flow.
A physician may prescribe medications and therapy to help protect the brain from damage and ischemia (lack of oxygen) as well as IV fluids, and medications to help control blood pressure. In some cases, life support measures may be needed, including ventilators (machines to assist with breathing).
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 possible side effect related to dysphagia caused by stroke
- reduce other possible complications
- provide education to empower you to prevent future strokes
Emergency Treatment for Stroke
Beaumont Health provides advanced stroke care. 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.
If the stroke is ischemic, or caused by a blood clot, and the patient presents within 4.5 hours of their symptoms starting, t-PA may be an option. The stroke emergency team's goal is to begin intravenous t-PA dosing for those patients who qualify within 45 minutes of the patient's arrival at the Emergency Center.
Beaumont Health neurologists work closely with the Emergency Center to treat acute stroke patients with IV t-PA. The majority of stroke patients are cared for at facilities in their local community, but for those patients who are critically ill and require additional intervention, consultation and transfer to tertiary care facilities are options.
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.