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Stroke treatment should be started as soon as possible and, therefore, it is important to know how to identify the first symptoms to call an ambulance immediately, because the sooner treatment is started, the lower the risk of sequelae such as paralysis or difficulty speaking. See here which signs may indicate a stroke.
Thus, the treatment can be started by the doctor already in the ambulance on the way to the hospital, with remedies such as antihypertensive drugs to stabilize blood pressure and heartbeat, use of oxygen to facilitate breathing, in addition to controlling vital signs, as a way to restore blood flow to the brain.
After the initial treatment, the type of stroke should be identified, using tests such as tomography and MRI, as this influences the next steps of treatment:
1. Treatment for ischemic stroke
Ischemic stroke happens when a clot blocks the passage of blood in one of the vessels in the brain. In these cases, treatment may include:
- Tablet medications, such as AAS, Clopidogrel and Simvastatin: used in cases of suspected stroke or transient ischemia, as they are able to control clot growth and prevent clogging of the cerebral vessels;
- Performing thrombolysis with APt injection: it is an enzyme that must be administered only when the ischemic stroke is already confirmed with tomography, and should be used in the first 4 hours, as it rapidly destroys the clot, improving blood circulation to the affected area;
- Cerebral catheterization: in some hospitals, as an alternative to APt injection, it is possible to insert a flexible tube that goes from the groin artery to the brain to try to remove the clot or to inject anticoagulant drugs into the site. Learn more about cerebral catheterization;
- Blood pressure control, with antihypertensives, such as captopril: it is done in cases where the blood pressure is high, to prevent this high pressure from worsening oxygenation and blood circulation in the brain;
- Monitoring: the vital signs of the person who had a stroke must be monitored and controlled, observing the heartbeat, pressure, blood oxygenation, glycemia and body temperature, keeping them stable, until the person shows some improvement , because if they are out of control, there may be a worsening of the stroke and the sequelae caused.
After a stroke, brain decompression surgery is indicated in cases where the brain has a large swelling, which increases intracranial pressure and can cause a risk of death. This surgery is done by removing, for a period, part of the skull bone, which is replaced when the swelling subsides.
2. Treatment for hemorrhagic stroke
Hemorrhagic stroke cases arise when a cerebral artery leaks blood or ruptures, as with an aneurysm or due to spikes in high blood pressure, for example.
In these cases, treatment is done by controlling blood pressure, such as antihypertensives, in addition to the use of an oxygen catheter and monitoring of vital signs so that bleeding is controlled more quickly.
In the most severe cases, where there is a complete rupture of the artery and it is difficult to stop the bleeding, emergency brain surgery may be necessary to find the bleeding site and correct it.
In cases of major hemorrhagic stroke, brain decompression surgery can also be performed, as it is common to experience irritation and swelling of the brain due to bleeding.
How is stroke recovery
Generally, after controlling the symptoms of acute stroke, a hospital stay is required for about 5 to 10 days, which varies according to the clinical status of each person, to be observed, in order to ensure an initial recovery and to assess the consequences that resulted from the stroke.
During this period, the doctor can start using medicines or adapt the patient's medications, recommending the use of an anti-aggregant or anticoagulant, such as Aspirin or Warfarin, in case of an ischemic stroke, or removing the anticoagulant in case of Hemorrhagic stroke, for example.
In addition, drugs may be needed to better control blood pressure, blood glucose, cholesterol, for example, to reduce the risk of new episodes of stroke.
Some sequelae may remain, such as difficulty in speech, decreased strength on one side of the body, changes to swallow food or to control urine or feces, in addition to changes in reasoning or memory. The number and severity of sequelae vary according to the type of stroke and the affected brain location, as well as the person's ability to recover. Better understand the possible complications of stroke.
Rehabilitation to reduce the consequences
After a stroke, the person needs to do a series of rehabilitation processes to speed recovery and reduce the consequences. The main forms of rehabilitation are:
- Physiotherapy: Physiotherapy helps to strengthen the muscles, so that the person is able to recover or maintain body movements, improving their quality of life. See how physical therapy is done after a stroke.
- Occupational therapy: it is an area that helps the patient and the family to find strategies to reduce the effects of stroke sequelae on a daily basis, through exercises, adaptation of the house, bathroom, as well as activities to improve reasoning and movements;
- Speech therapy: this type of therapy helps to recover speech and swallowing in patients who have had this area affected by stroke;
- Nutrition: after a stroke, it is important that the person has a balanced diet rich in vitamins and minerals that nourish the glass and in a healthy way, to avoid malnutrition or a new stroke. In some cases where it is necessary to use a probe to feed, the nutritionist will calculate the exact amount of food and teach you how to prepare it.
Family support is essential in this period of recovery from a stroke, both to help with activities that the person is no longer able to perform, as for emotional support, since some limitations can be frustrating and cause a feeling of helplessness and sadness. Learn how to help someone who has difficulty communicating.
Created by: Tua Saúde Editorial Team