The brain is packed with arteries and veins that supply structures such as the four lobes of the brain and the cerebellum. The proper functioning of these blood vessels is imperative for daily functioning. These cerebral arteries are prone to blockages that can disrupt blood supply and thus, brain functioning. An example of when these arteries become blocked is an acute ischemic stroke. An Acute ischemic stroke results when a blood clot forms in one of the cerebral arteries and impairs with blood flow. There are two different classes of acute ischemic strokes: thrombotic and embolic. The difference between the two is where the original blood clot originates. In a thrombotic stroke, the blood clot originates in the brain, while in an embolic stroke; the blood clot originates elsewhere in the body. Ischemic stroke pathophysiology is related to plaque build up, termed atherosclerosis and damage to blood vessels. Both plaque and trauma directly increases the likelihood of blood clot development. Acute ischemic strokes are the most common type of stroke today. Due to the severity of an acute ischemic stroke, it is important to minimize the risk factors associated with its development. These risk factors include hypertension, diabetes, heart irregularities or disease, smoking, obesity and lack of exercise. These risk factors can contribute to atherosclerosis development in the arteries of the body and promote clotting.
It is important to discuss with your doctor on how best to minimize and control these risk factors. Acute ischemic stroke symptoms are evident and must be monitored for. This is due to the fact that quick acute ischemic stroke treatment may be life saving. Common acute ischemic stroke symptoms include muscle weakness, facial paralysis, difficulty with vision and severe headaches. Upon detection of symptoms, ischemic stroke diagnosis can include a variety of tests and procedures. These can include computed tomography (CT) scans, angiograms, and ultrasonography. It is imperative that these diagnostic methods are done immediately following the suspicion of an acute ischemic stroke. This is to improve ischemic stroke prognosis and begin treatment. Management of ischemic strokes include lifestyle changes, medications and if needed, emergency surgery. Lifestyle changes include exercising and improving diets, while common medications include anticoagulants and thrombolytics. If necessary, emergency surgery includes endarterectomy and angioplasty. Your physician is the best person to determine the method of treatment of an acute ischemic stroke.
Ischemic stroke pathophysiology is related to narrowing of arteries via plaque build up or trauma. When these arteries begin to narrow extensively, blood clots can form. Depending on where the clot forms, an acute stroke can development. In the case of both thrombotic and embolic strokes, this location varies.
Cerebral embolic strokes result when a blood clot forms somewhere else in the body and travels to the brain. These blood clots have the potential to develop anywhere in the body and travel to the brain. In most cases, these blood clots form in the chest and neck regions and travel to the brain due to proximity.
Cerebral thrombotic strokes result when a cerebral artery begins to narrow due to atherosclerosis and severely decrease in diameter. This encourages blood clot formation and thus, acute ischemic stroke development in the brain.
There are numerous risk factors associated with acute ischemic stroke development. Some of these risk factors are preventable, while others are not. The unavoidable risk factors associated with acute ischemic strokes are aging, sex, and genetic factors. In the terms of sex, acute ischemic strokes are more common in males than females. The preventable risk factors to minimize in acute ischemic stroke development include smoking, obesity, abnormal cholesterol levels, and lack of exercise, alcohol consumption, and drug use. Also, it is important to manage diabetes, hypertension, blood sugar levels, and heart related complications or disease. It is important to discuss with your doctor on how to minimize the risk factors associated with acute ischemic stroke.
It is important to be proactive on the symptoms of an acute ischemic stroke. This is to improve ischemic stroke prognosis, as treatment is needed immediately. Common symptoms of an acute ischemic stroke are muscle weakness, facial paralysis, inability to move an extremity, cognitive decline, speech impairment, loss of vision, difficulty walking or balancing, and severe headaches or migraines. If any of these symptoms present themselves, contact medical assistance immediately. It could be life saving and greatly improve ischemic stroke prognosis.
If acute ischemic stroke symptoms are present, physicians usually will elect to perform various diagnostic tests to confirm the presence of a blood clot. Ischemic stroke diagnosis can include the use of blood tests, computed tomography (CT) scans, cerebral angiograms, echocardiograms and carotid ultrasonography.
A D-dimer test is usually done to confirm the presence of a blood clot. If abnormal levels of d-dimer are present, it can confirm the presence of a blood clot. Blood tests are usually used in conjunction with other diagnostic procedures.
CT scans are non-invasive method to provide detailed images of the brain. It is commonly used to detect the presence of blood clotting or abnormal bleeding in the brain. It is one of the most common tests done immediately after the suspicion of an acute ischemic stroke.
A cerebral angiogram is an invasive procedure and usually done if CT scans are negative. It involves the insertion of catheter into the groin region so a radioactive dye can be inserted into the blood vessels of the body. This radioactive dye can thus be examined via X-Ray imaging to examine blood flow in the body. If a blood clot is found, acute ischemic stroke treatment will begin immediately.
Echocardiograms are a non-invasive procedure and especially important in the detection of an embolic stroke. Echocardiograms can help provide detailed images of the heart and determine if the heart is contributing to blood clot formation. Echocardiograms are thus crucial in the management of ischemic strokes.
Carotid ultrasonography is a non-invasive procedure that helps determine how blood is flowing through the carotid artery. Since the carotid artery directly supplies the brain with nutrient and oxygen rich blood, carotid ultrasonography can be life saving. Carotid ultrasonography can help detect the presence of plaque build up and examine for blood clots in the carotid artery.
It is recommended to consult with your doctor on ischemic stroke diagnosis and management.
The management of ischemic stroke is imperative to improve daily life. It is also crucial that acute ischemic stroke treatment begins immediately following detection. Treatment in a timely fashion can greatly improve ischemic stroke prognosis and can be life saving. After detection, management of ischemic stroke symptoms can include lifestyle changes, medications and if needed, emergency surgery.
Lifestyle changes in the management of ischemic stroke are usually the first recommended method. The lifestyle changes recommended are also directly related to minimizing the risk factors associated with acute ischemic stroke. Common lifestyle changes include dietary changes, exercise, weight loss, quitting smoking, and avoiding alcohol. If these lifestyle changes are not enough in the treatment of acute ischemic strokes, medications are required.
There are numerous classes of medications that can aid in the treatment of an acute ischemic stroke. These can include anticoagulants, antiplatelet, antihypertensive and cholesterol managing medications. Anticoagulants and antiplatelets are directly involved in minimizing the risk of blood clotting further. They can also prevent the present blood clot from increasing in size. The most commonly prescribed anticoagulant and antiplatelet are warfarin and aspirin respectively. The best class of medication in the treatment of an acute ischemic stroke is thrombolytics. These medications actively seek out work towards dissolving blood clots. The most common used thrombolytic if tissue plasminogen activator, which is also known as the gold standard to ischemic stroke treatment. This medication, if given in a timely fashion, can greatly improve ischemic stroke prognosis and recovery. Tissue plasminogen activator is the reason why treatment must be sought immediately in acute ischemic stroke patients. It should be noted that it is important to minimize high risk situations associated with bleeding as one of the main side effects of thrombolytic medications is excessive bleeding which can be fatal.
If deemed serious and life threatening, surgery may be required. Surgery is often used as a last resort in the treatment of an acute ischemic stroke due to the risk of further complications and blood clotting. Two of the most common procedures are carotid endarterectomy and angioplasty.
Carotid endarterectomy is a highly invasive procedure which requires precise surgical abilities. Surgeons will cut into the carotid artery to subsequently remove plaque build up or the blood clot present. It is highly effective and only used if a severe case of atherosclerosis is present in the carotid artery.
Angioplasty is also an invasive procedure and is used to help restore proper blood flow to arteries in the body. It involves the insertion of stent with a small balloon on its anterior surface. This balloon can be inserted into arteries suffering from severe atherosclerosis and when expanded, can greatly restore proper blood flow to regions of the body, including the brain.
It is important to discuss with your doctor the best method in the treatment of an acute ischemic stroke.