The brain is a delicate organ with a vast quantity of cerebral arteries supplying it with blood. These cerebral arteries are imperative to human life. Without these arteries supply the brain with a constant supply of blood, survival would be difficult. These cerebral arteries, like any other artery in the body, they are not immune to blockages. Blockages in these arteries can be especially problematic and can result in a life threatening situation or permanent brain damage. When these cerebral arteries become occluded, a thrombotic stroke can result. Thrombotic strokes result when the cerebral arteries become narrowed due to atherosclerosis or other arterial situations. The narrowing of these arteries promotes blood clot formation and thus, can directly cut off the supply of blood to important structures of the brain. These types of brain complications tend to fall under the broader category of thromboembolic strokes. A thromboembolic stroke includes both a thrombotic stroke and embolic stroke. A thromboembolic stroke usually presents the same symptoms in both a thrombotic and embolic event. Common risk factors for suffering from a thrombotic stroke include genetic history of blood clotting, diabetes, hypertension, high blood cholesterol, aging and tobacco consumption.

It is important to mitigate these risk factors to avoid suffering from a thrombotic stroke. Thrombotic stroke symptoms are often very serious and life threatening. They can include severe headaches, cognitive impairments, muscle weakness, numbness, trouble with vision and motor coordination. It is important to be aware of thrombotic stroke symptoms, as treatment must begin immediately. Treatment of thrombotic strokes in a timely fashion can greatly improve prognosis and recovery. If symptoms are present, physicians will often use a number of diagnostic tools and tests to confirm the presence of a thrombotic stroke. These can include computed tomography (CT) scans, magnetic resonance imaging (MRI), ultrasounds and echocardiograms. If the detection of a thrombotic stroke is found, physicians will begin treatment of thrombotic stroke symptoms immediately. This can include lifestyle changes, medications and/or surgery. Your physician is the best person to determine what treatment method of a thrombotic stroke is necessary.

Pathophysiology of Thrombotic Stroke

Thrombotic strokes occur when blood vessels in the brain suffer from trauma or disease. The most common causes of a thrombotic stroke are high blood cholesterol, which is turn contributes to the development of atherosclerosis, aging and high blood pressure. These causes directly put added strain on the cerebral arteries making them more prone to occlusions and narrowing. Depending on what cerebral artery is affected, a thrombotic stroke can be further subdivided into large vessel thrombosis and small vessel thrombosis. Large vessel thrombotic strokes tend to be more serious as these arteries supply a greater region of the brain with blood.

Risk Factors of Thrombotic Stroke

Avoiding the common risk factors of the development of a thrombotic stroke is crucial in maintaining good brain health. These risk factors directly contribute to the narrowing or damage of cerebral arteries in the brain. Common risk factors for a thrombotic stroke include aging, genetic history clotting, poor diabetes management, hypertension, high cholesterol, alcohol consumption, smoking and illegal drug use. Some of these risk factors are unavoidable, such as aging and a previous family history of thrombotic strokes, thus it is imperative your physician is made aware of these factors.

Diabetes

Poor management of diabetes can result in blood vessels becoming exposed to high levels of blood sugar for a prolonged period of time. This can directly contribute to the damaging of cerebral arteries.

Hypertension

Often deemed the “silent killer”, high blood pressure plays a crucial role in the development of a thrombotic stroke. Chronic hypertension can weaken blood vessels and make them more prone to blood clotting.

Cholesterol

It is especially important to limit your intake of high cholesterol foods as these directly contribute to the development of plaque build up in arteries and thus, atherosclerosis.

Alcohol, Smoking, Drugs

It is important to limit the consumption of alcohol, smoking and illegal substances as they can contribute to the hardening of your arteries and thus, promote inadequate blood flow and occlusions. Also, alcohol has been shown to negatively impact cholesterol levels.

It is important to discuss with your doctor on how to minimize the risk factors of suffering from a thrombotic stroke.

Thrombotic Stroke Symptoms

Suffering from a thrombotic stroke can be very dangerous and even fatal. It is important be aware of the early signs and symptoms of a thrombotic stroke as treatment must begin immediately. Thrombotic stroke symptoms also have the potential to vary depending on which cerebral artery and thus, which area is the brain is affected. Common thrombotic stroke symptoms include migraines, confusion, muscle weakness, sensory numbness, trouble with vision and speech, and difficulty with motor movements. If any of the above thrombotic stroke symptoms present themselves, contact medical assistance immediately. It is crucial that treatment begins immediately to avoid permanent brain damage or death.

Thrombotic Stroke Diagnosis

If thrombotic stroke symptoms are present, physicians will often recommend several diagnostic procedures to confirm the presence of a blood clot a cerebral artery. Common diagnostic procedures include cerebral computed tomography (CT) scans, magnetic resonance imaging (MRI), ultrasounds and carotid angiography.

Cerebral Computed Tomography (CT) Scan

A cerebral CT scan is often the first test of choice by a physician after the suspicion of a thrombotic stroke. CT scans are non-invasive method to provide detailed images of the brain and cerebral arteries. They can provide information on brain bleeding and help detect the presence of a blood clot.

Magnetic Resonance Imaging (MRI)

Magnetic resonance imaging (MRI) is also a non-invasive test that can provide highly detailed images of the brain and surrounding structures. They are often used if CT scans come back. They are also important in detecting changes in brain structure and if bleeding is present.

Doppler Ultrasound

Doppler ultrasounds are also a non-invasive test and can help detect the presence of blood flow irregularities. If a blood flow abnormality is detected, it usually signals the presence of plaque build up or a blockage.

Carotid Angiography

Carotid Angiography is an invasive procedure and thus, usually done only if needed. It involves the insertion of a catheter, usually in a lower extremity, which is then transported through the body into the carotid artery. A contrast dye is also inserted through the catheter to observe blood flow throughout the body via X-Ray imaging.

Your physician is the best person to determine what diagnostic procedure should be used in the detection of a thrombotic stroke.

Treatment of Thrombotic Stroke

Treatment of a thrombotic stroke should begin immediately after detection. It is imperative treatment begins in a timely fashion as it can prevent permanent brain damage and may be life saving. Treatment of thrombotic strokes usually includes lifestyle changes, medications and if needed, emergency surgery.

Lifestyle Changes

Lifestyle changes are recommended in all cases of stroke treatment. They are also directly related to minimizing the risk factors associated with a thrombotic stroke. Common lifestyle changes are exercising regularly and eating a healthier diet. This includes eating more leafy greens and fruits, while avoiding saturated and trans fats. It is also important to minimize sugar consumption. Other lifestyle changes include quitting smoking and alcohol consumption.

Medications

Medications are often recommended in the treatment of thrombotic strokes. Common medications are anticoagulants, antiplatelets and thrombolytics. Anticoagulants and antiplatelets help to deter further clotting and prevent the growth of the present blood clot. The most common anticoagulant is warfarin, while in terms of antiplatelets; it is acetylsalicylic acid, commonly known as aspirin. Thrombolytic medications are the most important in the treatment of a thrombotic stroke. These medications act to dissolve the present clot and work tor restore proper blood flow to brain regions. The most common thrombolytic medication is tissue plasminogen activator, or tPA. Tissue plasminogen activator is a time sensitive medication. It must be administered as quickly as possible to ensure beneficial results. The best time period for administration of tissue plasminogen activator is roughly 3-4 hours after detection of a thrombotic stroke.

It is important to discuss tissue plasminogen activator with your doctor as it comes with severe side effects. The most prevalent side effect is severe bleeding, which can be fatal. Thus, it is important to avoid risky situations or trauma while taking tissue plasminogen activator. Other medications that may be recommended are related to the specific risk factors present. For example, medications may be used to help control high blood cholesterol and hypertension as these directly contribute to the further growth and development of blood clots. Statins are the most commonly used medication in the treatment of high blood cholesterol, while diuretics and ACE inhibitors are common in the treatment of high blood pressure. It is important to consult with your doctor about the medications for the treatment of thrombotic stroke.

Surgery

If deemed necessary, surgery may be needed in the removal of a blood clot. Surgery is only used as a last resort as it presents many serious complications and risks. The most common emergency surgery used is a carotid endarterectomy. In this procedure, surgeons remove fatty deposits from the carotid artery, which helps to restore blood flow to the brain and surrounding structures.

It is important to discuss with your doctor on all possible treatment options for a thrombotic stroke.