Ischemic Stroke

Ischemic Stroke General Information

Ischemic Stroke is the generic medical term conferred to a situation when a blocking of an artery leading to the brain occurs. Normally, blood takes away cellular waste and carbon dioxide from the brain, and replaces it with fresh nutrients and oxygen. Thus, the brain relies on the arteries leading to it to receive these fresh supplies, in order to continue functioning properly. In the event that one of the arteries is blocked, the neurons in the affected area fail to produce sufficient energy, which eventually leads to the death of the affected brain cells if the artery is not unblocked within a few minutes. In such cases, emergency medical attention is critical in order to prevent the death of the brain cells and to ensure that the brain will resume its proper functioning.

There are several different medical conditions that may cause or evolve into this medical condition. Most commonly, the neck and head arteries suffer a narrowing due to atherosclerosis, or a gradual accumulation of cholesterol along the blood vessel inner walls. In such cases, the arterial passages may become so narrow, that blood cells may accumulate and form clots which block the blood vessel in which they were formed – condition known as thrombosis. Another possibility is that the blood clot dislodges and is transported closer to the brain, blocking blood vessels that are closer to the central nervous system in the condition known as embolism. Ischemic Stroke may also be caused by blood clots formed in the heart due to abnormalities of the heart, heart attack or medical conditions which cause irregular heartbeat – such as atrial fibrillation. These are not the only conditions that may cause this type of stroke. There are several other possible causes, including but not limited to drugs, trauma (especially trauma affecting the neck) or blood clotting related affections.

Ischemic Stroke Symptoms

In the typical case of Ischemic Stroke, symptoms occur suddenly. Most often, their severity degree is maximal within a few minutes from occurrence. The stroke may cause the death of the brain cells in the affected area within minutes after which, little or no additional damage will occur. After the initial outbreak the condition becomes stable, and remains like that for the next few days.

In less common cases of Ischemic Stroke, the symptoms develop from consecutive strokes that continue for longer periods of time, up to a few days. In such cases, the affected area of the brain is slowly enlarging as a continuously increasing number of brain cells are killed by the condition. The condition may appear to improve temporarily, as the progression of the damage and symptoms is interrupted by short stable periods. This type of the condition is generally known as an evolving stroke, and it is caused by a blood clot that has formed in a narrowed artery.

The symptoms of Ischemic Stroke largely depend on which blood vessel is blocked, and thus which part of the brain is affected. In the case the internal carotid is being blocked, the most common symptoms that the patient will experience are partial blindness, affecting one eye, as well as weakness or paralysis in one side of the body. If the patient has suffered a blocking of the vertebral arteries, dizziness, vertigo, generalized weakness in the entire body and double vision are the most common symptoms. In both cases, the above symptoms can be accompanied by may other symptoms as well, such as impaired consciousness, speaking disorders, coordination loss and urinary incontinence.

Ischemic Stroke Treatment

It is imperative that patients that experience any symptoms related to an Ischemic Stroke should immediately be placed under emergency medical attention, as in such cases it is critical that a treatment is administered as soon as possible to improve the patient’s chances for recovery. The first stage of the treatment consists in checking the patient’s heart rate, breathing and temperature and if needed, to restore them to normal values. Fever needs to be immediately treated if present, as any increase in body temperature may worsen the patient’s condition and amplify the damage done to the nervous cells.

While low blood pressure is a symptom that needs to be relieved urgently, high blood pressure may be normal in patients that present narrowed blood vessels, and is generally not treated immediately – however high blood pressure may lead to heart, eye and kidney damage, so it is advised that the examining health care specialists decides whether treatment to reduce blood pressure should be applied to the patient immediately or not.

Severe cases of Ischemic Stroke are characterized by swelling and a dramatic increase in brain pressure, so it may be necessary for the treatment to include drugs such as Mannitol which will help relieve these symptoms. The treatment also includes drugs that dissolve blood clots that have already been formed (drugs from the thrombolytic class of medication) or anticoagulants and antiplatelet drugs which hinder the formation of new blood clots.

From the thrombolytic class of medicines, one of the most commonly administered drugs in cases of Ischemic Stroke is a tissue plasminogen activator. It is administered intravenously, and it is very effective in restoring the normal blood flow to the brain, mostly by breaking up any clots that may have formed. However, this drug has a high probability of causing internal bleeding, in the brain as well as in other internal organs, so the doctors must first assess if the patient can safely undergo treatment with this drug. A CT may be useful in providing information regarding any possible brain bleeding before beginning treatment with this drug. Treatment with tissue plasminogen activator should be started within at most 3 hours from the beginning of the Ischemic Stroke. It is possible to administer this drug after the mentioned timeframe, however catheter administration is recommended in such cases.

If the patient is not eligible to undergo thrombolytic drug therapy as soon as he is brought under medical attention, antiplatelet drugs are the treatment of choice. Anticoagulants can also be employed however their effectiveness is lower in such cases. Antiplatelet-class drugs are also commonly used in the long term treatment of patients diagnosed with Ischemic Stroke; however, as this type of medication does not seem to inhibit the forming of blood clots within the heart, patients that have a medical history of heart disorders may be given anticoagulant class drugs instead.