Stroke is a cerebrovascular health problem caused by the sudden interruption of blood flow to the brain, leading to mental and physical impairment. According to data from the Turkish Ministry of Health, stroke ranks first among diseases that affect the quality of life. Stroke can be categorized into two main types: ischemic stroke and hemorrhagic stroke. Some individuals may experience a transient ischemic attack, which is a temporary interruption of blood flow to the brain that does not result in permanent symptoms.

Ischemic Stroke 

Ischemic stroke is the most common type of stroke. It occurs due to the narrowing or blockage of blood vessels in the brain. The blocked or narrowed blood vessels may be caused by:

• Accumulation of fat particles in the blood vessels over time,
• Blood clots circulating in the bloodstream that lodge in the brain's blood vessels,
• Other debris or remnants.

Hemorrhagic Stroke 

Hemorrhagic stroke occurs when a blood vessel in the brain starts to leak or rupture. Brain hemorrhages can result from various events affecting the blood vessels.

• Hemorrhagic Stroke Triggering Factors
• Uncontrolled high blood pressure
• Excessive exposure to blood-thinning medications
• Swelling in the blood vessel walls
• Trauma
• Accumulation of protein deposits causing weakness in the vessel walls
• Hemorrhage caused by ischemic stroke.
• Arteriovenous malformation

Transient Ischemic Attack (TIA)

 A transient ischemic attack (TIA) is similar to a stroke, but the key difference is that it does not cause permanent effects. It results from a temporary decrease in blood flow to a part of the brain. TIAs can last for five minutes or even shorter. Like ischemic strokes, transient ischemic attacks are caused by conditions such as blood clots or fatty deposits that block the blood vessels.

Indeed, despite the short duration of symptoms and rapid improvement, a person who experiences a Transient Ischemic Attack (TIA) should seek immediate medical help. It is not possible to make a proper evaluation based solely on the symptoms. Having a TIA increases the risk of a full stroke.

What are Stroke Treatment Methods?

Treatment methods for stroke vary depending on the type of stroke. For ischemic stroke, the main goal is to restore blood flow to the brain quickly.

Preventive Medications: 

If you have had an ischemic stroke or TIA, your doctor may prescribe medications to reduce the risk of another stroke.

Emergency Medication Treatment:

 Medications to break up the blood clot causing the blockage should be administered within four to five hours from the onset of symptoms. Early administration of these drugs is crucial to improve outcomes and minimize potential risks.

Emergency Endovascular Procedures: 

In some cases of ischemic stroke, experts may resort to treating the blocked blood vessel directly through endovascular procedures. When looking at the results of endovascular treatment, this method has shown significant improvement and reduced potential disabilities over the long term. Emergency procedures should be performed as quickly as possible.

Intra-Arterial Thrombolysis: 

Experts insert a long, thin tube into an artery in the groin and guide it directly to the area where the stroke is occurring. This allows for the direct delivery of clot-dissolving medication to the affected brain region. It takes slightly longer compared to intravenous thrombolysis.

Mechanical Thrombectomy with Stent Retrievers:

 Experts can use a catheter-based device with a stent retriever to physically remove the blood clot from the blocked brain artery. This approach is highly effective for certain cases of large vessel occlusion and can significantly improve outcomes for stroke patients.

These endovascular procedures have revolutionized the treatment of acute ischemic stroke, providing a more targeted and effective approach to removing blood clots and restoring blood flow to the brain. However, as with all stroke treatments, time is of the essence, and early intervention is crucial for the best possible outcomes.

Other Procedures

To reduce the risk of experiencing a transient ischemic attack (TIA) or another stroke, various procedures can be considered depending on the individual's condition. The available alternatives may vary depending on the situation:

Carotid Endarterectomy:

 This method involves removing the plaque that is blocking the carotid artery, reducing the risk of ischemic stroke.

Angioplasty and Stenting: 

During angioplasty, a catheter is threaded from an artery in the groin to the carotid artery. Afterward, a stent may be placed to widen the narrowed artery. Emergency treatment for hemorrhagic stroke focuses on controlling bleeding and reducing the increased brain pressure caused by excess fluid. Treatment alternatives include:

Emergency Measures:

 To prevent blood clotting, anticoagulant medications may be used, and in certain cases, medications or blood product transfusions may be administered to counteract the effects of anticoagulants.

Stroke Surgery: 

If there is extensive bleeding, the doctor may consider surgery to remove the blood and reduce brain pressure. After emergency treatment, the patient is closely monitored for at least one day. Subsequent stages of treatment involve rehabilitation and efforts to reintegrate into normal life.

In cases where stroke has caused damage to the right side of the brain, movement, and sensations on the left side of the body can be affected. Stroke survivors are typically included in a rehabilitation program tailored to their age, overall health, and the level of disability caused by the stroke.