Acute Therapy

To reduce the damage a stroke causes in the brain and to improve the chances of a complete recovery of brain functions, diagnosis and treatment should start as early as possible. The treatment options depend on the type of stroke. The attending physician has to adjust the patient’s treatment individually.
In the acute phase of stroke, intensive medical treatment focuses on four principles:

Vital Signs

Respiration should guarantee adequate levels of blood oxygen. Blood pressure and blood sugar should be set neither too high nor too low. If the patient has fever, body temperature should be lowered with calf packing or medication.

Recanalization of Vascular Occlusions

If the stroke is caused by a blood clot blocking a blood vessel, the clot can in some cases be dissolved with a drug (so-called thrombolysis). The drug is injected through a blood vessel into the blood stream.  The treatment is carried out in highly specialized hospitals and is approved only within the first four-and-a-half hours (4,5h) after stroke onset. But in any case: the sooner the lyses, the greater the success.

Preventing Stroke Recurrence

A patient who has suffered a stroke has an increased risk of suffering another stroke. Even if the first stroke had little impact, the damage by a following stroke may be large. Therefore, a thorough examination to determine the cause of stroke is always advisable. Ususally the doctor will prescribe a blood thinning drug to reduce the risk of recurrence.

Minimization of Secondary Damages

When the brain swells as a result of a stroke, and further swelling is hindered by the skull bone, it may be necessary to remove a piece of bone to give the brain space for further expansion.
There are hospitals with special wards for the treatment of stroke. These facilities are called stroke units. Reasons for stroke unit admission:

  • a fresh stroke which occurred in the last 72 h
  • a deterioration of the patient’s condition
  • unstable vital signs with problems of blood pressure, heart rhythm, body temperature and blood sugar levels
  • the possibility of carrying out a re-opening of vessel occlusion  

Patients who are so severely affected that they fall into a coma or require ventilation should not be treated in a stroke unit, but rather in an ICU.

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