Jerold H. Fleishman, MD, chief of neurology and medical director of the Stroke Center, in his office at MedStar Franklin Square in Baltimore
Every minute the brain is deprived of blood flow, more brain cells die. The earlier the blood flow is restored, the less likely a stroke sufferer will have permanent damage. It is essential to receive intensive care that assures the control of blood pressure, breathing, and heart function.
Not only is it important to diagnose if someone has just had a stroke, physicians must also determine the type of stroke. The treatment is different, based on whether it is a hemorrhagic stroke or an ischemic stroke. Depending on the type and severity of the stroke, treatment options will vary, and may include surgery.
Physicians will order a variety of diagnostic tests to determine the location and extent of brain injury, as well as evaluate the condition of the arteries in your heart and neck that supply blood to your brain.
- Ischemic stroke: The most effective medicine for the treatment of ischemic stroke is the FDA-approved drug, t-PA (tissue plasminogen activator). Taken intravenously, it works with your body's enzymes to dissolve blood clots. This highly-effective treatment must be given within three hours of the onset of stroke so it imperative to seek medical care without delay.
- Hemorrhagic stroke: The best and safest way to remove blood from the brain after a hemorrhage and minimize damage to the brain include surgical removal of the clot, clot busting medication to dissolve the clot, and medications to minimize swelling caused by the clot. For hemorrhages caused by aneurysms and arteriovenous malformations, a skilled neuroradiologists or neurosurgeon can repair or block the vessels to prevent further bleeding. Many of these procedures can be performed through a minimally invasive technique.
Beyond providing the highest level of emergency stroke intervention, MedStar Health specialists are also helping to shape new standards of care for cerebrovascular patients through interventional neuroradiology. These nonsurgical treatments of strokes, aneurysms and AVMs include:
- Vascular stents
- Detachable coils
- Advanced embolization procedures