Stroke Science Series 5 Acute treatment of ischemic stroke

Mondo Health Updated on 2024-01-30

Stroke is one of the leading causes of human disabling diseases and can be life-threatening. Stroke is divided into ischemic and hemorrhagic stroke, of which ischemic stroke accounts for about 60-80% of all strokes, and whether the cerebral blood vessels with acute occlusion can be recanalized in time, whether the progression of intravascular thrombosis can be inhibited in time, and whether the degree of disability can be minimized is closely related to the prognosis of patients, which is an important target for clinicians' diagnosis and treatment.

The key to stroke diagnosis and treatment lies in early diagnosis and early diagnosis, and the standardization of the acute phase (within 2 weeks of onset) is crucial, mainly including the following means:

Ultra-early thrombolysis**.

Intravenous thrombolysis** is currently internationally recognized as the most important and effective method for restoring blood perfusion in acute ischemic stroke, and the time window for administration is within 6 hours after the onset of the drug, especially 4Within 5 hours, if contraindications are ruled out, thrombolysis** can be considered, which can reduce disability, stay away from paralysis, and even save lives in about 1 to 3 patients. Thrombolytic agents include recombinant tissue plasminogen activator (RT-PA, alteplase), urokinase, and tenecteplase. Therefore, time is of the essence, and if you have a suspected stroke symptom, you need to immediately seek medical treatment in a large general hospital with stroke emergency capabilities near your place of residence, so as not to miss the possible opportunity for thrombolysis.

Endovascular intervention**.

Patients with acute ischemic stroke with more serious conditions are generally caused by large vessel occlusion, and the effect of intravenous thrombolysis is often poor, so it is necessary to start neurointervention in time**, mainly in the catheterization laboratory for whole cerebral angiography, to find the site of local blood vessel blockage, and use a special thrombectomy device to remove the thrombus from the blood vessels, called mechanical arterial thrombectomy, through which the blood flow of the occluded site can be restored, bringing a glimmer of life to the patient's treatment. The optimal time window for mechanical arterial thrombectomy is within 6 hours of onset, and it can be extended to up to 24 hours, and the longer the delay, the worse the prognosis. Therefore, it is also emphasized that the sooner the treatment, the greater the hope.

Antithrombotic**. These include antiplatelet aggregation and anticoagulation**. For patients who are unable to undergo intravenous thrombolysis or arterial thrombectomy, antiplatelet agents such as oral aspirin and/or clopidogrel should be given as soon as possible after onset. In patients following intravenous thrombolysis**, aspirin should be started 24 hours after thrombolysis. After the patient's condition is stabilized, cardiogenic cerebral infarction due to atrial fibrillation or emboli detachment requires anticoagulation with drugs such as warfarin or dabi** rivaroxaban**.

Take your medication as soon as possible!Management of risk factors for stroke.

Hypertension, diabetes, hyperlipidemia, smoking, etc. are controllable risk factors for stroke, and poor regulation of blood pressure and blood sugar can make the symptoms of acute stroke progress, so it is necessary to standardize the monitoring and management of blood pressure, blood sugar, and blood lipids under the guidance of neurologists, and do not blindly lower blood pressure, otherwise it may lead to aggravation of stroke symptoms.

Stroke**. Stroke is very important in the standardized whole process management of stroke, mainly including the assessment and functional training of movement disorders, aphasia, swallowing disorders, balance disorders, etc., and the division uses advanced equipment to provide patients with targeted treatment, which can minimize the degree of disability caused by neurological deficits, prevent complications, and improve the quality of life of patients.

This article is limited to public welfare science popularization and academic exchanges, if you feel unwell, please seek medical attention as soon as possible, part of the information in the article ** on the Internet, invaded and deleted, thank you!

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