Basically, a distinction is made between treatment in the acute stage and subsequent rehabilitation treatment. The latter also includes preventive measures to avoid further strokes. Very important in the acute stage is to start treatment as soon as possible. Just as in the case of myocardial infarction, the following also applies to stroke: the earlier adequate measures are initiated, the lower the complication rate and the extent of permanent neurological deficits.
Lysis therapy as a form of treatment
The only causative measure, in ischemic insult caused by vascular occlusion, is lysis therapy, in which a drug given as an infusion dissolves blockages in the vessel. However, this is only effective if it starts within the first three to four hours after the infarction. To date, it is estimated that only a quarter of patients can be admitted to an appropriately equipped hospital or even a stoke unit (a department specially equipped for strokes) during this time.
Other treatment options include blood-thinning drugs given through veins that reduce the blood’s ability to clot, thus improving blood flow to the affected area of the brain and reducing the extent of the damage. Under certain conditions, an attempt can also be made at special centers in the acute stage of a stroke to expand the blocked vessel again using a balloon catheter that is inserted into the vascular system (balloon dilatation).
If an acute stroke is caused by hemorrhage into the brain, for example in the case of a brain tumor or after a vessel rupture, brain surgery to relieve pressure may also be necessary under certain circumstances (trepanation).
Stroke: treatment options
After the acute phase in stroke is over, measures begin to reduce or compensate for permanent deficits, manage everyday life, reduce risks for another stroke, and correct possible causes. Thus, the following treatment options arise:
- Physiotherapy or physiotherapy, occupational therapy, speech therapy.
- Medication for blood thinning
- Control of risk factors for stroke (diabetes, dyslipidemia, adjust blood pressure well, stop smoking, exercise regularly, reduce or lose excess weight).
- Operation of large narrowed neck vessels
- Treatment of underlying heart disease