Thrombocytopenia
Blood clots can be dissolved with the help of certain drugs. However, dissolving a clot is not always preferred in the treatment of thrombotic and embolic events, so mechanical procedures, such as using an instrument like a small pair of forceps to remove the clot, are also used. In the treatment of strokes, clots can be dissolved with a so-called lysis therapy.
This involves the use of r-tPA. This drug can dissolve the clot. However, this procedure can only be used up to 4.5 hours after the stroke symptoms occur.
Anticoagulant drugs are generally used to dissolve blood clots. For example, heparin or anticoagulant tablets such as Apibaxan are used for thrombosis of the leg veins. In long-term therapy, the anticoagulant drug Marcumar® (phenprocoumon) is usually used. The duration of the medication depends on the severity of the disease and existing risk factors.
Blood clot in head/brain
Almost 90% of strokes are described as ischemic. This leads to an occlusion of an important blood vessel and consequently to a reduced supply of blood, nutrients and oxygen to the brain. A distinction is made between vascular occlusions caused by blood clots that have been carried away (“embolus”) and those caused by locally formed clots (“thrombus”).
Risk factors for embolic vascular occlusions of the brain are e.g. atrial fibrillation or a narrowing of the carotid artery (“carotid stenosis”). Furthermore, basic diseases such as diabetes melittus, high blood pressure, excessive blood fat values (hyperlipidemia), overweight and nicotine abuse are also decisive for the formation of blood clots in the brain. These mainly lead to the closure of small vessels (lacunar infarction).
Typically, the stroke symptoms are hemiplegia, speech and language disorders and sudden onset. It is important to act quickly and to initiate a so-called lysis therapy within 4.5 hours after the stroke. This involves dissolving the clot with the drug r-TPA.
A mechanical removal of the clot (thrombectomy) is also possible. These clinical pictures involve the closure of veins or the venous sinus of the brain by blood clots (thrombi). There are two main mechanisms of formation, namely non-infectious and infectious formation.
Non-infectious sinus and venous thromboses mainly affect women in childbed. Other causes are cancers, the use of hormonal contraceptives, basic haematological diseases such as polycythaemia vera and coagulation disorders (APC resistance, factor 5 disease, etc.). Infectious thromboses are caused, for example, by the progression of inflammation of the middle ear or paranasal sinuses.
Other infections in the facial area can also be carried over into the brain vessels and cause a thrombosis there. The symptoms can be similar to those of a stroke, but usually tend to creep in over a period of time. However, the onset can also be sudden.
Typical symptoms are nausea, vomiting, headaches, double vision, hemiplegia and drowsiness. About 40% of those affected even suffer epileptic seizures. Imaging procedures such as CT or MRT are used to confirm the diagnosis.
The therapy focuses on stabilizing the patient and immediately heparinizing the blood. The heparin makes the blood more “fluid”, so to speak, and leads to the brain being better supplied with blood again. In addition, local thrombolysis (dissolution of the blood clot) can be considered. In the case of infectious causes, antibiotics or surgical removal of the focus of the infection are used.
