- On Doc’s Mind
An acute stroke signifies loss of brain tissue due to lack of blood flow in the affected area. Most strokes occur arising out of blockage or impairment of blood flow known as an ischemic stroke (85%) while the rest arise from bleeding within the brain (15%).
Some symptoms of an acute stroke include:
An acute stroke is an emergency! TIME IS BRAIN. The goal of care is that a patient should get to an ER (Emergency Room) as soon as possible for effective treatment to maximize your chances of recovery.
For ambulance arrivals, our ER is pre-alerted to an incoming stroke. However, should relatives or care givers bring in their own relatives, it would be beneficial, if possible, to call in at 662-2766 (press 1 for ER) and give an ETA.
Upon arrival we conduct immediate assessments, run the relevant blood tests and expedite the time to scan where we routinely perform a CT Brain and Angiogram Brain. This helps us to determine what type of stroke there is and the presence of any severe blockages in the arteries of the brain which may need treatment.
After a diagnosis is made and depending on the timeframe we may proceed to treatment with specific “clot medications” known as thrombolytic agents. In some instances, before that decision is made, we may do MRI scans to help assess candidacy for these medications. Additionally, we may sometimes need to perform further interventions such as a cerebral angiogram with clot removal. This is usually done in the Catherization Lab by our Neurovascular Neurosurgeon.
In patients who were treated with thrombolytic agents or received care in the Catheterization Lab, we usually admit to the High Dependency Unit for 24-hour observation. For stable non acute stroke, we may admit to the regular ward for observation and follow up.
Once patients have stabilized, we then look for causes of the stroke which includes further testing but not limited to, such as:
Post stroke care is vital for a good outcome. We may enlist the services of the following providers depending on the source of the stroke: