• Saanvi Jain

Acute Stroke Intervention

Did you know that every 40 seconds, someone in the United States has a stroke? About 87% of these strokes are acute ischemic strokes. Such strokes can be quite fatal and are one of the biggest causes of stroke-related death in the United States. Acute ischemic strokes occur when a clot, or a mass of thickened blood, blocks the blood flow through a brain artery. Initially, these clots occur either in the heart or in the carotid artery in the neck, but it breaks off and obstructs one of the main arteries that go to the brain. This can result in a lack of oxygen and nutrients and a part of the brain being cut off from the rest due to the dying of the cells. Because of this quite sudden loss of blood circulation in the brain, many neurological functions can be affected and in severe cases, even lost. This is due to the fact that a stroke affects the normal signals that the brain sends to the body to function.

Some of the effects on neurological functions of a person such as speech and language, swallowing, memory, vision and perception skills, emotional functioning, and personality may be permanently affected by an ischemic stroke. In terms of speech and language, a stroke can make it hard for a stroke patient to find the correct name for objects or people or even understand what others are saying. Reading may also become a challenge for them. The patient may also face challenges with swallowing food, drinks, and even medications. One of the biggest effects of a stroke is on memory, specifically short-term memory. Someone who has had a stroke may not be able to retain any new information or even access any of their past memories. Strokes can also affect visual memory and verbal memory so a patient may have difficulties recognizing the faces of others or naming items. Vision and perception skills can also be affected by a stroke. For example, an individual may be unable to pay attention to a specific side of the visual field, for most stroke patients, this happens to be the left side. Balance is also often disturbed. A patient may also have emotional problems like depression and mood swings resulting from a stroke. Personality changes are often also very common such as a lack of interest in previously interesting activities. In addition, some of the main risk factors for an acute ischemic stroke include high blood pressure, atherosclerosis, high cholesterol, atrial fibrillation, a prior heart attack, sickle cell anemia, clotting disorders, congenital heart defects, diabetes, smoking, having excess abdominal fat, heavy alcohol misuse, and use of drugs such as cocaine or methamphetamines.

Although acute ischemic strokes can be quite dangerous and life-changing for many, there are quite a few treatments and intervention processes for it. One of the most standard patient care methods for these strokes are intravenous (IV) tissue plasminogen activators (tPA). IV tPAs break up clots by dissolving them. tPA is a protein found in cells that line the blood vessels called endothelial cells, which activates the conversion of plasminogen to plasmin. In other words, it is an enzyme and blood thinner that can help restore blood flow towards the brain by breaking down the clots that caused the acute ischemic stroke in a patient. By injecting tPA through an IV injection, the regimen is administered. This treatment is most effective no later than four and a half hours after a stroke. Patients that get an IV tPA within 3 hours of their stroke have shown better and even complete recoveries. However, an IV tPA can result in bleeding if a patient has a history of a hemorrhagic stroke, bleeding in the brain, or has undergone a recent major surgery or head injury. Because of the high success rates of an IV tPA treatment, this method is considered the most common for an acute ischemic stroke.

Doctors may also perform emergency endovascular procedures and treat a stroke directly in the vessel that is blocked. One such method is delivering the tPA directly to the clot. This is done by inserting a catheter, which is a thin tube, to the brain through an artery found in the groin. Another method is used for patients who have larger clots for which a tPA treatment is not enough. In this method, doctors remove the clot from the blocked blood vessel through a stent retriever attached to the catheter. This method is also known as a mechanical thrombectomy.

Through the hard work of scientists, researchers, and medical professionals, there are a variety of acute stroke intervention methods to treat an acute ischemic stroke after it has occurred. Although acute stroke intervention techniques are extremely effective in eliminating clots and stopping strokes, many stroke patients have to go through additional therapy to go back to their normal lives, and some may not even be able to do that. Thus, the best steps one can take to stay healthy are preventative. Everyone should do whatever is possible to decrease the risk of ever having a stroke. The key is to live a healthy lifestyle with clean foods, lots of exercise, and plenty of self-care.