Acute Stroke and its management

Acute Stroke — Symptoms and Management 👇

🧠 What is a Stroke?

A stroke occurs when blood flow to a part of the brain is interrupted or reduced, depriving brain tissue of oxygen and nutrients — causing brain cells to die within minutes.

Two main types:

Ischemic Stroke (≈ 85%) — due to blood clot or blockage in an artery.

Hemorrhagic Stroke (≈ 15%) — due to rupture of a blood vessel, causing bleeding in or around the brain.

⚠️ Symptoms of Acute Stroke

Remember the FAST rule:

Other symptoms may include:

Sudden numbness or weakness (especially one-sided)

Sudden confusion or trouble understanding speech

Sudden vision problems (one or both eyes)

Sudden dizziness, loss of balance, or coordination

Severe, sudden headache (especially in hemorrhagic stroke)

🏥 Emergency Management (Initial Steps)

Immediate Action:

Call emergency services (don’t wait for symptoms to improve).

Check airway, breathing, and circulation (ABCs).

Do NOT give anything to eat or drink.

Note the time of symptom onset — crucial for treatment decisions.

💉 Hospital Management

1. Diagnosis

CT or MRI brain to distinguish ischemic vs hemorrhagic stroke.

Blood glucose, electrolytes, CBC, coagulation profile etc.

2. Ischemic Stroke Treatment

🩸 Goal: Restore blood flow quickly.

IV thrombolysis (tPA / Alteplase) if:

Within 4.5 hours of onset.

No contraindications (e.g., bleeding, recent surgery, etc.).

Mechanical thrombectomy (clot removal using catheter):

Within 6–24 hours for large vessel occlusion.

Supportive care:

Maintain airway, oxygen, and hydration.

Control blood sugar and blood pressure (avoid rapid drops).

Start antiplatelet (aspirin) after 24 hours (if no bleeding).

3. Hemorrhagic Stroke Treatment

🩸 Goal: Control bleeding and reduce brain pressure.

Stop anticoagulants/antiplatelets if being used.

Manage blood pressure carefully (reduce if very high).

Surgical options:

Evacuation of hematoma if large or causing mass effect.

Repair of aneurysm or AVM if present.

Control intracranial pressure: Head elevation, osmotic diuretics (mannitol).

🔄 Post-Stroke Care & Prevention

Rehabilitation: Physiotherapy, speech therapy, occupational therapy.

Prevent recurrence:

Control BP, diabetes, cholesterol.

Stop smoking, limit alcohol.

Continue antiplatelet (Aspirin/Clopidogrel) and statins as advised.

Tags: by | October 31, 2025, 10:34 am | 0 Comments

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