Stroke and aneurysm: What you need to know

Acute Ischemic Stroke

An acute ischemic stroke occurs when a blood clot blocks an artery that brings blood to the brain. Deprived of oxygen and nutrients, the brain cells start to die at a rate of two million neurons per minute, which is why every minute that passes increases the risk permanent brain damage, disability or death. Recognizing stroke symptoms and acting fast to get medical attention quickly can save a life and minimize disability.

Stroke symptoms can include sudden:

  • Numbness or weakness of the face, arms or legs – especially on one side of the body
  • Confusion, difficulty speaking or understanding
  • Trouble seeing
  • Difficulty walking, dizziness, loss of balance or coordination
  • Severe headache

How are strokes treated?

Studies show that choosing the right hospital for treatment saves critical minutes in the treatment process. In fact, the likelihood of having a good outcome decreases if patients need to be transferred between hospitals. Prisma Health Greenville Memorial Hospital is the only certified Comprehensive Stroke Center in the Upstate, and offers the most advanced care to ensure the most successful outcomes for patients who have experienced a stroke.

In stroke treatment, the rule is “Time is Brain!” The faster the stroke is recognized and treatment can be initiated, the better chance of a successful outcome. For patients who come to the hospital with 4.5 hours of symptom onset, intravenous t-PA (a clot-busting drug) is often given.

However, for the worst strokes, mechanical thrombectomy is considered to be a breakthrough in stroke treatment. Removing the blood clot from the brain through a minimally invasive procedure leads to better outcomes for stroke patients. For many patients, including those who cannot get tPA, this option is the best opportunity to have a good recovery from a stroke. The doctors at Prisma Health–Upstate were the pioneers of this technique, which has been shown to be just as effective as a stent, but safer, faster and less expensive. The goal is to remove the clot and restore blood flow to the affected part of the brain.

Hemorrhagic stoke

A hemorrhagic stroke (intracranial hemorrhage or ICH) occurs when there is bleeding in the brain. This bleeding causes a severe headache and, in many cases, weakness or numbness on one side of the body. In some cases, the bleeding is so severe as to cause people to slip into a coma.

When small, ICH can be managed without surgery. However, large bleeds compress vital structures of the brain, and the blood itself is toxic to the brain. These large amounts of blood may need to be removed surgically.

These procedures are performed through a small, dime-sized hole in the skull. Using image guidance, a small camera is used to see as the bleed is controlled and the blood clot is removed. Studies show that if you can remove the hemorrhage in a minimally invasive manner, the patient will leave the hospital sooner and achieve a better outcome.

Brain aneurysms and subarachnoid hemorrhage

An aneurysm is a weak spot on a blood vessel and looks like a sac or a ballooning out from the vessel wall. A subarachnoid hemorrhage is caused by an aneurysm rupturing or bleeding. When an aneurysm bleeds, it is a life-threatening emergency. The main symptom is what is classically described as the worst headache of your life. If this happens, call 911 immediately.

While aneurysms can be treated by traditional open surgery, newer, minimally invasive methods have been shown to be equally effective and better tolerated by patients. An aneurysm can be treated by a number of different minimally invasive techniques.

Article author Raymond Turner, MD, is a neuroendovascular surgeon with Southeastern Neurosurgical & Spine Institute.

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