Stroke drug choice and treatment measures required

A stroke occurs when the blood supply that carries oxygen and nutrients to the brain is interrupted or reduced, causing brain cells to die. This then interferes with the brain's ability to control brain functions such as movement, taste sensitivity, speech, understanding and memory. Stroke is a condition that must be treated immediately. However, what are the drug and treatment options that can be done to treat stroke? Check out the full explanation below.

Treatment options for stroke based on type

Treatment for stroke is usually determined based on the type of stroke experienced. Here are the drug choices and stroke treatment based on the type.

Ischemic stroke treatment

Ischemic stroke is a stroke that occurs due to a blockage in a blood vessel. Treatment for this type of stroke is prioritized to stop the blockage and restore blood flow to the brain as before. The following stroke medicines and treatment options that can be done:

1. Administration of tPA drugs

Medicinal therapy using drugs tissue plasminogen activator (tPA) for ischemic stroke can break down the clot and is given through a vein (intravenously). However, the tPA drug must be given within 4.5 hours after the first stroke symptoms appear.

The sooner this medicine is given, the better. Treatment that is carried out quickly and precisely can increase the patient's potential for recovery, as well as reduce the risk of stroke complications.

This stroke drug is included in the standard of treatment for ischemic stroke. This medicine can restore blood flow by shedding the blood clot that caused the stroke. The sooner the cause of the stroke is treated, the faster the patient will recover fully from this condition.

Even so, while using the tPA drug, the doctor will consider several risks, such as bleeding in the brain to determine whether this stroke drug is suitable for your condition.

2. Endovascular procedures

Apart from using tPA drugs, doctors can also treat strokes directly in blocked blood vessels. This can be done by undergoing endovascular procedures. This therapy is considered quite good in reducing the effects of ischemic stroke.

However, you must remember that for therapy to be of maximum effect, this procedure must be carried out as soon as possible. There are two ways to undergo this endovascular procedure, one of which is stroke medication given directly to the brain.

The doctor will insert a catheter, which is a long thin tube through an artery in the inner thigh and directs it to the brain to release tPA right in the blocked artery.

This procedure can also be done by inserting a device attached to a catheter to immediately remove a blood clot that is blocking an artery in the brain. This procedure is very beneficial for patients whose blood clots are too large and cannot be resolved even when using the tPA stroke medication.

3. Use of antiplatelet drugs

When a blood vessel bursts, platelets or pieces of blood will try to cover the wound in the blood vessel by clotting the blood. However, if a blood clot occurs in an artery, there is a risk of triggering a stroke.

Antiplatelets are blood thinners. This drug is useful for preventing blood clots caused by these blood clots.

One of the most common antiplatelet stroke treatments that doctors use in an emergency is acetylsalicylic acid (ASA) or better known as aspirin. Apart from being shown to be effective at thinning blood, aspirin can help channel blood to the affected area.

However, you or other family members should tell the doctor if the patient is already taking aspirin for heart disease or other conditions.

However, some people cannot treat this stroke because they have bleeding problems, allergies, or have certain medical restrictions. Apart from aspirin, several other antiplatelet drugs that can be used are clopidogrel, dipyridamole and ticlopidine.

It is important to know, if you are taking blood thinners for stroke, then you are at risk of bleeding faster than usual when injured.

4. Use of anticoagulant drugs

Your doctor may give you an anticoagulant medication to reduce the risk of new blood clots forming. These drugs work by changing the chemical composition of the blood so that blood clots do not form.

Coagulant drugs for stroke including warfarin, apixaban, dabigatran, edoxaban, and rivaroxaban that can be used for a long time. There are also anticoagulants such as heparin which are usually given by injection and can only be used for a short period of time.

Usually, anticoagulant drugs are given when:

• The patient has an abnormal heart rate such as atrial fibrillation. which can cause blood clots.
• The patient has a history of blood clots.
• Blood clots occur in the blood vessels in the leg area, so that a stroke causes the patient to be unable to move one leg.

5. Medication for lowering high blood pressure

If you have high blood pressure, it can cause a stroke. Therefore, the use of drugs to lower high blood pressure may be able to overcome this stroke.

High blood pressure drugs that can be used to treat ischemic strokes include:

• Thiazide diuretic.
• Angiotensin-converting enzyme (ACE) inhibitors.
• Calcium channel blockers .
• Beta-blockers.
• Alpha-blockers.

6. Carotid endarterectomy

Ischemic stroke can also occur if the arteries in the neck become narrowed. In fact, these carotid arteries carry blood to the brain. This narrowing, also known as carotid stenosis, can cause plaque buildup.

If this condition gets worse, you may have to undergo surgery to open the blockage in the vessel. This surgical procedure is referred to as carotid endarterectomy . During this procedure, the doctor will dissect the neck to open the carotid arteries and remove the plaque contained in them.

Treatment for hemorrhagic stroke

In contrast to ischemic strokes that occur due to blockage of blood vessels, hemorrhagic strokes occur because there is bleeding in the brain. The following are drug and treatment options for bleeding stroke, such as:

1. Emergency measures

If you have previously used blood thinners to prevent clots, your doctor may order drugs or a blood transfusion to counter the effects of blood thinners. In addition, the doctor may also prescribe drugs to lower blood pressure in the brain, lower normal blood pressure, and prevent seizures.

2. Operation

In addition to using drugs to treat strokes, patients may have to undergo surgical procedures as a way to cure their strokes. This operation aims to remove blood from the brain and repair the broken blood vessels. This operation is known as a craniotomy.

During the surgical procedure, a small part of the skull is removed so that the surgeon can reach the source of bleeding in the head.

The surgeon will repair damaged blood vessels and ensure that there are no blood clots that can prevent blood flow from entering the brain.

After the bleeding has been successfully stopped, a small portion of the skull that was previously removed is replaced by a metal disk.

3. Endovascular embolization

Treatment options for hemorrhagic stroke are usually done by undergoing medical procedures rather than using stroke drugs. One of them is endovascular embolization.

This procedure is usually performed by inserting a catheter into an artery found in the inner thigh and directing it towards the brain. The surgeon will insert a loop that can be removed into the aneurysm to fill it. This can prevent blood flow to the aneurysm and cause blood clots.

4. AVM removal operation

According to the Mayo Clinic, one of the treatments for hemorrhagic stroke is the removal of arterial-venous malformations (AVM) if they are located in an accessible area of ​​the brain. This can help reduce the risk of a broken blood vessel causing a hemorrhagic stroke.

However, not all arterial-venous malformations can be removed, especially if they are located deep in the brain, are large, or the removal procedure risks causing major changes in brain function.

5. Operation for hydrocephalus

In fact, the surgical procedure that is usually performed to treat hydrocephalus disease can also be used to treat bleeding strokes.

This can be done if the damage caused by a stroke causes cerebrospinal fluid to accumulate in the brain cavity, causing headaches, dizziness, vomiting, and the patient loses balance.

This hydrocephalus can also be treated by placing a small tube inside the brain so that fluid flows out of the brain.

6. Stereotactic surgery

Instead of using drugs, the option for subsequent hemorrhagic strokes is to have stereotactic surgery. This surgery can be performed using multiple beams or high radiation, but it can be very effective at repairing vascular malformations that can be a cause of stroke.

Therapy and recovery after a stroke

After taking medication and undergoing various medications, it is important to always monitor the condition of stroke patients. You may also need to focus on helping the patient's recovery process so that his physique can function as before.

Even so, the effects of a stroke can vary from person to person. This, usually, depends on the area of ​​the brain that is affected and the amount of tissue damaged.

If a stroke attacks the right side of the brain, the movement and sensitivity of the left side of the body may be impaired. Meanwhile, if a stroke attacks the left side of the brain, the movement and sensitivity of the right side of the body will be affected. Not only that, damage to the left brain can interfere with speaking and language skills.

After passing the critical period of stroke, most patients have to undergo rehabilitation or therapy for stroke. Usually, the doctor will recommend the type of therapy that is suitable for your age, overall health condition, and the severity of the stroke you are experiencing.

The doctor may also consider lifestyle, hobbies, priorities, and the availability of a caregiver or family member who will be there to be there for the patient. Rehabilitation will begin before the patient is completely allowed to leave the hospital.

After being discharged from the hospital, the patient may be asked to continue the rehabilitation program at the same hospital, or the patient may also be allowed to undergo rehabilitation at home with the help of a nurse from the hospital.

Rehabilitation for stroke may be assisted by several people, including:

• Neurologist.
• Rehabilitation specialist.
• Rehabilitation nurse.
• Nutritionists.
• Physical therapist.
• Speech therapist.
• Psychologist.
• Religious expert.

Of the various types of treatment above, the doctor at the hospital will determine the type of treatment based on the type of stroke, the health condition of the body, to the severity.