Stroke Fast Track: Ischemic Stroke

Stroke Fast Track: Ischemic Stroke

Dr. Ittikorn Saelao, a Neurologist at Vibhavadi Hospital, stated that an ischemic stroke is caused by constricted cerebral blood vessels which leads to a lack of blood supply to the brain. This will cause the brain tissue to begin to die, starting in the middle cerebral hemisphere and expanding out to other parts of the brain, resulting in paresis or paralysis.

Stroke Fast Track

Dr. Ittikorn Saelao, a neurology physician at Vibhavadi Hospital, stated that an ischemic stroke is caused by constricted cerebral blood vessels, resulting in a lack of blood supply to the brain. As a result, the brain tissue will start to die in the middle cerebral hemisphere first, before gradually spreading to other areas of the brain, potentially causing paresis or paralysis.

It was discovered that after 4 and a half hours (270 minutes) of the patient exhibiting symptoms, a medical breakthrough was made regarding the treatment of Cerebral Infarction (Ischemic Stroke) with thrombolytic drugs, known as Thrombolytic Therapy. This is an important period for physicians to use when planning for treatment.

Four and a half hours, or 270 minutes, is the amount of time between the moment a patient experiences their first symptom of a stroke and when a doctor injects them with fibrinolytic medication. If the patient arrives at the hospital later than this often they are unable to receive such treatment, as brain tissue can only endure ischemia for 270 minutes before it dies. This stroke treatment plan is known in medicine as the "Stroke Fast Track," "Stroke Expressway," or "270 Minutes of Life."

Symptoms that are abnormal and are warning signs that there is a chance of ischemic stroke are:

1.             Symptoms and signs

-               Hemispherical First Limb hemiparesis

-               Numbness of the limbs (hemisensory loss)

-               Weakness in both limbs

-               Slurred speech oret

-               Blurred vision (double vision or dij)

-               Can't speak, can't hear (aphasia)

-               Blurred vision (hemianopia , mor)

-               Staggering without balance (ataxin)

-               Dizzy, spinning house

2.             Time Course (one or the other)

-               Quickly or instantly

-               After waking up

Risk factors of ischemic heart disease is

-               Gender: Men have a higher chance than women.

-               Age: As age increases, starting at 45, the likelihood of having a stroke increases, indicating that the older you get, the more chances you have of developing the condition.

-               Family history: People with a family history of this disease, such as a parent, sibling, or other direct relative, may have a higher chance of developing it themselves.    

-               Congenital disease: People with congenital disease especially diabetes hypertension Hyperlipidemia, heart disease

-               People who smoke

-               People who are overweight

Cause

1.             Adhesion of fat on artery walls (atherosclerosis)

2.             Blood clots dislodged from the heart (Cardiac emboli)

3.             Torn artery wall (arterial dissection)

4.             Others such as

-               Inflamed blood vessels (Vasculitis)

-               Blood viscosity (Hyperviscosity)

-               Abnormal blood clotting (Hypercoagulability)

Risk factors can be divided into

Factors that cannot be prevented include:

-               Older age, especially from 45 years old, there is a greater chance of having an ischemic stroke.

-               Gender: People with a family history of the disease, such as a father, mother, or siblings, are more likely to develop it than those without such a family history. Additionally, men are slightly more likely than women to get the disease.

Preventable factors include:

-               Congenital diseases such as high blood pressure, diabetes, hyperlipidemia certain heart diseases heart disease (arrhythmias, valvular heart disease)

-               Smoking

-               Those who are overweight

-               Lack of exercise

If you have any unusual symptoms that could be indicative of an ischemic stroke, it is important to seek medical attention immediately. Taking steps to manage the risk factors associated with stroke can help to reduce the chances of experiencing a stroke. However, if a stroke occurs, it is important to get to the hospital as soon as possible. With the Stroke Fast Track program, you can get from the stroke expressway to the hospital within 270 minutes, dramatically increasing the chances of a positive outcome.

Ischemic Stroke Treatment

At Vibhavadi Hospital, there is a team of doctors, nurses, and multidisciplinary professionals ready to provide quick screening and treatment of any abnormal symptoms related to ischemic stroke. The Stroke Fast Track treatment plan involves a 60 minute procedure, including neurological examination, blood tests, and a CT brain scan if the patient has symptoms within 4.5 hours and has no contraindications to drug administration. The standard treatment for ischemic stroke today is the intravenous administration of a blood-thinning drug called Recombinant Tissue Plasminogen Activator (rtpa). The Neurology Center would like to clarify the benefits and complications that may occur from intravenous fibrinolytic injection of this drug.

Benefits

The study revealed that patients who were given the drug experienced an improvement in their symptoms. Additionally, those who did not receive the drug but had either a mild level of residual disability or a full recovery after three months were 30% more likely than those who did not receive the drug.

Potential Complications

The study revealed that 6.4% of patients who took the drug were more likely to experience complications such as brain hemorrhage, compared to the 0.6% of those who did not. Nevertheless, by carefully selecting patients and checking for drug allergies, the chances of further complications can be minimized.

Other Treatments

If the patient is not able to receive intravenous fibrinolytic drugs, the doctor may opt to give anticoagulant drugs instead to prevent stroke complications. The patient will need to be admitted to a stroke unit to ensure their neurological health, as well as regulate their cardiovascular system, respiratory system, body temperature, blood pressure, and blood chemistry. Furthermore, physical therapy may also be used to further rehabilitate the patient.

Ischemic stroke can be managed to reduce the risk of death through careful monitoring and control.

Risk factors that can be controlled, such as managing underlying conditions to stay within healthy range, adjusting lifestyle habits to fit, such as eating a balanced diet of all five food groups, exercising regularly, keeping weight within the suggested range, abstaining from smoking, and avoiding alcohol consumption, and seeing a doctor immediately if any abnormal symptoms appear, are critical components of the 270 minutes of Life Stroke Fast Track.

At Vibhavadi Hospital, our team of doctors and nurses are ready to quickly assess any abnormal symptoms that a patient may be experiencing, such as paralysis or stroke. We have a Stroke Fast Track Treatment Plan that follows all service procedures to ensure that treatment is provided as soon as possible upon arrival at our hospital. Generally, it takes about 60-90 minutes from arrival until treatment begins.

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