Stroke often leads to widespread and long-lasting problems.stroke is a life-threatening condition that is caused when a part of the brain’s blood supply is cut off. As per WHO 150 individuals out of 1 lakh have a stroke each year in india and it is the fifth leading cause of death.Stroke is a medical emergency, and seeking early treatment is crucial to ensure that the risks of brain damage and potential complications are minimized.
While stroke is a life-changing event that may lead to feelings of frustration, helplessness, and depression, so it is very essential to reduce the morbidity and mortality.
In his lecture
Dr Navin Tiwari said identification of CVA could be done by acronym FAST.
F.A.S.T. campaign (Face drooping, Arm weakness, Speech difficulty, Time to call STROKE TEAM) to improve awareness of stroke and to expedite activation of emergency services for stroke victims. It is critical to establish the time of onset of symptoms because this determines whether a patient meets the 4.5-hour eligibility window for thrombolytic treatment . Noncontrast CT scan Brain immediately determine whether the stroke is ischemic or hemorrhagic, which is critical because treatments are different. Stroke severity is determined by performing a complete neurologic exam and assessing the patient using the National Institutes of Health Stroke Scale (NIHSS). The NIHSS is a 15-item scale that can be performed in about 5 minutes (National Stroke Association, 2015). A score of greater than 16 predicts a high probability of death or severe disability, whereas a score of less than 6 predicts a good recovery.
He also said, the goal of treatment in the acute phase of ischemic stroke is to salvage brain tissue by restoring blood flow as soon as possible. Emergency management for ischemic stroke consists of assessment of the patient’s airway, breathing, and circulation; stabilization of the patient; and complete initial evaluation including neurologic exam, imaging, and laboratory studies within 60 minutes of patient arrival. Early intravenous administration of the thrombolytic agent, recombinant tissue plasminogen activator (rt-PA) improves outcomes if given up to 4.5 hours after onset of initial symptoms. Emphasing on treatment modality
Dr. Navin Tiwari said science has progressed alot and new techniques are evolving to treat iscemic stroke.
Another treatment option is an endovascular surgical procedure called mechanical thrombectomy. In this procedure, the blood clot causing the ischemia is extracted by threading a catheter with a wire-caged device called a stent retriever into the blocked arterial vessel in the brain. The procedure should be done within 6 hours of acute stroke symptoms and only after a patient receives rt-PA. Recent studies show success with thrombectomy up to 8 hours after the onset of stroke symptoms.