Ischemic (Infraction): In an ischemic infraction, blood supply to part of the brain is decreased, leading to dysfunction of the brain tissue in that area. There are four reasons why this might happen:
- Thrombosis (obstruction of a blood arteries by a blood clot forming locally)
- Embolism (obstruction due to an embolus from elsewhere in the body)
- Systemic hypo perfusion (general decrease in blood supply, e.g., in shock)
- Cortical Venous thrombosis
Include:
- Sudden numbness or weakness of the face, arm or leg, especially involving one side of the body.
- Sudden confusion, trouble speaking or understanding.
- Loss of vision in one or both eyes.
- Trouble walking, dizziness, loss of balance or coordination.
- Sudden, severe headache with no known cause.
Diagnostic testing such as:
a) Laboratory testing (e.g., complete blood count, electrolytes, blood urea nitrogen, creatinine, glucose, prothrombin time/international normalized ratio [INR], activated partial thromboplastin time [APTT], hemoglobin A1c, fasting lipid profile, troponin, aspartate aminotransferase [AST], urine or serum pregnancy testing),
b) Electrocardiogram,
c) Echocardiogram,
d) Brain and vascular imaging (e.g., computed tomography [CT] of the head without contrast,
e) CT angiography of head and neck,
f) Magnetic resonance imaging [MRI],
g) Diffusion-weighted MRI,
h) Magnetic resonance angiography [MRA],
i) CT or carotid ultrasound),
j) Cardiac monitoring
To treat an ischemic stroke, doctors must quickly restore blood flow to your brain.
- Emergency treatment with medications. Therapy with clot-busting drugs must start within 3 hours if they are given into the vein — and the sooner, the better. Quick treatment not only improves your chances of survival but also may reduce complications. You may be given:
- Aspirin. Aspirin is an immediate treatment given in the emergency room to reduce the likelihood of having another stroke. Aspirin prevents blood clots from forming.
- Intravenous injection of tissue plasminogen activator (TPA). Some people can benefit from an injection of a recombinant tissue plasminogen activator (TPA), also called alteplase.
- Emergency procedures. Doctors sometimes treat ischemic strokes with procedures that must be performed as soon as possible, depending on features of the blood clot:
- Medications delivered directly to the brain. Doctors may insert a long, thin tube (catheter) through an artery in your groin and thread it to your brain to deliver TPA directly into the area where the stroke is occurring.
- Mechanical clot removal. Doctors may use a catheter to maneuver a tiny device into your brain to physically break up or grab and remove the clot.
- Carotid endarterectomy. In a carotid endarterectomy, a surgeon removes plaques from arteries that run along each side of your neck to your brain (carotid arteries)
- Angioplasty and stents. In an angioplasty, a surgeon gains access to your carotid arteries most often through an artery in your groin. Here, he or she can gently and safely navigate to the carotid arteries in your neck. A balloon is then used to expand the narrowed artery. Then a stent can be inserted to support the opened artery.
Consult at Aadil Hospital for medical and surgical procedure.
