Neuroscience & Stroke
Doctors know that speed is essential in minimizing the damaging effects of stroke. But what’s in their arsenal to treat it?
Identifying a Stroke — Fast
First and foremost, the type and location of the stroke must be identified. To aid the stroke team, St. Anthony’s Medical Center has a biplane angiography unit, an imaging system that obtains very clear, three-dimensional rotational images of blood vessels prior to and during actual clot-busting procedures. The technology makes neurological procedures easier and safer.
Technology Used on Potential Stroke Patients
- A CT scan to check for bleeding and to see if surgery is needed.
- Magnetic resonance imaging (MRI) scans are used to find blood clots. This technology provides doctors with highly defined images of the brain and nervous system tissue which are important for early diagnosis of many diseases and hyperacute or very recent stroke.
- Extra-sensitive magnetic resonance angiography (MRA) can be used to view small arteries or veins and find blood clots.
The stroke team injects a clot-busting drug called tissue plasminogen activator or tPA into the veins. tPA is the only FDA-approved clot-busting medicine available, and it must be used within three hours of the onset of a stroke.
Strict guidelines govern the use of tPA. Patients may not be able to receive it if they have had:
- any history of bleeding in the brain
- major surgery within the past 14 days
- gastrointestinal bleeding in the past 21 days
- previous stroke or head trauma in the past three months
At St. Anthony’s Medical Center, some patients who are beyond the three-hour time limit may still be able to receive tPA intra-arterially — by threading a catheter through an artery and then injecting the drug directly at the site of the clot. Not many hospitals offer this advanced option because it takes a skilled physician to maneuver a catheter through the body and into the brain.
Other Options for Stroke
There are other options available. In these procedures, physicians must be careful to capture all of the pieces of the clot so that new blockages don’t form farther in the brain.
- physically breaking apart a clot by using a catheter
- implanting a stent to keep the blood vessel open
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