Discovery Fit & Health
When doctors see someone who thinks he's just had a stroke, the first thing they need to do is determine that the symptoms were really caused by a stroke; there are times when a brain tumor, a nerve injury or even a migraine can bring on similar symptoms. It's been suggested that as many as one-fourth of patients who exhibit stroke symptoms are not actually having strokes [source: Kolata]. The doctors also need to quickly work out if the patient has had a hemorrhagic stroke (caused by a burst artery) or an ischemic stroke (caused by a clot) so that appropriate treatment can be given as soon as possible. Often, brain imaging technology is needed, such as a CT or MRI scans.
Ischemic strokes happen when a clot blocks the blood flow to a part of the brain. The most common treatment is with tissue plasminogen activator (tPA, also known as Activase). This medication is effective at breaking up and dissolving clots, but only in the first three hours after the stroke occurs. Other treatments may control blood pressure and strengthen the heart. Anticoagulants may be given to stop future clots from forming. It is also important to combat any fever, since it increases the likelihood of brain damage. Surgery is rare in treating ischemic strokes.
There are several problems with using tPA, which is the only drug approved by the Food and Drug Administration to break up and dissolve blood clots. It is an effective treatment for ischemic strokes when administered on time. In about six percent of patients, however, tPA causes bleeding in the brain [source: Kolata]. This can be particularly bad if tPA is mistakenly given to someone who's had a hemorrhagic stroke because he or she already has bleeding in the brain. Further, tPA could actually activate a hemorrhagic stroke in the 20 percent of people over age 60 who exhibit signs of microbleeding (small drops of blood leaking from arteries in the brain) [source: Kolata]. Israeli prime minister Ariel Sharon suffered this fate in 2005 [source: Kolata].
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