Introduction
Treatment options for stroke have been transformed in recent years, saving more lives and reducing disability for those who have access.
6 key facts about stroke treatment
1. Early recognition makes a big difference.
Knowing the signs (BE FAST) and symptoms of stroke and getting treatment quickly saves lives and improves recovery.
2. Around 1 in 10 more people make an excellent recovery when cared for in a specialized stroke unit.
All patients with stroke (ischaemic or haemorrhagic) should be admitted to a specialized well equipped and advanced stroke unit, which involves a designated ward with a specialized and dedicated stroke team.
3. Clot-busting drugs (tPA or thrombolysis) increase the chance of a good outcome by 30%.
To dissolve a blood clot, (t-PA) is given within four and half hours of stroke through intravenous route to the suitable Stroke patients-Tissue plasminogen activator (t-PA) is an enzyme found naturally in the body that converts, or activates, plasminogen into another enzyme to dissolve a blood clot. t-PA may also be used in an IV by doctors to speed up the dissolving of a clot. The first FDA-approved acute treatment for ischemic stroke is a recombinant, or genetically engineered, form of tissue plasminogen activator (rt-PA). We found that carefully selected stroke patients who received in our Stroke Unit within four and half hours of the beginning of stroke symptoms were at least 33 percent more likely to recover than patients given a placebo to recover from their stroke with little or no disability after three months. The most common complication is brain hemorrhage.
To dissolve a blood clot between within 6 hours and some times upto 24 hours of stroke, thrombolytic drug can be given through intra-arterial route after performing cerebral digital substraction angiography in the Stroke patient.
4. Clot retrieval treatment increases the chance of a good outcome by more than 50%.
Clot retrieval treatment (mechanical thrombectomy) involves removing a blood clot and can improve survival rates and reduce disability for many people with ischaemic stroke caused by large artery blockage.
Endovascular mechanical thrombectomy may be employed, either as a standalone therapy or as an adjunct to IV tPA, and has several potential advantages, including a wider time window (upto 8Hr), the capacity for use in coagulopathic patients and higher recanalization rates (up to 82%).
Mechanical treatment approaches for acute ischemic stroke treatment aim for fast and efficient reperfusion with short procedure times and high recanalisation rates,thus extending the treatment window.
Suitable treatment is given to the Stroke patients – Antiplatelet (Drugs to make the blood thin) , drugs to control raised intracranial pressure in brain, to control Diabetes, Blood pressure & Cholesterol .
For better improvement of power and speech, limb & Speech Physiotherapy is given from the very start.
Some problems which are related to Paralysis or Stroke like any infection, physical wound, improper diet, frozen shoulder and swelling of joint should be intervened early in a well Equipped Stroke Unit with experienced multideciplinary team for better outcome.
It is ideal to do all this treatment in well equipped Stroke Unit.
Surgical procedure like decompression of brain can be done (Decompressive Hemicraniectomy) in first 48 hours to save life and better long term outcome.
In the condition of more than 50% blockage in brain / neck vessels, angioplasty & stenting of vessel or surgery (Endartrectomy) is done for Stroke patients to prevent further stroke in future which is around 10 to 30 % in future, if symptomatic carotid stenosis is more than 50%. Carotid angioplasty and stenting is well established after recent largest multicentre, NIH funded, well designed randomized control trial (CREST)
It is important to know etiology of Stroke/Paralysis, to provide suitable treatment like if there is symptomatic carotid stenosis more than 50%, then carotid angioplasty and stenting(CAS) is necessary to prevent reoccurence.
Various neurointerventions like coiling of aneurysm in subarachnoid hemmorhage, embolisation of arteriovenous malformation are to be done in suitable patient.
5. Rehabilitation is a critical step in the treatment process.
Rehabilitation starts in the hospital as soon as possible following a stroke. It can improve function and help the survivor regain as much independence as possible over time.
6. One in four survivors will have another stroke.
Treatments that prevent another stroke include drugs to lower blood pressure and cholesterol, antiplatelet therapies, anticoagulation for atrial fibrillation, surgery or stenting for selected patients with severe carotid artery narrowing.
Lifestyle changes can also greatly reduce the risk of another stroke. Changes include eating well, being physically active, being tobacco-free, managing stress, and limiting alcohol consumption.
Key treatment issues
Low public awareness of symptoms, inadequate and uneven access to specialist stroke treatment and lack of coordinated action around the world are key issues in stroke.
Awareness
Saving lives and improving outcomes from stroke starts long before a patient has contact with a health professional. It starts with public awareness of stroke symptoms. Awareness of FAST improves timely access to specilaist medical treatment which minimises damage to the brain, increases the treatment options available, reducing the risk of death and disability. Sustained public awareness campaigns supported by governments and delivered in partnership with local stroke organizations go hand in hand with efforts to access to acute treatment.
Access to healthcare
Financial barriers to prevention and detection of stroke risk factors through universal health coverage and access to essential medicines is critical to stroke prevention and will reduce the individual and community costs of stroke. Acess to specialist acute stroke care through the development of stroke units and professional education is needed to broaden access to quality stroke care.
Access to rehabilitation and life after stroke support
Rehabilitation starts in the hospital as soon as possible following a stroke. It can improve function and help the survivor regain as much independence as possible over time. Many stroke survivors will need on-going treatment to address the physical impact of stroke and to maintain their mental health and well-being. Universal health coverage should include access to rehabilitation and long-term care needs of stroke suruvivors.
To dissolve a blood clot between within 6 hours and some times upto 24 hours of stroke, thrombolytic drug can be given through intra-arterial route after performing cerebral digital substraction angiography in the Stroke patient.
Life after stroke
Around the world, around 80 million people have experienced a stroke. Stroke can affect how you think, talk, move and feel. Many survivors will live the rest of their lives with some form of disability or impairment which cause practical, emotional and financial challenges. With specialist rehabilitation and support, stroke survivors can however recover or find their ‘new normal’ and enjoy life.
Stroke recovery and support
Stroke can happen to anyone, anywhere, at any age – from babies to the elderly. The impact of a stroke will vary from person to person and the type of rehabilitation and support needed after a stroke will vary, too. With the right treatment and support, life after stroke can be enjoyed.
Common effects of stroke
Pain
Paralyzed shoulder muscles are not able to help tendons keep the upper end of the arm in the shoulder joint. As a result the arm drops from the joint which is very painful and can prevent rehabilitation of the hand and arm. Rehabilitation and medication can help.
Depression
Depression after stroke, as after any severe illness, is very common, often goes without diagnosis, reduces motivation and capacity for rehabilitation and affects quality of life. Depression not only affects the individual who has had a stroke, partners, family members and carers are also at higher risk of depression. Post-stroke care should encommpass mental health and well-being and appropriate treatment should be offered.
Changes in cognition
Stroke and TIA (transient ishemic attack or mini-stroke) can lead to changes in the thinking ability of survivors and can cause problems with memory, including dementia. TIAs are often not recognised and over time can cause significant problems for patients.
Communication difficulties
A third of stroke survivors will experience aphasia a disorder that affects how the brain processes language. Aphasia can affect speech, comprehension, reading and writing. With specialist speech and language support, survivors with aphasia can learn new ways to communicate.
Changes in cognition
Stroke and TIA (transient ishemic attack or mini-stroke) can lead to changes in the thinking ability of survivors and can cause problems with memory, including dementia. TIAs are often not recognised and over time can cause significant problems for patients.
Spasticity
Spasticity is like a “wicked charley horse” or severe cramp. Brain injury caused by a stroke sometimes causes paralyzed muscles to involuntarily contract (shorten or flex) after trying to move a limb. This creates stiffness and tightness. The contracted muscles often freeze the joints of the hand and arm permanently into an abnormal and often painful position. When a muscle can’t complete its full range of motion, the tendons and soft tissue surrounding it can become tight. This makes stretching the muscle much more difficult. Spasticity in the arm can cause a tight fist, bent elbow and arm pressed against the chest. This can seriously interfere with a stroke survivor’s ability to perform daily activities such as dressing. Spasticity in the leg may cause a stiff knee, pointed foot and curling toes. Spasticity can be addressed with medication and rehabilitation.
For most stroke survivors, caregivers and families, the impact of stroke means that life will be different and the challenges of recovery are very real, but it is possible to moderate the impacts of stroke by working with a healthcare team, developing new routines and tracking small step-by-step goals.
Up Again after stroke
Stroke is a leading cause of death around the world. Yet, that’s only one part of the story. Around the world, there are approximately 80 million stroke survivors – more than 50 million of them live with some form of permanent disability. For many, life after stroke won’t be quite the same, but, with the right care and support living a meaningful life is still possible. As millions of stroke survivors show us every day, it is possible to get #UpAgainAfterStroke.
Living life after stroke
Stroke can happen to anyone, anywhere, at any age – from babies to children and teens to the elderly. The effects and the type of support needed after a stroke vary, too. What unites us is the resilience and determination of stroke survivors to build on the things that stroke can’t take away and keep going on our recovery journey.
For most stroke survivors, caregivers and families, life will be different. Accepting and adjusting to life after stroke is fundamental to your recovery and well-being. Finding your ‘new normal’ won’t happen all at once – but that’s OK. By working with your healthcare team, developing new routines and tracking small step-by-step goals, you can make progress.
Thoughtful care
Remember, your medical and physical rehabilitation team is there to help you. Keep the professionals involved in your care informed of your progress, changes to your condition or any concerns. Ask what you can do to support recovery at home. Recognise that your emotions and mood can have a huge impact on your quality of life and motivation, if you feel low talk to your healthcare workers.
The World Stroke Organization Post-Stroke Checklist is a way for you and for health professionals involved in your care to think, talk and respond to your on-going healthcare needs. It has been widely translated and can be downloaded from the World Stroke Campaign website.
Stroke can feel isolating for survivors and for caregivers alike. With 80 million survivors around the world – you are not at all alone! Connecting with others who have experienced a stroke or are caregivers; getting practical advice on daily challenges; or even just reading stories of survival and recovery are all powerful actions that help you adjust to the new normal.
Your survival network
There are organizations around the world dedicated to connecting you to the care and support you need. Many of them are run by and on behalf of stroke survivors and caregivers, reach out to them whenever you need them.
If and when you feel ready, you might want to get involved and help support other stroke survivors, or to raise awareness of stroke, or even help raise funds for local stroke support. No matter how you engage, we know that being part of a stroke support network can help you feel more positive about life after stroke.
Using technology to connect with others who share your experiences, have tips to share for your journey, or who you can help, can make a big impact. Technology can also support your rehabilitation. For example, using mobile apps that have been tested and approved by stroke experts and survivors can help your long term progress between therapy sessions.
About Us
Genesis & Mission
Stroke Support Group Udaipur (SSGU), was formed on 28th May 2010 with the following objectives :-
- To create awareness about the magnitude of the problem of stroke, identifying the disease in time, breaking myth about the disease and helping in correct and timely management.
- Regular interaction among members, patients and their relatives in the presence of professional to seek solution for any stroke related problem.
- Using various means for dissemination of information regarding prevention and timely interventions for the stroke patients.
- Helping Research and innovation in stroke sciences.
- To support patients and family from acute treatment to rehabilitation morally, medically and financially if possible.
- Helping training of medical professional, paramedics, care giver at various levels.
- To develop stroke support foundation for needy patients so that financial constraint does not become barrier for appropriate treatment.
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