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Stroke Recovery Treatment


Treatment for Stroke

Stroke recovery treatments provided by Dr.Vanchilingam Hospital is the best for all the stroke-related issues. Below are the services provided by Dr Vanchilingam Hospital.

1) Primary stroke prevention
Primary stroke prevention means providing treatment to individuals who have no history of stroke. There are some risk reduction measures to prevent primary stroke, they are the usage of drugs such as anticoagulants, antihypertensive medications, 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (stains) and platelet anti aggregants. Other preventive measures include smoking cessation, the dietary intervention like intake of diet rich in fruits and vegetables and potassium-rich foods, weight loss and involved in physical exercises. Diabetic patients should undergo close monitoring of sugar levels and regular monitoring of blood pressure for hypertensives.

2) Emergency management of stroke

  1. IV Thrombolysis  
    The most common treatment for stroke is intra-venous thrombolytic therapy where Intravenous recombinant tissue plasminogen activator (rt-PA) is given within 3 to 24 hours of stroke onset. This is favourable to patients who have occlusions beyond M1 segment of MCA and in posterior circulation and patients who are younger than 75 years. The outlook of these patient changes dramatically after the treatment.

  1. IA Thrombolysis  
    This is done in the Cath lab. Patient is catheterised at the groin via a femoral puncture and a guiding catheter is placed in the ICA. A microcatheter is navigated via the guiding catheter to the site of occlusion and chemical thrombolysis using Heparin,rt-PA or Urokinase is done locally via the microcatheter.
  2. Mechanical Thrombolysis
     Intra Arterial mechanical Thrombolysis is the gold standard treatment for the stroke at recent. Various devices and stentriever are used to pull out the blood clot from the occluded vessel. It can be done till 24 hours of stroke onset
  3. The least treatable stroke is intracerebral haemorrhage where the death rate is from 20% to 50%. Recombinant activated factor VII (rFVIIa) is used to reduce the growth of hematoma but does not improve survival.

3) Peri-stroke Management
Management of patients with large vessel occlusion in a dedicated stroke unit involves lots of hard work and experience. It involves Neuro physicians, strokologist, intensive care physicians, stroke care nurses, physiotherapist and respiratory therapists.

4) Stroke rehabilitation and physiotherapy
Passive physiotherapy and respiratory therapy for patients on ventilator form an important part of Stroke Rehabilitation. We have an experienced team of physiotherapist and respiratory therapist who work closely with the Physicians. Early involvement and assessment of the patients have to be done by the physiotherapist. Better outcome will be there if the patient undergoes early mobilization. Rehabilitation can take place in acute care or in any other ward but the care should be provided as seamless as possible. Patient's need will determine the type and intensity of the therapy.

Goals achieved by rehabilitation are

  1. Minimizing impairments
  2. Maximizing functions
  3. Preventing complications

There are two components in the rehabilitation program. Component one will target on maintenance of physical integrity and minimizing complications which prevent or prolongs functional return. This measure will begin immediately post stroke.  The second is the restorative treatment which will promote functional recovery. It begins when neurologically and medically the patient is stable and has physical and cognitive ability to actively participate in the rehabilitation program. Stroke patients management will begin in the acute care during acute hospitalization and will be continued as rehabilitative care when patient’s medical and neurological status has stabilized. Community reintegration of patients will be continued during the community care stage.

 

Authored By Dr Somesh Vanchilingam - Neuro Specialist, Thanjavur

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