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Stroke secondary to atherosclerosis

Overview Symptoms Treatment Prevention
Treatment:

Go to the emergency room as quickly as possible if you believe you have had or may be having a stroke. Stroke is an acute, serious condition that should be treated immediately. Strokes are now called "brain attacks" to stress that time is of the essence in treating this condition.

The most effective treatment for stroke (intravenous rtPA), which works to dissolve the offending clot and prevent permanent deficits, can only be given in the first 3 hours after stroke onset. There is risk of serious bleeding with this treatment so it cannot be used in all cases, but the most important factor in effective treatment for stroke is arriving at the hospital as early as possible from the onset of symptoms. For virtually all strokes, there is a need for hospitalization, possibly including intensive care and life support.

For patients who can't be treated with clot-busting drugs, treatment will be based on the type of stroke they may have had, however, the focus will be supportive (that is, blood pressure control, adequate fluid management, and prevention of complications such as infections).

Rehabilitation is important following stroke to maximize function in affected areas. Treatment is also aimed at prevention of future strokes. Recovery may occur as other areas of the brain take over functioning for the damaged areas. The goal of treatment is to prevent spread (extension) of the stroke and to maximize the ability of the person to function.

Special treatment (in addition to treatment for stroke in general) may include medications to control blood cholesterol levels.

A special diet for stroke patients often follows the American Heart Association recommendations for people with hyperlipidemia (increased fats/lipids in the bloodstream). This may include restriction of fat, especially saturated fat. It may also include restriction of salt/sodium if stroke is accompanied by high blood pressure.

A carotid endarterectomy (removal of plaque from the carotid arteries) may be needed by some people to prevent new strokes from occurring.

Expectations (prognosis):

Stroke is the third leading cause of death in developed countries. About 25% of sufferers die as a result of the stroke or its complications, about 50% have some degree of recovery but are left with variable disability, and about 25% recover most or all function.

There are three important signs occurring at the onset of the stroke that best predict who is least likely to make a full recovery: low-grade fever, high blood sugar (hyperglycemia), and low blood pressure (hypotension). Contrary to common belief, recurrence of stroke is only around 2% within the first 14 days.

Complications:
Calling your health care provider:
Go to the emergency room or call the local emergency number (such as 911) if symptoms occur indicating a stroke.
Stroke
Stroke
Central nervous system
Central nervous system
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