Treatment for stroke depends on whether the stroke is caused by a blockage in your artery (ischaemic stroke) or bleeding into your brain (haemorrhagic stroke).
There are two main treatments for ischaemic stroke (a blocked artery); thrombolysis and thrombectomy, and the quicker a patient receives these treatments the better their chances of making a full recovery.
Some ischaemic strokes can be treated by thrombolysis also known as a clot busting drug. The drug aims to dissolve the clot and restore the blood flow to the brain.
This drug treatment is only effective if received quickly (less than 4.5 hours of a stroke starting). This is why it is so important to get to hospital immediately because even within this 4.5hrs, the more time passes the less effective it is.
However, thrombolysis is not suitable for everyone.
You may also be given aspirin or other anti-platelet medicines to reduce the stickiness of your blood and stop clots forming.
“ The symptoms of stroke can be completely reversed and cured if you get to treatment within the first few hours,”
Thrombectomy is a relatively new but very effective and potentially life-saving therapy for the treatment for acute ischemic stroke; this is where the stroke is caused by a blood clot in a major blood vessel in the brain. It is estimated that approximately 10 to 20 per cent of stroke patients would have this type of stroke.
Unlike thrombolysis which uses drugs to try and dissolve a blood clot, thrombectomy is a radiologically guided interventional procedure where doctors use specialist equipment to mechanically remove the clot from the brain and restore blood supply. Thrombectomy is carried out in two specialist centres in Ireland at Beaumont Hospital in Dublin and Cork University Hospital in Cork.
Patients need to be treated as fast as possible, as with every short interval of time that passes they may become unsuitable for treatment or not get as good a recovery, if the stroke becomes permanent.
On average for every minute that you save in removing the clot you gain a week of healthy living post stroke, so thrombectomy can have quite a dramatic effect.
Some patients treated with thrombectomy will make a full recovery and will live several or many years with a completely normal life and other patients will have a partial recovery but unfortunately when the treatment isn’t successful, or it is too late, some patients don’t gain as much benefit.
Studies have shown that in eligible patients, thrombectomy can reduce the death rate from stroke by half and almost doubles the rate of recovery to complete independent living.
Almost half of patients who received a thrombectomy in Ireland in 2019 returned to living a fully independent life.
On average for every minute that you save in removing the clot you gain a week of healthy living post stroke
A Haemorrhagic stroke is caused by bleeding on the brain as opposed to a clot.
With haemorrhagic stroke the emergency treatment focuses on controlling the bleeding and reducing the pressure it is causing in your brain and careful management of the blood pressure.
Surgery also may be needed to remove the blood and repair the blood vessel to help reduce future risk.
" If you could reopen the blood supply to the brain within a few minutes everybody would completely recover from a stroke,"
We asked the experts – Why act F.A.S.T.?
Dr John Thornton, Consultant Interventional Radiologist and Director of the National Thrombectomy Service (NTS) at Beaumont Hospital in Dublin.
“Time is critical when it comes to acute ischaemic stroke because as soon as the vessel is blocked off you start to get cell death, you start to damage the brain tissue. This change which is initially small and reversible starts to become permanent as the minutes tick by. Brain cells depend on blood for oxygen if you cut off the oxygen supply then the brain cells will die and for most people brain cell death starts to take effect almost straight away. However, the brain has the capacity to change the circulation for a short period, allowing for the possibility of recovery if the blood vessel is opened up within the first few hours.”
Treatment for stroke such as thrombectomy or thrombolysis work to reopen the blood vessels that have been blocked in the brain and Dr Thornton added that for every minute lost in reopening the blood vessels the more likely it is that you will have a severe and permanent stroke. Therefore, the sooner a patient gets treatment the less severe the stroke.
If you could reopen the blood supply to the brain within a few minutes everybody would completely recover from a stroke, he added.
" Minutes matter, the quicker you get to hospital the better."
Dr Angie Brown, Medical Director of the Irish Heart Foundation said it was vital to call the emergency services immediately if you think you are having a stroke as “minutes matter.”
”Minutes matter, the quicker you get to hospital the better so if you think you are having a stroke dial 112 or 999 to call an ambulance. Remember act F.A.S.T. ” she said.