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Which Doctor Do I see For Possible Brain Stroke?

The short answer is a Neurologist!

But this is probably a bit of an oversimplification. In fact, your recovery from stroke will involve at least three different types of practitioners, starting with your primary care Doctor. Not only can it take from minutes to hours – stroke patients do not have this kind of time – to get hold of a neurologist, your primary care Doctor is also very well equipped to determine whether or not you are actually suffering a stroke attack. And if they feel that you indeed are suffering from something acute, they can always start the process of evaluating your symptom, and perform all the basic tests before referring you to a specialist, who would need those tests anyway.

Exams and Tests

The first test that your primary care Doctor can perform before he hands over your case to a specialist is the CT scan or an MRI to help confirm the presence of a bleeding in the brain and to determine the exact location thereof. The test will also help establish whether it’s an ischemic stroke or a hemorrhagic stroke. The additional test that your Doctor will typically recommend will include:

  • Electrocardiogram or ECG
  • Blood tests to check Complete blood count (CBC), Blood sugar, Electrolytes, Liver and kidney function, Prothrombin time and INR.

If your Doctor feels that you have a narrowing in the carotid artery, he may order below mentioned additional tests:

  • Carotid ultrasound/Doppler scan
  • Magnetic resonance angiogram (MRA)
  • CT angiogram and Carotid angiogram
  • Echocardiogram, or Holter monitoring, or Telemetry test to rule out heart-related complications

Identifying and Treating Stroke

While a Neurologist is on the way, your primary care Doctor will want to identify the type of stroke, its location, and the extent of damage that has been caused to the brain. He will also want to rule out other conditions and, to that end, he will:

  • Inquire about your symptoms, when they started, and any medical history
  • Check your level of consciousness, ability to move, coordination, and balance
  • Check for numbness or weakness in the body, and vision or speech impairment

Thrombolysis

Once your primary care Doctor has ascertained stroke, and the affected area of the brain, the next course of action will be a Thrombolytic Therapy, which is the procedure to dissolve the clots in blood vessels, thereby improving blood flow, and preventing damage to tissues and organs – in this case, the brain.The procedure might also involve removing the clot, or physically breaking it up. Since this procedure involves using a long catheter to deliver a clot-busting drug directly to the site of the blockage in the brain, your primary care Doctor will defer it to a trained Neurologist.

Your Neurologist will most likely use one of the below-mentioned drugs, also known as Thrombolytic Agents:

  • Eminase (anistreplase)
  • Retavase (reteplase)
  • Streptase (streptokinase, kabikinase)
  • t-PA (class of drugs that includes Activase)
  • TNKase (tenecteplase)
  • Abbokinase, Kinlytic (urokinase)

Stroke Rehabilitation

Once your primary care Doctor and Neurologist have worked together to remove the blood clot or the bleeding from the brain, a therapist will take over to ensure proper post-operative care, including stroke rehabilitation, the goal of which is to help you reacquire the skills that were lost because of the stroke. The actual length of this therapy will vary depending on the severity of the stroke and damage caused, but will typically last from few months to even years after the stroke.

The therapy will primarily focus on two areas:

  • Physical activities – These will include motor-skill exercises to help improve your muscle strength, mobility training to help stabilize and strengthen your body while you relearn to walk, constraint-induced therapy to reduce your dependency on the unaffected limb, and range-of-motion therapy to ease muscle tension and spasticity.
  • Cognitive and emotional activities– These will include therapy for cognitive disorders to help you with lost cognitive abilities such as memory and problem-solving, therapy for communication disorders to help you regain lost abilities in speaking and comprehension, and psychological evaluation to test your emotional adjustment and prescribe counseling or a support group.

So this will be the team of health professionals that will assist you in your journey to recovery from a stroke. However, it will all still depend on whether or not the patient reached a hospital within 3 to 4 hours of suffering the stroke. To that end, the importance of performing the B.E.F.A.S.T. test (Balance loss; Eye-sight impairment; Face drooping; Arm weakness; Speech difficulty; Time to act) on a person who is showing the symptoms of stroke, cannot be emphasized enough. If a loved one has failed the B.E.F.A.S.T. test, contact us at 8008104199 immediately to properly diagnose the issue and evaluate treatment options available to you!

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Treatments Options For Brain Stroke

When a stroke attack occurs, the brain tissues begin to die due to a lack of oxygen, and sooner the medical intervention is provided, the more brain tissues can be saved. Read more

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Causes And Symptoms Of A Brain Stroke

As we know, when the blood supply to the brain is interrupted, the brain is deprived of oxygen and other nutrients, causing the brain cells to die, and this is what we call a Stroke.

In most cases, the stroke affects the Middle Cerebral Artery(MCA) area of the brain, with tissue-death being observed in two general regions – the Superficial Divisions and the Lenticulostriate Branches.

Now that we have seen what is a Stroke, and what areas of the brain it can affect, let’s take a closer look at the causes and symptoms of the stroke.

Stroke is more likely to affect the elderly and those who have a positive familial history. But these circumstantial risk factors are not the only ones – stroke can also affect overweight people, people who have a sedentary lifestyle, people who have poor dietary preferences, people who drink and smoke heavily, and people who are addicted to the use of illicit drugs.

In addition, there are also a whole bunch of other non-circumstantial, non-controllable (but manageable) risk factors that can cause a stroke. These risk factors include:

  • Hypertension, or blood pressure of 140/90 mm Hg or above
  • Diabetes and high blood cholesterol of 240 milligrams per deciliter (mg/dL) or over
  • A congenital defect, or a head trauma
  • Medical conditions including moyamoya disease, venous angiomas, or a vein of Galen malformation
  • Certain drugs and medical conditions result in blood clotting

In addition, a Hormone Replacement Therapy (HRT) may also increase the risk in those who already have carotid artery disease. That said, specific causes can vary for different types of strokes. For example, the Ischemic stroke is caused either by a blood clot stopping the blood flow in the arteries that lead to the brain or by fatty deposits, which narrow the arteries and thus significantly reduce the amount of blood that reaches the brain. On the other hand, Hemorrhagic strokes are caused when an artery ruptures in the brain, thus creating pressure on brain cells and damaging them. This rupture can be the result of a high blood pressure, a weakness of the arterial wall, the side-effect of a blood-thinning medication, or even a trauma. And yet another, albeit rare, cause of stroke is vasculitis, which is a condition in which the blood vessels become inflamed, thus restricting the blood flow to parts of the brain.

Now, to understand the symptoms of a stroke! Except for an ITA, which almost always leads to a major episode of stroke within a year, a stroke often appears without a warning and does so suddenly. Key symptoms include:

  • a severe and sudden headache
  • paralysis of one side (hemiplegia) or weakness on one side (hemiparesis)
  • confusion, difficulty communicating, including slurred speech
  • nausea and vomiting with altered consciousness>
  • loss of vision (half or full), or balance, or coordination

Additionally, in the medium to longer term, patients might also experience the following symptoms, the severity of which may vary from patient to patient:

  • complete or partial loss of bladder or bowel control
  • depression, and trouble controlling or expressing emotions
  • progressive pain in the extremities

Also, different types of strokes affect the brain differently. For example, a stroke affecting the left side of the brain would affect speech and comprehension, whereas a stroke affecting the right side would weaken the face, the arm, the leg, or a combination of the three. It should also be noted that a right brain stroke would make the left side of the body weak, and vice-versa.

Again, the importance of performing the F.A.S.T. test (Face drooping; Arm weakness; Speech difficulty; Time to act) on a person who is showing the symptoms mentioned above, cannot be emphasized enough. If a loved one is high on the risk factors or has failed the F.A.S.T. test, contact us at 8008104199 immediately to properly diagnose the issue and evaluate treatment options available to you!

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