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
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)
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!