Comprehensive Stroke Center Treatments

Every minute the brain is deprived of blood flow, more brain cells die. The earlier the blood flow is restored, the less likely a stroke sufferer will have permanent damage. This is why stroke is an emergency. When the brain has been injured by loss of blood supply or by hemorrhage, it is essential to provide the intensive care that assures the control of blood pressure, breathing, and heart function.

Not only is it important to diagnose if someone has just had a stroke, physicians must also determine the type of stroke. The treatment is different, based on whether it is a hemorrhagic stroke or an ischemic stroke. Depending on the type and severity of the stroke, treatment options will vary, and may include surgery.

Immediate treatment

Physicians will order a variety of diagnostic tests to make these determinations. Imaging tests such as a CT scan or MRI provide valuable information on the location and extent of brain injury. Blood flow tests evaluate the condition of the arteries in your heart and neck that supply blood to your brain. When the brain has been injured by loss of blood supply or by hemorrhage, it is essential to provide the intensive care that assures the control of blood pressure, breathing, and heart function.

Ischemic stroke

The most effective medicine for the treatment of ischemic stroke is the FDA-approved drug, t-PA (tissue plasminogen activator). Taken intravenously, it works with your body's enzymes to dissolve blood clots. When a patient suffering a stroke is able to receive the potent clot buster tPA, blood flow may be restored. This highly-effective treatment must be given within three hours of the onset of stroke so it imperative to seek medical care without delay. If blood supply can be restored promptly, the brain can recover. While tPA is currently the best medication for stroke, sometimes even a full dose may fail to entirely dissolve the clot. In such instances, it may be possible to remove the clot from inside the arterial blood vessel by mechanical means.

Hemorrhagic stroke 

The best and safest way to remove blood from the brain after a hemorrhage and minimize damage to the brain include surgical removal of the clot, clot busting medication to dissolve the clot, and medications to minimize swelling caused by the clot. For hemorrhages caused by aneurysms and arteriovenous malformations, a skilled neuroradiologists or neurosurgeon can repair or block the vessels to prevent further bleeding. Many of these procedures can be performed through a minimally invasive technique.

Advanced treatment

Beyond providing the highest level of emergency stroke intervention, MedStar Health specialists are also helping to shape new standards of care for cerebrovascular patients through interventional neuroradiology. These nonsurgical treatments of strokes, aneurysms and AVMs include:

  • Angioplasty
  • Vascular stents
  • Detachable coils
  • Advanced embolization procedures

Surgical treatment

Strokes originating from carotid artery disease, brain aneurysms, AVMs and hypertensive hemorrhages often benefit greatly from emergency surgical interventions. Using the most advanced surgical and microsurgical techniques available today, including intraoperative angiography when necessary, our surgeons perform microvascular surgery, carotid endarterectomy and other complex procedures designed to improve outcomes and possibly prevent future occurrences.

MedStar Washington Hospital Center offers top-level expertise in:

  • Surgery of complex ruptured and unruptured brain aneurysms
  • Aneurysm embolization with GDC coils, a minimally invasive endovascular procedure suited for some favorably shaped aneurysms.
  • Aneurysm and AVM embolization using adhesives, liquid plastics and Onyx
  • CyberKnife® , which delivers concentrated beams of radiation from multiple positions and angles, sparing healthy tissue
  • Clot-retrieval device, a new technology which allows doctors to retrieve the blood clot and remove it
  • Carotid stenosis or narrowing of the internal carotid artery, which supplies blood to the brain. Plaque in the artery can be removed by surgical endarterectomy, or opened by endovascular stenting

Neurorehabilitation

Our multidisciplinary group of experienced physical therapists, occupational therapists, speech therapists and neurorehabilitation physicians provide comprehensive patient-centered rehabilitation therapies designed to maximize stroke recovery.