How to Diagnose and Treat a Stroke

Symptoms of stroke appear suddenly and last only a few minutes or hours, but rarely more than 2 days. Everyone should be able to recognize the five main symptoms of stroke and seek immediate medical attention if any of these symptoms occur:

• sudden paralysis or numbness of the face, arm or leg (usually on one side of the body only);
• the sudden appearance of a slurred speech or difficulty understanding what is said;
• the sudden loss of vision (often in one eye) or double vision;
• the sudden onset of dizziness or loss of balance or coordination;
• severe headache occurring suddenly without apparent cause (often described as "the worst headache of my life."

Transient Ischemic Attack - TIA

A transient ischemic attack or TIA is a "mini-stroke" caused by temporary interruption of blood flow to the brain. Symptoms of a TIA are the same as those of a stroke, except that they disappear within a few minutes or hours, and they usually last no more than 24 hours. However, TIAs require immediate medical attention. TIAs are important warning signs that a future stroke is possible. Medical treatment is necessary.

Diagnosis of Stroke

If you experience symptoms of stroke or transient ischemic attack (TIA), your doctor will ask about your medical history and any recent events may be related to your symptoms. After a physical and neurological examination, additional tests may be performed to confirm the diagnosis. They may include brain images obtained using computed tomography or magnetic resonance imaging (MRI) or analysis of brain electrical activity highlighted by an electroencephalogram (EEG).
In addition, other tests such as angiography or Doppler ultrasound, among others, are often useful to evaluate blood flow in the vessels and detect arterial obstruction. Further analysis could include blood tests, chest x-rays and examinations of the heart using an electrocardiogram (ECG) or ultrasound.

Treatment and Prevention of Stroke

It is imperative to recognize the signs and symptoms of stroke and seek medical attention immediately. Treatment is required in the first few hours after the onset of stroke to prevent the formation of brain damage and disability, and promote healing. Brain cells die if they are deprived of blood flow and oxygen, even if it occurs only for a few minutes.
Among the drugs used in the treatment of stroke, there are those which act in the short term and others act on the longer term.

Short Term and Long Term Treatment for Stroke

There are two main types of short term treatments:
• thrombolytics (eg. the tissue plasminogen activator, tPA), which aims to dissolve the clot and unblock the blocked blood vessel to restore normal blood flow and limit damage to brain tissue. These drugs can be given to certain people within 3 hours of the onset of symptoms and are administered intravenously by trained health professionals;
• anticoagulants (eg. heparin) are used in some cases to reduce the clotting of blood. They do not dissolve blood clots already formed, but they can prevent the increase of the clots.

The long-term treatment for stroke includes drugs taken by mouth to reduce the risk of recurrent stroke such as:
• platelet inhibitors (eg. acetylsalicylic acid, clopidogrel, dipyridamole, ticlopidine);
• anticoagulants or "blood thinners" (eg. dabigatran and warfarin).

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