A stroke can be a devastating medical occurrence. It happens when blood flow to a portion the brain is impaired due to a blood clot or broken blood vessel. Much like a heart attack, the lack of oxygen-rich blood can lead to tissue death. When brain cells begin to die as a result of the reduced blood flow, symptoms occur in the parts of the body that those brain cells control. These symptoms can include sudden weakness, paralysis, and numbness of the face or limbs. As a result, people who experience a stroke may have difficulty thinking, moving, and even breathing.
Though doctors now know the causes and implications of a stroke, the condition hasn’t always been well-understood. Hippocrates, the “father of medicine,” first recognized stroke more than 2,400 years ago. He called the condition apoplexy, which is a Greek term that stands for “struck down by violence.” While the name described the sudden changes that can occur with a stroke, it didn’t necessarily convey what is actually happening in the brain.
Centuries later, in the 1600s, a doctor named Jacob Wepfer discovered that something disrupted the blood supply in the brains of people who died from apoplexy. In some of these cases, there was massive bleeding into the brain. In others, the arteries were blocked.
In the decades that followed, medical science continued to make advances concerning the causes, symptoms, and treatment of apoplexy. One result of these advancements was the division of apoplexy into categories based on the cause of the condition. After this, apoplexy became known by such terms as stroke and cerebral vascular accident (CVA).
Today, doctors know that two types of stroke exist: an ischemic and a hemorrhagic stroke. An ischemic stroke, which is more common, occurs when a blood clot lodges in the brain. This blocks blood flow to various areas of the brain. A hemorrhagic stroke, on the other hand, happens when an artery in the brain breaks open. This causes blood to accumulate in the brain. The severity of the stroke is often related to the location in the brain and to the number of brain cells affected.
According to the National Stroke Association, stroke is the 5th-leading cause of death in the United States. However, an estimated 7 million people in America have survived a stroke. Thanks to advancements in treatment methods, millions of people who’ve experienced a stroke can now live with fewer complications.
History of Stroke Treatments
One of the earliest known stroke treatments occurred in the 1800s, when surgeons began performing surgery on the carotid arteries. These are the arteries that supply much of the blood flow to the brain. Clots that develop in the carotid arteries are often responsible for causing a stroke. Surgeons began operating on the carotid arteries to reduce cholesterol buildup and remove blockages that could then lead to a stroke. The first documented carotid artery surgery in the United States was in 1807. Dr. Amos Twitchell performed the surgery in New Hampshire. Today, the procedure is known as a carotid endarterectomy.
While carotid artery surgeries certainly helped to prevent stroke, there were few treatments available to actually treat a stroke and reduce its effects. Most treatments were more focused on helping people manage any difficulties after a stroke, such as speech impairments, eating problems, or lasting weakness on one side of the body. It wasn’t until 1996 that a more effective treatment was implemented. During that year, the United States Food & Drug Administration (FDA) approved the use of tissue plasminogen activator (TPA), a medication that breaks up the blood clots that cause ischemic strokes.
Though TPA can be effective in treating ischemic strokes, it must be administered within 4.5 hours after symptoms begin. As a result, receiving prompt medical attention for a stroke is vital to reducing and reversing its symptoms. If someone you know is experiencing symptoms of a stroke, such as sudden confusion and weakness or numbness on one side of the body, take them to the hospital or call 911 immediately.
Advancements in Stroke Treatments
TPA is the preferred treatment method for ischemic strokes. However, an emerging treatment for these types of strokes is the Mechanical Embolus Removal in Cerebral Ischemia (MERCI) retriever. This device can physically remove a blood clot in someone having an ischemic stroke. Since its first use in 2001, the MERCI retriever has treated approximately 10,000 people. However, the drawback is that many surgeons still need to be trained in its use, and hospitals need to purchase the equipment, which can be very expensive. While TPA is still the most commonly used treatment for ischemic strokes, the MERCI retriever may increase in popularity as more surgeons become trained in its use.
Hemorrhagic stroke treatments have also come a long way. If the effects of a hemorrhagic stroke affect a large portion of the brain, doctors may recommend surgery in an attempt to reduce long-term damage and relieve pressure on the brain. Surgical treatments for hemorrhagic stroke include:
- Surgical clipping: This operation involves placing a clip to the base of the area causing the bleeding. The clip stops the blood flow and helps prevent the area from bleeding again.
- Coiling: This procedure involves guiding a wire through the groin and up to the brain while inserting small coils to fill areas of weakness and bleeding. This can potentially stop any bleeding.
- Surgical removal: If the area of bleeding can’t be repaired through other methods, a surgeon may move a small section of the damaged area. However, this surgery is often a last resort because it is considered very high risk and can’t be performed on many areas of the brain.
Other treatments may be required, depending on the location and severity of the bleeding.
Advancements in Stroke Prevention
While stroke continues to be a leading cause of disability, approximately 80 percent of strokes are preventable. Thanks to recent research and advancements in treatment, doctors can now recommend prevention strategies for those who are at risk of having a stroke. Known risk factors for stroke include:
- being over age 75
- having atrial fibrillation
- having congestive heart failure
- having diabetes
- having high blood pressure
- having a history of stroke or transient ischemic attack
People who have these risk factors should talk to their doctor about how they can lower their risk for stroke. Doctors often recommend taking the following preventive measures:
- quitting smoking
- taking anticoagulant medications to prevent blood clotting
- taking medications to control high blood pressure or diabetes
- eating a healthy diet low in sodium and rich in fruits and vegetables
- exercising three to four days a week for at least 40 minutes a day
While a stroke can’t always be prevented, taking these steps can help to minimize your risk as much as possible.
Quiz: Test Your Stroke IQ
A stroke is a life-threatening medical event that can cause lasting brain damage and long-term disabilities. Seeking treatment immediately can increase the likelihood that you or a loved one receive one of the innovative treatments used to treat stroke and minimize complications.