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Treatment of Stroke

Stroke is a leading cause of death and major disability worldwide. There are many risk factors including high blood pressure, diabetes, smoking, irregular heart beat (in medical terms called atrial fibrillation).

In the majority of patients who become victims of this disease, the cause is blockage of one the arteries of the brain by a clot. It results in damage to the part of the brain which does not get enough blood flowing (because of the blockage of artery) and this part of brain becoming dead. Until recently there was not a good treatment available. In the last decade the ‘clot-busting’ medication became available which is given by an injection. The patient needs to be treated within 4.5 hours of onset of symptoms. It only gives benefit to 30% of patients after treatment who get better. It has no improvement in 70% patients treated with it.

The recent advance is a revolutionary treatment which is ‘mechanical clot removal’. In medical terms ,it is called ‘thrombectomy’. The neuro-radiologist (the x-ray specialist doctor of the brain) removes this blood clot from the brain artery mechanically. They use the clot removal equipment while simultaneously seeing the brain arteries and clot on the CT scan. Sometimes they use a device to suck the clot (like a Hoover). The results are amazing. Up to 80% patients treated with this technique make full recovery with no residual weakness or disability.

On arrival to hospitals patients will be assessed by doctors, and immediately get brain scans. If it shows signs of a stroke they will get the treatment to save their lives and disability. For this to happen, patients need to be rushed to hospital straight away. The assessments and brain scans take some time. To be eligible for these treatments patients need to be in time window of treatment. It is 4.5 hours from start of symptoms to start of treatment. This why it is called ‘Time is Brain’.

It is an old saying, “prevention is better than cure”. It is still true and valid. Please make sure you get regularly checked by your own doctor for risk factors of stroke, namely high blood pressure, diabetes and irregular heart beat. Please quit smoking if you are a smoker. There is lot of help available with your doctor to help you in quitting. If you are overweight and have a sedentary life style then consider regular exercise and weight loss. Eat healthy food with lots of vegetables and fresh fruit. If your doctors find that you have either high blood pressure, diabetes or irregular heart beat then he/she will discuss with you the treatment options. It will be mostly in the form of different tablets. It is very important for you to stick to the medical advice given and get the treatment for these risk factors. It is an investment in the future of your own heath so that you don’t get stroke and become disabled.

Please remember FAST (campaign running in media) in recognising symptoms of stroke in your loved ones. This new treatment of clot removal is available in Auckland, Wellington and Christchurch. The specialists in other areas are working hard for these treatments to be available to all the citizens of NZ.  Remember “Time is Brain”.

Dr Intesar H Malik, Consultant Physician | Gisborne Hospital | Private practice:Skin Deep Clinic, Gisborne  | 06 863 2688 | | 188 Cobden St, Gisborne