Treatment options entirely depend on two main things, which are the type of stroke and how quickly the patient reaches care. The priority is to restore blood flow for ischaemic strokes and the first-line acute stroke treatment for eligible patients is intravenous thrombolysis. This is often called clot-busting therapy and is a medication that must be given within a strict time window, typically up to four and a half hours from symptom onset and dissolves the clot. To save precious minutes, this therapy can be initiated in the CT room itself at NMC.
For patients who arrive outside this window or have large vessel blockages, a mechanical thrombectomy may be an option This interventional procedure involves threading a small catheter through an artery, usually in the groin, up to the brain which then a stent retriever device removes the clot physically. For carefully chosen patients, this brain stroke treatment can still work up to 24 hours after symptoms start. That gives more people a real chance at recovery.
For a haemorrhagic stroke, the approach is different with controlling bleeding and reducing pressure inside the skull the top priorities. To reverse any blood-thinning effects and to lower blood pressure, medications are given and if the bleeding is severe or caused by a ruptured aneurysm, neurosurgical intervention may be required. Endovascular coiling is a minimally invasive technique where tiny platinum coils are placed inside the aneurysm to seal it off.
When the acute stroke phase is managed, attention turns to rehabilitation. The stroke rehabilitation clinic at NMC provides a structured programme involving physiotherapists, occupational therapists and speech and language therapists. Rehabilitation although begins on the ward, it continues after discharge, either as an outpatient or through home visits. Whether through walking again, returning to work or simply managing daily tasks like dressing and eating, the goal is to help the patient regain as much independence as possible.
