Medical Management and Emergency Management of Stroke, Dr.Roopesh Kumar

பக்கவாதத்திற்கான மருத்துவ சிகிச்சை Medical management of Stroke Dr.Roopesh Kumar
Medical Management and Emergency Management of Stroke

#stroke #strokeawareness #DrRoopeshKumar

Located in: MGM Healthcare
Address: No 54, Old, 72, Nelson Manickam Rd, Aminjikarai, Chennai, Tamil Nadu 600029
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So, we have seen about the causes of stroke, the ways to clinically diagnose stroke and the types of investigations for stroke.

How do we treat stroke? Stroke prevention is primarily through medication. As soon as the stroke happens, the treatment is medical as well. If the stroke is about to happen, if the risk factors are high, what medications do they need? Blood thinners. There are various types of blood thinners. The most commonly used is similar to Aspirin. So, Aspirin should definitely be part of the treatment.

For some, aspirin will not be enough. If they are high-risk patients, we use 2 anti-platelet drugs along with aspirin. We use clopidogrel. This is in the initial high-risk period. Other than this, to reduce cholesterol in those whom it is high, anti-cholesterol drugs, they are called statins. We use statins. These are the medications in the blood thinners category. Anti-platelet drugs and statins.

Other than these, patients who are high-risk, having protein C and S deficiency, those with hyper-coagulability, we give them anti-coagulation medication also. There are various types of anti-coagulation medications. Like the "warfarin" group. There are newer anti-coagulants as well. Previously when warfarin was used, to make sure the medication stayed in the blood, regular PT/INR testing was required. Some vegetables could not be eaten raw by the patient. A lot of restrictions were there. But in the newer anti-coagulation medications those restrictions no longer apply. No more avoiding raw vegetables, no frequent PT/INR testing. Without these restrictions, the newer medications can be used. This is the primary medical treatment.

Other than this, the important things are, medication to regulate sugar levels, medication to regulate blood pressure, all these are given. The sixth most important medication is water. Water is very very important to prevent stroke and dilute the blood, water intake should be sufficient. These are the medical management and preventive measures.

Now, as soon as the stroke happens, like I mentioned earlier, there is a need to watch for F.A.S.T, or B.E.F.A.S.T. In an emergency room, if the patient comes in within 4-5 hours, we can use an intra-venous injection. If we give that injection it will cause IV thrombolysis. that means, we can dissolve the clot in the blood vessel. If we dissolve the clot, stroke can be prevented in an emergency. That's where IV thrombolysis agents can be used, within 4.5 hours of the stroke. This will not work after the 4.5 hours have passed. Bleeding risk will increase. This is intra venous thrombolysis treatment

The same medications can be given if the patient comes late. Intra-arterial thrombolysis can be done, that is, I had mentioned angiogram. Where we inject into the thigh, insert a catheter and diagnose. Using the same catheter, right before the block or clot in the blood vessel we can give an injection and dissolve the clot. This is called intra-arterial thrombolysis. If that is also not possible, we have something called stent retriever or clot retriever, that is, it can be used to dissolve the full clot and remove it. These are ways of endo-vascular management. These are the primary methods of treatment for stroke, endo-vascular.

That is why we ask patients to come early to the hospital. If the patient comes to us in the golden period, 4.5 hours, we can do IV thrombolysis, for those who come to us a bit late, say, in 6-8 hours, intra-arterial thrombolysis can be done. Clot retrieval can be done. All these can be done in the endo-vascular method, with a small pinhole injection in the thigh. If we remove the clot, major stroke can be prevented.

This is the emergency medical treatment for stroke. So we have seen one type of medication to prevent stroke. The other is used immediately after the stroke happens. Within a few hours. What medications we give to dissolve the clot. This is the medical treatment we have discussed in this video.

Chapters

00:00:25 Treatment of stroke by medication
00:00:42: Blood thinners
00:00:55: Anti platelet drugs like clopidogrel
00:01:05 Anti cholesterol drugs
00:01:25 Anti-coagulation medications
00:01:35 Warfarin
00:01:45 PT/INR test
00:02:22 Water, the most important medication
00:02:40 F.A.S.T and B.E.F.A.S.T
00:02:50 Intra-venous injection IV thrombolysis
00:03:15 Intra arterial thrombolysis
00:03:40 Stent retriever or clot retriever

Видео Medical Management and Emergency Management of Stroke, Dr.Roopesh Kumar канала Dr. Roopesh Kumar