Acute Ischemic Stroke

by Michael_Koger

In these times of coronavirus and the devastation which has resulted, there is no question that the health care system has dramatically changed.

Many questions have arisen for patients as well as medical doctors. Queries include etiology, diagnosis, and clinical management. The matter of acute cerebrovascular disease is one of several, and primary care as well as specialists seek to solve the problem as quickly as possible (1, 2, 3).

There are reports from European and Chinese health care systems, and they indicate that acquired stroke may be present 2.5 to 6 percent there. Other sources include severe acute respiratory syndrome and Middle East respiratory syndrome. These illnesses have become epidemics. Additional observations of these regions of the globe include low cardiac ejection fraction, disseminated intravascular coagulation, and nonbacterial thrombotic endocarditis (1, 2, 3).

Biomedical Concerns

     Despite these interesting investigations, D-dimer studies and others do not resolve this question.  They may have the presence of arterial or venous abnormalities.  This leaves the question of ischemic stroke without resolution.  There have also been studies of antiphospholipid antibodies and COVID-19.  Again, the question is whether those associations are representative or descriptive of adequate solution (1, 2, 3).

     Organizations such as the American Heart Association have long examined this infirmity.  There is surely an event which clinicians recognize as acute ischemic stroke and other variations.   Impairment of blood flow to the brain is well-known.  Of much concern is damage to these biological systems.  One important measure, however, is the use of tissue plasminogen activator Alteplase as a remedy for clot dissolution.  It is, in fact, the gold standard--Alteplase IV r-tPA.  Time may not be very much in these cases, and bleeding in the human brain can occur.  Moreover, there is reason to believe that these methods may lead to less morbidity or mortality (1, 2, 3).

Healthcare Observations

     Obviously, this well-known condition has to do with blood supply to many parts of the body.  There may be blockage to the human arterial system, and the result can be blood clot or the presence of atherosclerosis.  In many patients, the illness can quickly occur—and resolve in a similar situation.  In other instances, the condition can quickly take place and worsen.  For these reasons, it is best that any concern or reservation is a sign that fast response from family members is likely indicative of the need to transport the patient to a health care facility.  The patient may have experienced numbness of the face, speaking impairment, mental confusion, and difficulty walking.  As with certain other infirmities, the patient or family must seriously consider an emergency phone call to 911 (1, 2, 3).

     These situations, of course, originate from abnormalities of the heart.  Examples include rhythm disturbances.  Also, blood clotting as well as infection can have a role in this deterioration of the body.  One must also keep in mind that demographic variables have a role.  Specifically, African- American clients are more likely than Caucasians to experience them.  Moreover, women carry higher death rates from them than others.  Nevertheless, men still have higher occurrences than women in general.  Cigarette smoking has long contributed to these diseases.  Other factors which lead to these include high blood pressure, hypercholesterolemia, and diabetes mellitus.  It is true that comorbidities overlap from them.  Also, these is much concern about migraine, substance use disorder, and energy drinks (1, 2, 3).

     Management of these serious illnesses will entail laboratory assessments such as electroencephalogram, angiography, computed tomography, and magnetic resonance imaging.  The use of thrombectomy is one way to reverse some stroke symptoms.  So will oxygen and intravenous fluids.  Additional approaches include carotid artery stenting, aneurysm management, and the use of arteriovenous malformation assessment (1, 2, 3).

     Other concerns include cardiac arrest as these scenarios lead to irreversible brain damage.  The client may develop subarachnoid hemorrhage.  The human body will in many of these cases suffer from hypoperfusion of the brain.  It may present as multifocal or focal damage to that organ (1, 2, 3, 4).

Conclusions

     Progress in the management of these patients develops over the years.  The team will have views which, in the long run, will lead to better outcomes for acute ischemic stroke than in the past.   

References

  1. Hassett, C., Gedansky, A., Mays, M., and Uchino, K.  (2020).  Acute ischemic stroke and COVID-19.  Cleveland Clinic Journal of Medical, pages 1-3.
  2. American Heart Association.  American Stroke Association.  (2018).  Together to end stroke. 
  3. Cedars-Sinai.  (2020).  Ischemic stroke.  
  4. Columbia University Department of Neurological Surgery.  (2020).  Cerebral ischemia.
  5. Copyright 2020.  All rights reserved.  Michael Koger, Sr., M.D.

Disclaimer

     The information contained in this article is for educational purposes only, and one should not use it for diagnosis or treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact their physician for advice.

Updated: 12/25/2020, Michael_Koger
 
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