What causes ischemic stroke and how to treat
What causes ischemic stroke and how to treat
Ischemic stroke is the most common type of stroke. They occur as a result of an obstruction within a blood vessel supplying blood to the brain. Learn about treatment options in Columbia, South Carolina from Prisma Health Chief of Neurosurgery Roham Moftakhar, MD.
Content
0 -> [Music]
9.84 -> when someone has an
11.12 -> ischemic stroke what ends up happening
13.679 -> is that there is a part of the brain
15.92 -> that's not getting enough blood flow
18.8 -> there are parts of the brain that are
20.32 -> silent meaning that someone has
22.4 -> is having a stroke and they will never
24.32 -> know it they might find out later on
26.32 -> because we do some sort of a scan of
28.08 -> their brain ischemic strokes
30 -> they can come from the heart and we move
33.52 -> from the heart all the way up into the
35.44 -> brain so in the heart
37.12 -> there could be a abnormal arrhythmia and
40.719 -> atrial fibrillation for instance some
42.64 -> folks have that condition
44.16 -> where the heart is not regularly beating
47.2 -> it's in a rhythmic way and what can
50.079 -> happen is that blood flow
52.079 -> has a irregularity and turbulence to it
55.12 -> and clot forms and when the clot forms
57.76 -> it can get lodged into the brain
60 -> and that clot causes a
63.28 -> lack of blood flow to that part of the
65.04 -> brain causing the
67.2 -> damage to that part called the ischemic
69.52 -> stroke
70.24 -> now let's move from the heart to the
72.159 -> neck your neck has different blood
74.24 -> vessels one of them being the carotid
76.08 -> artery
76.88 -> vertebral arteries on the back the
78.96 -> carotid arteries sometimes can get
81.439 -> plaque buildup cholesterol buildup and
84.479 -> when they get narrow enough the blood
86.88 -> flow doesn't have a really
88.32 -> smooth way of getting through it there's
90.56 -> a lot of irregularity there's a lot of
92.56 -> turbulence
93.6 -> and when that happens again the blood
96.079 -> can clump together
97.68 -> and it can be sent into the brain
100.079 -> causing the blockage of the artery into
102.399 -> the brain
103.36 -> now we move up one step higher now there
106.32 -> could be a problem in the brain blood
108.079 -> vessels
108.88 -> in the brain blood vessels you can have
110.72 -> narrowing in the blood vessel
112.56 -> and when you have narrowing the blood
113.92 -> vessel again the same phenomena
115.84 -> of clumping of the blood together
119.04 -> blockage of the artery and not enough
120.96 -> blood flow to the brain
123.92 -> if someone's having a stroke their face
126.479 -> could be involved so you might see that
128.319 -> your face is drooping
129.84 -> it could be that the arms are not
132 -> working well so
133.44 -> most of the strokes are on one side of
135.36 -> the body where
136.56 -> there could be a drooping of the side it
138.959 -> could be heaviness
140.239 -> numbness tingling now i want to say that
142.72 -> there are
143.36 -> strokes that involve both sides of the
145.36 -> body but that's a little bit less
147.84 -> common people can have a problem with
150.56 -> speech production
152.08 -> meaning that they're trying to talk but
154 -> they're not able to get their wards out
156.08 -> they're trying to understand but they're
158.08 -> not understanding other people
160.08 -> so that's called aphasia that's a
161.84 -> technical word for it your doctor might
163.68 -> talk about that
164.8 -> so speech problems are the other things
167.519 -> the
168.239 -> last thing that can happen is numbness
170.879 -> tingling of the hands
172.4 -> those things also might happen the
175.12 -> treatment options for ischemic stroke
177.519 -> have advanced quite a bit even in the
179.76 -> last six months to a year
182.159 -> the next step in evolution of stroke
184.72 -> therapy was
185.68 -> a clot busting medication and it's
189.12 -> called tpa
190.319 -> tissue plasminogen activator this is a
192.8 -> fda-approved medication
194.64 -> it's given through the intravenous route
196.959 -> and it's administered
198.159 -> in the hospital the success rate of
201.2 -> this tpa or tissue plasma engine
203.28 -> activator
204.64 -> is pretty decent but on the order of
207.68 -> about
208.239 -> anywhere between 20 and below
211.84 -> this is a good option for patients who
214.239 -> are having a stroke
215.92 -> to get to the hospital as soon as
217.68 -> possible in order to hopefully
219.92 -> qualify to get this medication not
222.4 -> everyone can get it
223.519 -> because there are criteria in terms of
226.159 -> when did you arrive
227.68 -> to the hospital because we can't give it
229.68 -> after a certain period of time
231.2 -> how big is the stroke already but the
233.439 -> point is the sooner the patient gets to
235.76 -> the hospital the better
237.12 -> the newer technology that we have or the
239.519 -> newer methods that we have
240.959 -> are through an endovascular approach
243.2 -> where
244 -> we actually gain access to the blood
245.92 -> vessel through the femoral artery
248.08 -> under x-ray technology we go through and
251.519 -> we are able to locate the area where the
253.92 -> blockage is happening
255.599 -> and try to extract or take out that
258.32 -> blood clot from the blood vessel
260.479 -> to reestablish the blood flow into the
262.8 -> brain again
263.68 -> that method has been really shown to be
266.8 -> the most effective
268.32 -> and that makes sense is that if you
270.32 -> re-establish blood flow to a part of the
272.32 -> brain that's starving for blood
274.639 -> that has the highest chance of someone
276.96 -> making ultimate recovery
278.56 -> we offer that 24 7
281.759 -> we have a whole dedicated team who is on
284.32 -> call at all times
286 -> so we were able to serve those patients
299.93 -> [Music]
304.08 -> you
Source: https://www.youtube.com/watch?v=1k_PCpsvrtc