Ischemic Stroke (Blockage/Stenosis)

Recent Stroke or Brain Attack (Within Past 6 Months)

A stroke, also known as a brain attack, is a disease in which the blood vessels that supply oxygen and nutrients to the brain rupture or are clogged by a blood clot or other mass. When the nerve cells of the brain lose their supply of oxygen, they can’t work and die within minutes, and without those nerve cells, the area of the body they control ceases to work as well.

Today, stroke is often referred to as a “brain attack,” because just like a heart attack is caused by a lack of blood supply to the heart, a stroke is caused by a lack of blood supply to the brain. Although there is no cure, if action is taken quickly when a stroke occurs, most victims have a good chance for survival and recovery. We provide treatment to patients who have experienced a stroke within the last six months.

Acting quickly when you or someone else shows signs of a stroke – sudden numbness or weakness of the face, arm, or leg, especially on one side of the body, sudden confusion or difficulty speaking or understanding, sudden loss of vision in one or both eyes, sudden trouble with gait, dizziness, loss of balance or coordination – is critical to ensuring the best chance of survival and recovery. Call 911 right away if you suspect that you or someone else is having a stroke.


Cerebral Sinus Thrombosis (CSVT)

A cerebral sinus thrombosis (CSVT) is a type of stroke that occurs when a blood clot forms in the brain’s venous sinuses, preventing blood from draining out of the brain. This can cause blood cells to break and leak blood into brain tissues, causing a hemorrhage or severe brain swelling. If caught early, this condition can be treated without life-threatening complications. CSVT is less common than other types of stroke, most commonly occurring in babies and children, and affecting women more than men.

Common symptoms of a CSVT include severe headache, blurred vision, nausea, and vomiting, but more serious symptoms can be stroke-like and include speech impairment, one-sided body numbness, weakness, and decreased alertness. The most severe symptoms can include fainting, limited mobility in parts of the body, seizures, coma, or even death. If you or someone else begins to experience any of these symptoms, it is imperative to call 911 right away.


Cerebral Blood Vessel Stenosis Or Blockage

Cerebral blood vessel stenosis, commonly referred to as intracranial stenosis, is the narrowing of an artery in the brain, which can result in a stroke. This narrowing is caused by a buildup of plaque, and the process is called atherosclerosis. The four arteries that are most likely to be affected by cerebral blood vessel stenosis are in the internal carotid artery which supplies blood to the front of the brain, the middle cerebral artery which is the largest branch of the internal carotid artery, the vertebral arteries which supply blood to the back areas of the brain, and the basilar artery which is formed where the right and left vertebral arteries meet in the skull.

The first symptom of cerebral blood vessel stenosis is most often a transient ischemic attack, also known as a warning stroke, which has symptoms similar to a stroke, but lasts just 2 to 30 minutes. Symptoms of a stroke include sudden numbness or weakness of the face, arm, or leg, especially on one side of the body, sudden confusion, sudden trouble speaking, sudden trouble seeing in one or both eyes, sudden trouble walking, dizziness, loss of balance, loss of coordination, or a sudden, severe headache with no known cause. These symptoms can occur suddenly, and calling 911 immediately is imperative.


Inpatient Acute Stroke Treatments (Clot Busters) For Patients At Piedmont Medical Center

Clot busters, also known as thrombolytics or TPA, are drugs administered through an IV to break up blood clots. This treatment is used to quickly restore blood flow to the brain and is considered the “gold standard” of treatment for ischemic stroke. The sooner these drugs are given, the better – quick treatment not only increases the chances of survival, but may also reduce complications.

This drug can only be given within the “golden window” of 4.5 hours since the onset of symptoms. Administration of clot busters does involve some risk, so this is done as an inpatient procedure so that the patient can be closely monitored.

Swift treatment is imperative to ensure the best outcome, so it is important to seek medical care at the first sign of a stroke. If you or someone else exhibits symptoms of a stroke, which includes trouble speaking or understanding speech, paralysis or numbness of the face, arm or leg, often on one side of the body, problems seeing in one or both eyes, a sudden, severe headache that may be accompanied by vomiting, dizziness, or altered consciousness, or trouble with walking or coordination, call 911 immediately.


Minimally Invasive Stroke Rescue Procedures (Mechanical Thrombectomy) To Remove Clots

Previously there was only one proven therapy for ischemic stroke, and that was clot-busting drugs called tissue plasminogen activators (tPA). Today, mechanical thrombectomy with a stent retriever is another available stroke rescue procedure. This minimally invasive procedure is used to remove the clot from the artery. Using fluoroscopy, the doctor guides instruments through the arteries to the clot, extracting it all at once. This method is more effective for removing large clots than tPA on its own, and can lead to better outcomes for stroke patients including greater independence and mobility. When used in combination with tPA, this procedure significantly reduces disabilities and mortalities related to stroke.

When someone experiences a stroke, swift action is imperative to ensure the best outcome. If you or someone else is showing signs of a stroke, including sudden numbness or weakness of the face, arm, or leg, especially on one side of the body, sudden confusion, sudden trouble speaking, sudden trouble seeing in one or both eyes, sudden trouble walking, dizziness, loss of balance, loss of coordination, or a sudden, severe headache with no known cause, call 911 right away.


Cerebral Sinus Thrombosis (Venous Clot): Diagnosis and Treatments

Cerebral venous sinus thrombosis (CVST) is a stroke that occurs as a result of a blood clot in the dural venous sinuses, which are responsible for draining blood from the brain. When blood is unable to drain from the brain, blood cells can break and leak blood into brain tissues, causing severe hemorrhaging or swelling. CSVT is less common than other types of stroke and can be treated without life-threatening complications.

Diagnosis of CSVT may be suspected based on symptoms, such as the combination of a headache, raised intracranial pressure, and issues with speech, vision, and/or hearing, or when other causes of headache and neurological abnormalities have been ruled out. Final diagnosis is usually made based on how the blood is flowing in the brain, and this can be determined with imaging tests. Blood tests may also be utilized in diagnosis of a CSVT.

Treatment for CSVT should begin immediately to ensure the best possible outcome for the patient. This may include fluids, antibiotics if an infection is present, anti-seizure medication if seizures have occurred, monitoring and controlling the pressure inside the head, anticoagulants to stop the blood from clotting, surgery, continued monitoring of brain activity, measuring visual acuity and monitoring change, and rehabilitation.


Carotid Artery Stenosis Or Blockage: Carotid Artery Balloon Angioplasty And Stenting Procedure

Carotid artery stenosis or blockage is a potentially life-threatening condition that could lead to stroke or brief stroke-like attacks. The carotid arteries supply the brain with oxygen-rich blood, and when one or both of these arteries becomes narrowed from a buildup of plaque, blood flow to the brain is reduced, which can lead to stroke.

A carotid artery balloon angioplasty and stenting procedure is used to improve blood flow in an artery or vein. During this procedure, a thin tube with a balloon at its tip is used to open up the artery. A thin, flexible tube called a catheter is inserted into an artery in the groin, and then gently threaded up to the carotid artery that is in need of treatment. A tiny, deflated balloon at the tip of the catheter is then inflated, which opens up the narrowed area. Next, a tiny mesh tube called a stent is placed in this area, and left in place to help keep the artery open.

As with all medical procedures, a carotid artery balloon angioplasty and stenting procedure carries some risks with it. Risk is based on the patient’s overall health, the severity of their condition, and other factors, which their doctor will assess and discuss with them.


Vertebral Artery Stenosis Or Blockage: Medical Guidance, Angioplasty And Stenting Treatment

Vertebral artery stenosis is a condition in which one or more vertebral arteries can become clogged with plaque. As the plaque builds over time, the vessels can become so clogged that blood is unable to easily pass through, and this significantly increases the risk of stroke or a transient ischemic attack.

A minimally invasive method of treating vertebral artery stenosis is with angioplasty and stenting. During this procedure, a surgeon inserts a catheter with a deflated balloon at its tip into an artery at the groin, and then threads it through until it reaches the affected area. The narrowed artery is then expanded by inflating the balloon, and a stent is inserted to keep the artery propped open.

While this procedure is generally safe, there are some risks which the doctor will discuss with the patient. Recovery is usually fairly fast with some patients able to move about within hours, and complete recovery is typically within a week or less.


Intracranial Stenosis Or Blockage (ICAD): Medical Guidance, Angioplasty And Stenting Treatment

Intracranial stenosis is the narrowing of an artery inside the brain caused by a buildup of plaque. As the plaque builds up, blood flow to the brain is reduced, and stroke that leads to brain damage or death can occur.

Most intracranial stenosis is maintained by medical treatments and lifestyle modifications. If this fails, a minimally invasive method of treating intracranial stenosis is with angioplasty and stenting. During this procedure, a surgeon inserts a catheter with a deflated balloon at its tip into an artery at the groin, and then threads it through until it reaches the affected area. The narrowed artery is then expanded by inflating the balloon, and a stent is inserted to keep the artery propped open.

While this procedure is generally safe, there are some risks which the doctor will discuss with the patient. Recovery is usually fairly fast with some patients able to move about within hours, and complete recovery is typically within a week or less.