Stroke treatment varies depending on the type of stroke. In addition to medication, physical and mental treatment programs should also be implemented.
Is there a treatment for stroke?
There is treatment for stroke, depending on the type of stroke. If it is in the form of vascular occlusion, first of all, treatments to improve early vascular occlusion are applied. This early treatment can be performed with a clot dissolver given intravenously within the first 4-6 hours or by angiography to open the blocked vessel with a clot dissolving drug. Early treatment is urgent and can be administered within a certain time window. Therefore, people need to be vigilant to recognize disaster. The second treatment approach is so-called secondary prevention. In the case of a blood vessel blockage, an appropriate blood thinner can be used later to reduce the risk of stroke.
In the case of cerebral hemorrhages, if there is a vascular cause of the bleeding, surgery or angiography may be necessary. In both cases, the risk factors causing the stroke are identified and each risk factor is corrected.
Which medicines are used?
Stroke treatment in someone who has not had a stroke is called primary prevention or primary prophylaxis. Here, if necessary, the physician starts the patient on preventive medications such as oral blood thinners, blood pressure medication or cholesterol medication. A person who has had a stroke can be given intravenous blood thinners in the early period, as well as various blood thinners and supportive therapies in the late period.
What are the steps of stroke treatment?
Stroke treatment consists of primary prophylaxis, emergency treatment of stroke, post-stroke treatment and secondary prophylaxis to prevent recurrence of stroke. Primary prophylaxis actually means preventive treatment and it means starting treatment before the stroke occurs. The aim here is to investigate the previously mentioned risk factors and to minimize the risk of stroke as much as possible by treating these risk factors one by one. Emergency stroke treatment should be performed under emergency conditions and as soon as possible. This treatment consists of intravenous blood thinners and mechanical removal of the clot to be performed in stroke centers. After the emergency treatment is over, the patient is followed up either in the intensive care unit or in the neurology ward. The aim here is to stabilize the patient, that is, to keep him/her in balance. The patient is closely monitored during hospitalization. The aim of the follow-up in the ward is to monitor the general condition of the patient, monitor blood pressure and other vital signs, ensure nutrition, and treat any internal problems. Meanwhile, as a result of research on the cause of the stroke and where it originated from, treatments are organized to prevent recurrence of the stroke, which we call secondary prophylaxis.
How is stroke treatment performed at NPISTANBUL Hospital?
In NPISTANBUL Hospital, the above-mentioned procedures are carried out with a multidisciplinary approach accompanied by an experienced team. The team includes neurology specialist, internal medicine specialist, cardiology specialist, physical therapist, physiotherapist, speech therapist, swallowing therapist and doctors from other specialties when necessary. The aim here is to gather different expert opinions under one roof and to provide the highest benefit to the patient by providing consensus (council evaluation) on diagnosis and treatment.
TMU application in Stroke Treatment:
It can be used to stimulate or suppress various parts of the brain with magnetic energy method.
Why is TMU used in Stroke Treatment?
TMU in Stroke Treatment As it is known, stroke means a sudden disorder in the blood supply of the brain. There is no blood supply to a part of the brain or the nutrition of the brain tissue is disrupted as a result of a hemorrhage. This usually results in weakness in the opposite half of the body. It can also lead to loss of dexterity and rigidity, which I call spasticity. In addition to weakness, speech impairment may also occur. When a stroke first develops, we try to reduce the paralysis by intervening as early as possible. However, in many patients, weakness and stiffness may remain despite the first intervention. In this case, the rehabilitation process comes into play. Rehabilitation is performed by specialized physiotherapists and the main goals are to maintain joint range of motion in stroke treatment, to stimulate the brain to facilitate its re-functioning and to restore muscle strength. TMU in Stroke Treatment is another treatment method that can be applied together with Physiotherapy. The most commonly used method in TMU in stroke treatment is the suppression of the opposite side of the brain, not the damaged one. For example, TMU is given to the right brain in an individual whose left brain is damaged after a stroke. Thus, the functions of the intact right brain are suppressed and the damaged left brain is allowed to recover. In addition to strokes, TMU can be used in the treatment of stroke in the treatment of speech disorders that develop after stroke.
TMU in Limb Weakness
After a stroke or paralysis, weakness in the hand and arm can remain a significant problem in up to 20 percent of patients. For a long time, physical therapy was used to relieve muscle weakness in the hand and the accompanying muscle contraction (spasticity).
With the brain stimulation techniques developed in recent years, it has been shown that repetitive magnetic stimulation given to the brain from the outside causes a structural and functional change in the damaged area of the brain and significantly reduces hand weakness. For this purpose, in conjunction with physical therapy, the damaged brain area or the opposite area of the brain can be magnetically stimulated from the outside of the head, resulting in structural and then functional recovery, with the ultimate benefit to the patient as improvement in hand-arm muscle strength. The type of repetitive magnetic stimulation (frequent intermittent stimulation, infrequent intermittent stimulation) varies according to the time elapsed after the stroke and the patient's findings.
TMU in Limb Contractions (spasticity)
As with limb weakness, muscle contraction called spasticity can occur after a stroke or even months after a stroke. Especially when it is accompanied by limb weakness, it creates resistance to movements and makes it difficult to function in daily life. Repetitive magnetic brain stimulation can be useful in reducing spasticity. Repetitive magnetic brain stimulation, especially in combination with physical therapy, is beneficial in terms of improvement in limb weakness, while at the same time reducing hand-arm muscle stiffness and facilitating the use of hand-arm in daily life.
TMU inAphasic Speech Disorders
Speech disorders called aphasia can frequently occur after stroke/stroke, especially with right-sided weakness. Depending on the location of the vascular occlusion in the brain, aphasias can be in the form of comprehension, expression or both comprehension and expression disorders.
Despite being a sequela that severely limits daily life and causes communication problems, the benefits of magnetic stimulation are promising. Repetitive brain magnetic stimulation applied both in the early and chronic-late period (years later) in aphasias due to strokes has been shown to have a positive effect on linguistic disorders, increase word output and improve comprehension. Especially the application of magnetic brain stimulation in combination with speech and language disorders rehabilitation increases its effectiveness.
TMU in Swallowing Disorders
Although persistent swallowing disorders after strokes are rare, they can persist in some strokes and cause distress as a loss of function that seriously affects the person's life. It is also important in terms of causing lung problems. Although swallowing rehabilitation and teaching swallowing techniques can be beneficial, repetitive magnetic brain stimulation, which has been applied in recent years, has been shown to provide significant improvement in swallowing disorders.
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Is TMU Adequate in Stroke Treatment?
Currently, there are many studies in the medical literature investigating the effectiveness of TMU use in stroke treatment after stroke and reporting positive results. Positive studies from these studies suggest that TMU can be easily used in stroke treatment in patients with stroke.
Is TMU Safe in Stroke Treatment?
The most reported severe side effect of TMU is epilepsy crisis. Therefore, it should be used with caution especially in people with epilepsy. Other than that, there are no known serious side effects. In stroke treatment, TMU can also be used easily in paralyzed patients.
How long should TMU be used?
TMU treatment can be started after the acute period of stroke, that is, after the first week has passed. It can also be used in patients who have had a stroke for a long time. Generally, the treatment is given daily and lasts for two weeks. However, in some cases, this period can be extended to get more benefit.