Diagnosis
Diagnosing a stroke promptly and accurately is crucial for effective treatment and management to minimise potential damage to the brain. Medical professionals use a combination of clinical assessment, imaging tests, and medical history to determine the brain stroke causes.

When a patient arrives at the hospital with symptoms suggestive of a stroke, the medical team begins with a thorough clinical assessment. This includes evaluating the patient’s symptoms, conducting a physical examination, and assessing their medical history.

The acronym FAST (Face, Arms, Speech, Time) is often used to quickly assess potential stroke symptoms such as facial drooping, arm weakness, and speech difficulties.

1. Following the initial assessment, imaging tests are typically performed to confirm the diagnosis and determine the type and extent of the stroke:

1. CT Scan (Computed Tomography): A CT scan of the brain is usually the first imaging test performed. It helps identify whether the stroke is ischemic (due to a blockage) or hemorrhagic (due to bleeding). CT scans can also rule out other conditions that may mimic stroke symptoms.
2. MRI (Magnetic Resonance Imaging): An MRI provides a more detailed image of the brain than a CT scan. It can detect smaller areas of damage and is particularly useful for identifying ischemic strokes in their early stages. MRI can also help determine the age of the stroke and assess the extent of brain tissue damage.

2. In some cases, additional tests may be done to evaluate the underlying cause of the stroke or to assess other factors that may influence treatment decisions:

1. Angiography: This test, such as CT angiography (CTA) or magnetic resonance angiography (MRA), helps visualise the blood vessels in the brain to identify blockages or abnormalities.
2. Echocardiography: An ultrasound of the heart may be performed to check for sources of blood clots that could have travelled to the brain and caused a stroke.
3. Blood Tests: Blood tests may be conducted to assess various factors such as cholesterol levels, blood sugar levels, and clotting factors, which can provide information about the patient’s overall health and potential stroke risk factors.

Once a stroke is diagnosed, further evaluation may be done to determine the most appropriate treatment plan, whether it involves medication, procedures to remove a clot, or rehabilitation efforts to aid recovery.

Stroke treatment typically involves a multidisciplinary approach coordinated by medical professionals specialising in neurology, emergency medicine, and rehabilitation. Here’s an overview of how a stroke is treated by medical professionals:

Emergency Response and Diagnosis

The first step in stroke treatment is rapid assessment and diagnosis. Emergency medical services (EMS) play a vital role in quickly transporting the patient to the hospital. Upon arrival, medical professionals assess the patient’s symptoms, medical history, and perform neurological exams and imaging tests such as CT scans or MRI to determine the type and severity of the stroke.

Acute Treatment

1. Ischemic Stroke Clot-Busting Medication (Thrombolytics): If the stroke is ischemic and within a certain time window, thrombolytic drugs such as alteplase (tPA) may be administered intravenously to dissolve the blood clot and restore blood flow to the brain.
2. Mechanical Thrombectomy: For large vessel occlusions, a mechanical thrombectomy procedure may be performed to remove the clot directly from the blocked artery, often using a catheter-based approach.
3. Hemorrhagic Stroke Controlling Bleeding: In hemorrhagic strokes, the focus is on controlling bleeding and reducing pressure on the brain. Surgery or endovascular procedures may be necessary to repair damaged blood vessels and stop bleeding.

Monitoring and Supportive Care

1. Intensive Care Unit (ICU) Monitoring: Patients with severe strokes may require close monitoring in the ICU to manage complications and ensure vital signs stability.
2. Medications: Medications to manage blood pressure, prevent blood clots, and prevent seizures may be administered as needed.
3. Oxygen Therapy: Oxygen may be provided to ensure proper oxygenation to the brain.
4. Fluids and Nutrition: Intravenous fluids and nutrition may be given to maintain hydration and adequate nutrition.

Rehabilitation

Following the acute phase of treatment, rehabilitation plays a vital role in helping stroke survivors in post stroke pain treatment and regaining function and independence:

1. Physical Therapy: Helps regain strength, mobility, and coordination.
2. Occupational Therapy: Focuses on relearning daily tasks such as dressing, eating, and writing.
3. Speech Therapy: Assists with communication and swallowing difficulties.
4. Psychological Support: Helps patients cope with emotional and cognitive changes post-stroke.

Secondary Prevention

After the acute phase, medical professionals work on preventing future strokes through:

1. Medications: Such as antiplatelets, anticoagulants, statins, and blood pressure medications.
2. Lifestyle Modifications: Including healthy diet, regular exercise, smoking cessation, and managing other risk factors like diabetes and high cholesterol.