Ischemic vs. Hemorrhagic Stroke
There are two separate categories of stroke, ischemic and hemorrhagic. Both can be life altering and are equally deadly, but for different reasons. Ischemic stroke is more commonly known as the classic stroke because it involves a blockage of a vessel cutting off circulation to that area of brain. On the other hand, hemorrhagic stroke involves the rupturing of a vessel, either caused by a vascular deformity, uncontrolled hypertension or trauma, causing pressure to build up on the affected are of brain, which leads to the death of brain cells. Ischemic stroke makes up about 80 to 85 percent of all strokes.
The common treatment for ischemic stroke is the patient is injected with TPA, a clot busting agent. Immediately after the injection, the patient is taken for a CT scan to locate the clot. Based on the information found in the CT scan, endovascular intervention may be required. Endovascular intervention involves taking catheters up through a port in the femoral artery to the location of the clot and using a retrieving stent to pull the clot out.
The common treatment for hemorrhagic stroke starts with getting the patient a CT scan with angiography, a picture method of the blood vessels. An IVC drain is almost always placed into the ventricles of the brain to release the pressure build up. Based on the location and severity of the vessel rupture, it is decided whether the patient should receive open brain surgery to clip the affected vessel or to attack the affected area through endovascular means. Clipping involves placing a metal clip on the vessel to permanently shutting off flow to the affected area. Endovascular means are more common for ruptured arteriovenous malformations or ruptured aneurysms. This process is called embolization, and there are two major types used to treat hemorrhagic stroke, liquid embolization or coiling. Liquid embolization is normally used to treat arteriovenous malformations and involves sending a glue-like substance into the malformation to shut down the blood flow to the malformation. Coiling is commonly used in saccular aneurysm treatment and involves placing metal coils into the sack of the aneurysm to stop blood flow into ruptured area.