T.C. Sağlık Bakanlığı İstanbul İl Sağlık Müdürlüğü İstanbul Sultan Abdülhamid Han Eğitim ve Araştırma Hastanesi

Stroke Center

What is the stroke?

Stroke occurs when a region of the brain is suddenly interrupted by a blood stream that provides oxygen and sugar, sometimes by bleeding into the brain tissue. As a result, there is a temporary or permanent damage to the brain cells. If permanent damage to the cells occurs, permanent loss of function may occur in the body region controlled by these cells. For example, a stroke that causes damage on the right side of the brain causes weakness in the left arm and leg.

How is stroke recognized?

As summarized in the following figures; sudden slipping in the mouth, weakness in the arms and / or legs, speech impairment, loss of balance, loss of vision in one or both eyes suggests that the patient has had a stroke. In such a case, 112 should be searched immediately.


Inmenine emergency treatment

The treatment of patients with cerebral hemorrhage-related strokes consists of close follow-up in the intensive care unit, blood pressure control, anti-edema treatment if necessary, and rarely surgical intervention. It is vitally important to start treatment immediately in patients with stroke due to vascular occlusion, because these patients can be completely corrected by "Stroke Centers" or by the more commonly used term "Stroke Units" with early intervention.

There are "intravenous thrombolytic therapy" and "endovascular treatment" in the emergency treatment of vascular occlusion.

"Intravenous thrombolytic therapy"; is a clot-dissolving drug application via the vein which can be made within the first 4.5 hours after the stroke indication has been started. Ideally, it should be done as soon as possible. This treatment solves the clot to help the blood flow improve quickly and effectively, thus helping the fetus to recover. However, & quot; intravenous thrombolytic therapy & quot; may not be sufficient to open it if the occluding vessel is a large vessel. Therefore, in "large-vessel occlusions" "intravenous thrombolytic therapy" as well as "endovascular treatment" should be applied.

"Endovascular treatment" can be summarized as follows: An angiographic method is used to enter the artery with a thin and flexible catheter through the crotch, where it is advanced to the veins feeding the brain, reaching the occluded artery causing clogging and the clogging obstructing it. The clogging clot is suctioned through the vein with special large diameter catheters (aspiration) or with special retractable stents and removed from the vessel.

"Endovascular treatment" is performed within the first 6 hours after the onset of the stroke, but it is possible to administer it to selected patients for up to 24 hours and obtain positive results.

"Intravenous thrombolytic therapy" is not available in patients who have had a 4.5 hour history of stroke onset or in the presence of various conditions (blood pressure that has not been reduced as desired, use of some blood thinners, etc.). In the presence of such conditions, if a large vascular occlusion is detected in the patient, the patient must be immediately brought to a center where "endovascular treatment" is feasible.