ทางเลือกในการรักษาโรคหลอดเลือดสมอง

The use of catheters for occluded cerebral blood vessels or combined radiotherapy is another treatment option for stroke patients who cannot be treated with thrombolytic drugs due to health issues, patient readiness, and the time elapsed since symptom onset.
<h2>Stroke symptoms that require patients to urgently go to the hospital 
</h2>
The prominent symptoms of stroke are slurred speech, facial drooping, numbness on one side, weakness in one side of the limbs, incomprehensible speech, inability to understand language, dizziness, unsteady walking, or sudden abnormal vision, commonly abbreviated as “BEFAST” 

Because these symptoms occur suddenly and immediately, anyone experiencing these symptoms should go to the hospital as soon as possible. Doctors will examine or send the patient for a brain scan to determine whether the cause is ischemic stroke or hemorrhagic stroke, so that appropriate treatment can be given to reduce cell death that may lead to paralysis or death.
<h2>Thrombolytic therapy and catheter use 
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Ischemic stroke may be caused by narrowing or blockage of the arteries. If the patient arrives at the hospital within 4.5 hours after symptom onset and has no contraindications to thrombolytic therapy, doctors can administer clot-dissolving drugs to reopen the blood vessels and restore blood flow to the brain, allowing brain cells to function normally again. 
However, thrombolytic therapy has limitations and cannot be given to all patients. For example, patients must arrive at the hospital within 4.5 hours after symptoms begin, and if the patient has a large artery occlusion, thrombolytic drugs may not be able to open the blocked vessel.
Therefore, in cases of large cerebral artery occlusion, doctors may treat by using a catheter to mechanically remove the clot blocking the cerebral blood vessel (Neurovascular Thrombectomy) to reopen the vessel and restore blood flow to the brain.
For this treatment, patients must arrive at the hospital within 24 hours of symptom onset. If doctors assess brain imaging and find that the area of dead brain tissue is not large and there is still brain tissue that can recover to normal by timely reopening the blood vessel to restore blood flow, this treatment can reduce the incidence of disability and help patients return to a quality daily life, being able to care for themselves normally in 40-60% of cases.
Therefore, anyone who suddenly experiences “difficulty speaking, facial drooping, or inability to raise limbs” should suspect stroke symptoms and urgently go to the hospital for doctors to examine, diagnose, and treat to restore blood flow to the brain as quickly as possible. Rapid treatment results in better outcomes, reducing disability and the risk of death significantly.
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Dr. Napasri Chaisinanankul 
Neurology Specialist 
Brain and Nervous System Center, Phyathai 1 Hospital

The use of catheters in occluded blood vessels in the brain or the use of adjunctive radiation therapy is another option for stroke patients who cannot receive thrombolytic drugs.

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