Stroke – Surgical Options

After receiving post stroke emergency care, some survivors may be required to go through a surgery. However, in most cases, surgery is relatively rare and less helpful in treating and preventing a stroke. The stroke survivor’s age and current condition are two of the most important factors that are considered before performing a surgery.

As most of the strokes occur when a blood vessel in the brain is blocked and blood flow stops, a life-saving surgery, Angioplasty, may be necessary to remove the blood clot and prevent brain swelling.

When patients have a serious blockage in the arteries in the neck (that help in blood supply to the brain), a surgery called Carotid Endarterectomy may be required to prevent a stroke or a Transient Ischemic Attacks (TIAs) also known as mini stroke. Blood flow to the brain may decrease temporarily in some TIA patients. Bypass surgery may also be advised for the patients who repeatedly experience TIAs.

In some patients, brain bleeding causes stroke. The bleeding may be a result of a weakened blood vessel leak or burst, which is called an Aneurysm. There are several types of surgery to repair an aneurysm. Commonly, a clip is placed across the neck of the aneurysm to stop the bleeding.

Surgical options for Ischemic Stroke

Based on the severity level of Ischemic Stroke, a patient might need an operation to reduce the risk of having another stroke. A surgical method called Carotid Endarterectomy removes blood clots and fatty deposits from one of the carotid arteries in the neck. Thrombectomy, a treatment that removes the clot with a mechanical device is also being practiced in few European countries. The recovery period after surgery depends on the severity and the degree of brain damage caused by Ischemic Stroke.

Surgical options for Hemorrhagic Stroke

Supportive care may be the only form of care the victim will need if a minor Hemorrhagic stroke is detected.  However, in case of severe rupture, surgical measures should be taken to repair the ruptured blood vessel and stop a great amount of bleeding and pressure.

If the stroke is triggered by an Arteriovenous Malformation (AVM), surgery may be used to remove it, depending on the AVM’s location. Few patients merely require surgery to be relieved from the pressure caused by the bleeding and brain swelling. Once bleeding stops, surgery, which focuses on repairing blood vessel abnormalities post stroke, may also be done for preventing another Hemorrhage.

Surgical options for Transient Ischemic Attacks (TIAs)

If any weakness-numbness, walk and coordination issue, vision problems or any impairments related to hearing, speech and language comprehension persist, the patient needs to be examined through a full neurologic exam, Electrocardiogram, CT scan and Carotid Ultrasound. Once the doctor has determined the reason behind bleeding in the brain and narrowing of the blood vessels in the anterior part of the neck, your doctor may suggest surgery.

If the carotid ultrasound detects major narrowing of the artery (stenosis), unclogging the artery using Carotid Endarterectomy will be needed. The preventive procedure involves removing part of the lining of the damaged carotid artery and any fatty deposits that have accumulated therein. The procedure is avoided for people with partial blockage due to the risk of having another stroke during the surgery.

In certain cases, Carotid Angioplasty, also known as Stenting, is recommended. The surgical method involves inserting and inflating a tiny balloon to open a clogged artery and placing a small wire tube (stent) into the artery to decrease the chance of it narrowing again.