Medically Reviewed by Christopher G. Cunningham, MD

Strokes – when the brain is deprived of blood – come in two essential forms. In one case, a blood vessel in the brain bursts, cutting off blood to the brain and exerting pressure on the brain from the leaking blood. A second type of stroke is caused by blockages building up in the neck’s artery, restricting the flow of blood. McLeod Vascular Surgeon Dr. Christopher Cunningham discusses surgical solutions for the second type of stroke:

Here are some of Dr. Cunningham’s points:

• Best way to prevent a Hemorrhagic Stroke – which is the rupture of a blood vessel in the brain – is to control your blood pressure.
• Once you have ruptured blood vessels in the brain, treatments are “supportive” to allow you to heal and survive. It may involve neurosurgery to relieve pressure on the brain.
• Embolic (or Ischemic) Stroke usually involves the carotid artery in the neck. There are three basic treatments for this problem.
  • Carotid Endarterecomy  (kuh-ROT-ed en-dar-terr-ECK-tuh-mee)
  • The artery is cleaned out through a small incision in the neck. The artery is exposed. The vascular surgeon places a temporary bypass, while he cleans out the blocked artery.
  • Within one minute of starting to work on the blockage, two things happen:
  • The blood flow to your brain is immediately better.
  • While the blood flows through the bypass, the surgeon can work on cleaning out the blockage without worrying that pieces of the blockage will go to the brain.
  • Usually, the material causing the blockage comes out in a single chunk, leaving a healthy artery.
  • The artery is stitched back up; the temporary bypass removed. The operation takes about an hour and patients go home the day after surgery.
  • Carotid Stenting
  • Some people can’t undergo Endarterectomy, because they have had head/neck cancer or have a neck deformity. In these cases, stenting can be performed.
  • A needle is inserted in a leg artery and threaded up to the blockage. A balloon is expanded to compress the blockage against the artery walls. The artery is held open by a wire mesh/cloth tube.
  • The procedure only takes about an hour. Patients generally go home the next day.
  • Thrombolytic Therapy
  • When you feel the sign of a stroke, you should get to a hospital immediately. Once in the Emergency Room, so-called clot-melting medicine is administered to restore blood flow to the brain. Treatment must begin within three hours of the stroke to be effective.
• It’s important to recognize the symptoms of a stroke and call 911 to get to the hospital as soon as possible.

You may also find these articles helpful:

Cut Your Risk of Stroke

When Your Body’s Plumbing Gets Plugged Up

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