Neurointervention in Acute Stroke

Introduction

Neurointervention In Acute Stroke Treatment in Ludhiana, Punjab, Neurovascular intervention is the approach that uses minimally invasive treatment for diseases of spine and brain blood vessels. Improved catheter technology and embolic device technology are used in conjunction with the upgraded treatment of the various conditions which are linked to neurovascular issues and there is evidence-based research for the same. Dr. Jhawar is a well-known neurologist in Punjab, who has successfully addressed the concern of acute stroke for thousands of patients.

Clinical Applications and Indications

The update in neuro intervention has helped to focus on surgical and medical neurology. The classification of neuroendovascular treatment is based on:

• Opening up procedure: For the opening up method, there is a similarity between the coronary interventions which have got applications in medical neurology and these are linked to ischemic stroke.
• Closing up procedure: For the closing up procedures, the applications are in link to neurosurgical problems like AVMs and aneurysms. The main approach is to block the pathology and ensure that the normal anatomy is proper.

What are the major clinical applications?

Acute Ischemic stroke

Also, around 87% of the cases are diagnosed as ischemic strokes which is the reason for blood flow getting blocked. The recurrence cases of the stroke are around 25%. The only method which has got approval by FDA is Intravenous recombinant t-PA administration which is for acute ischemic stroke. The method is termed revascularization (restoration of the body part which has suffered the effect of ischemia). In the past, several endovascular methods are used which includes:

• Mechanical wire disruption
• Thrombectomy by MERCI devices
• Intra Arterial Thrombolysis

Although, in the trials, there was not seen any type of positive evidence. Reperfusion hemorrhage, insignificant functional outcomes, thrombolytic linked with cerebral hemorrhages were the major factor which led to lack of impetus. One of the updated methods of clot retrieval stents is referred to as stent retrievers which are known as revise devices and solitaire devices. In endovascular intervention, it is the breakthrough for stroke. The use of retrievers has shifted the focus from thrombolysis to mechanical thrombectomy which is part of endovascular intervention.

Intracranial Aneurysms

Intracranial aneurysms in the general population are between 2% to 4% per 1000. Aneurysms are the condition when the artery wall becomes weak which creates a bulge in the artery. The problem is referred to as subarachnoid hemorrhage which indicates thunderclap headache. In some cases, the aneurysms are detected through:

• MR angiography
• CT angiography

The possible treatment options which are used in this condition include the following:

• Medical (non-surgical) therapy.
• Surgical therapy or clipping.
• Endovascular therapy or coiling adjunctive devices (with or without).

For the conditions of the wide-necked aneurysm, the advanced approach of hyper stents and complaint balloons is used.

Intracranial arteriovenous malformation and fistulae

It is the condition, which is depicted by an abnormal connection between a vein and an artery. When the brain has high flow vascular lesions, the problem can be presented in the form of:

• Seizures
• Headache
• Hemorrhage
• Focal Neurological deficit

The most preferred treatment option for dural AFVs is endovascular onyx embolization. Depending on your condition, the neuro doctor will give you a customized treatment plan.

Effective treatment approach

This is what Dr. Jhawar has been doing for years and his success & trust shown by the patient towards him is the clear description for the same. For more information, book your initial consultation with our neurosurgeon today only.