The most effective treatment with a clot buster is available within 3 hrs. It needs to be administered IV, so don't delay calling 911, every minute counts. The sooner within the 3-hr window the patient receives the IV treatment, the better the outcome and some of the deficits like speech, balance, vision, strength, and sensation can be restored completely. Some people are candidates for this treatment within 4.5 hrs, so, if not sure, bring the patient to the hospital and tell EMS that you are suspecting a stroke, so the hospital stroke team will be ready for you at the door.
These days, we can manage stroke up 24 hrs from the onset with the removal of the clot with special devices that are inserted into the occluded artery. The results are very good, but not every patient is a candidate for that. So, if the time is over 3 hrs from the symptom onset, or the patient woke up from sleep with the symptoms, still bring the patient to the ER and inform EMS it is a stroke and the stroke team needs to be notified.
Remember, BE FAST!
My sister is having a lot of headaches, which are not subsiding with any medicine. What should we do?
disorders, thyroid disorders, autoimmune disorders as lupus or vasculitis, and nutritional and hormonal deficiencies and excess. Brain MRI and blood vessel studies would always rule out a possibility of a mass lesion, vascular abnormalities as fistulas, aneurysms or arteriovenous malformations. Ophthalmology exam is also very helpful since it rules out increased intracranial pressure. At times, a lumbar puncture with cerebrospinal fluid testing can be indicated with particular clinical symptoms. In my practice, I've seen how just vitamin D and magnesium supplements spared patients from taking medication with serious side effects. It all depends on what we find.
If no causes of headaches are found, than it is most likely a primary headache, like migraines and cluster headaches, or paroxysmal hemicranias. The medication choice is completely different. There are over 100 medications and many supplements to treat this type of headaches. A trial is needed, sometimes a combination work instead of a single medications.
Besides oral medications, these days we widely use trigger point injections and Botox injections with different regimens. Recently, a sphenopalatine ganglion block gave us a new hope successfully treat some forms of headaches.
Also, there are other procedures as massage, stretching, physical therapy for the headaches, particularly the ones that originate in the neck. There is a lot to look for and just as much to try, in any way optimism is very important as well as open mindedness. Let me know if I can clarify some facts. I can go and discuss headaches for days.
Olga Kozlova, MD