What if you had a stroke and an aneurysm?
I regularly scan for news that pertains the stroke and recovery. You are a stroke survivor or a loved one I bet. A new study titled “Risk of Aneurysm Rupture After Thrombolysis in Patients With Acute Ischemic Stroke and Unruptured Intracranial Aneurysms” was published in Neurology recently. It covers exactly my condition. If I had only known before the first stroke… “If wishes were horses…,” I’d ride gallantly! (There is a proverb and nursery rhyme, first recorded about 1628 in a collection of Scottish proverbs. It suggests if wishing could make things happen, then even the most destitute people would have everything they wanted.)
I did not know I have an unruptured intracranial aneurysm. A brain aneurysm is a weakness in the wall of a blood vessel in the brain. The blood vessel inflates in the weak area, similar to blowing up a balloon. That area can get thinner and weaker over time, and at some point can rupture. It caused the clots which triggered the two strokes. Also, I suspect it produced the TIA (transient ischemic attack) that happened over two years prior to the strokes. Plus, I had regular migraines since I was in high school. I was in a migraine when the two strokes happen. The interesting thing is since the strokes occurred, I have not had migraines since the strokes occurred over 11 years ago.
After the first stroke occurred while I slept, funny things started happening when I woke up. If I thought about the probable causes when I fell unexplained that fateful morning, I would have acted completely differently. Instead, I continued to live my life until I had more significant signs later that evening. Bad idea!
How about your situation? If you were just given a diagnosis of an ischemic stroke, would you consent to be treated with tissue plasminogen activator (tPA) if you had an unruptured aneurysm (assuming you were a candidate)? Alteplase (tPA) is a powerful clot-busting agent used intravenously within 4.5 hours of occurrence to treat acute thromboembolism (stroke).
The research paper has shown that in spite of the conventional feeling that “(u)nruptured intracranial aneurysms (UIAs) are considered to be a relative contraindication for intravenous thrombolysis (IVT) in acute ischemic stroke (AIS).” The investigators had found that in almost 4,000 patients who had a stroke and had received a clot-busting injection, 132 patients also had an unruptured aneurysm. Only 3 patients (2.3%) died from a hemorrhagic stroke because of the aneurysm. They recommended that clot-busting injection could be used with patients that also have unruptured aneurysms. It’s a great newsflash!
If you want to get some help with your stroke or a loved one, look at one of 4 places: Our Facebook group, The Stroke Tribe; Our Facebook pages; Success 4 Lifetime, LLC or Stroke Survivor’s First Aid Kit; and our website, www.success4lifetime.org. When you are on our site, subscribe to get our blog. Also, we are going to do our next group training on October 25th at 5 PM ET.
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