An evolving stroke is one in which the damage to the brain worsens over time. A stroke causes a brain infarction (tissue death or necrosis in the brain). Over time, a stroke caused by bleeding in the brain or by a blood clot can cause tissue death in the brain that spreads out over time. The patient may begin to notice mild deficits that have worsened over time. An evolving stroke, also known as a stroke in evolution is not a diagnosis, it is an observation. The patient will be treated for his or her stroke symptoms.
The symptoms of a stroke may include these sudden changes with:
Thinking and understanding
Ability to move limbs
Weakness of limbs
Low blood pressure if bleeding is present in the brain
Unless the stroke is massive, a person should be able to call for help. It’s critical to get help within the first few minutes after the symptoms occur, because the stroke will get worse (evolve) over the passage of time. Doctors in the ER want to diagnose and begin treating a stroke patient within the first hour of the onset of symptoms.
The main objective of stroke treatment is to restore proper circulation to the brain as quickly as possible to arrest the symptoms. The ER doctor will have to determine where the stroke is by observing the symptoms, and by getting a CT scan or an MRI scan of the head. The scan will show whether the stroke is caused by a blood clot (ischemic stroke) or by a broken blood vessel in the brain (hemorrhagic stroke). A hemorrhagic stroke is most commonly caused by an aneurysm in the brain. After the scan the ER doctor will know whether the patient has had an ischemic or a hemorrhagic stroke.
If the stroke was caused by a blood clot (ischemic), the goal will be to dissolve the clot as quickly as possible. A clot dissolving medication may be given intravenously to dissolve the clot. Most ER protocols call for the patient to take a 5 grain aspirin tablet, if they are able to swallow. They may be given a medication to block platelet formation (an anti-platelet drug).
Treatment of a hemorrhagic stroke starts out by taking the vital signs. If the blood pressure continues to be low, this means there is active bleeding in the brain. The bleeding could be caused by an aneurysm. If there is an aneurysm, the patient will be taken to surgery to fix it. There are a couple of surgical options to repair an aneurysm. One way is to clamp it so that it stops bleeding, and the other way is to insert a coil into a vessel to block the flow of blood.
If you notice any sudden changes which are mentioned above, you should call 911 immediately. People living outside of the United States should call their emergency number to get help out to them as soon as possible. It is critical that you get medical help within the first few minutes after the onset of symptoms; thus, the sooner you are diagnosed and treated the better your recovery is likely to be. If you wait, your symptoms can evolve and get worse, which can make your condition much worse.