
Had Brain Stroke And Blood Clot Near The 'stem' Of Nerves. Can This Clot Be Unblocked By Any Medication?

Kindly suggest and/or provide inputs.
Thank you for posting your query.
I presume you are talking about the brainstem area of the brain, which controls functions such as strength of arms and legs, in addition to facial muscles, chewing, swallowing, speaking, etc.
In these cases, if the patient is seen within the first few hours after stroke, the blocked blood vessel can be reopened with an injection called as tissue plasminogen activator (tpa). However, this injection does not work after 24 hours, as the affected part of brain suffers irreversible damage after that time period.
Based on your cetails about 2 weeks have passed, so, we can not use tpa. At this stage, the medical treatment would consist of using blood thinners such as aspirin, clopidogrel, etc and statins. Risk factors for brain stroke, if any, should be controlled. Physiotherapy is also useful.
I hope it helps. Please get back if you have any more queries.
Best wishes,
Dr Sudhir Kumar MD Vellore, DM Vellore XXXXXXX Consultant Neurologist
Apollo Hospitals, Hyderabad


regarding your last suggestion of using blookd thinners, i want to know the extent of the help this can provide. Would this lead to unblocking the blooed path? From this situation what is the best recovery possible? Can we hope to get to a complete normal situation (even if it is a remote possibility) or would this mean a paralysis at best?
Generally, within 90 minutes of stroke onset, the thrombolytic therapy (with tpa) can be given, even if clot is already there (unless there is some contra-indication to the procedure). So, if you have taken your father to a good center, then tpa would have been considered and if it was not given, there must have been a contraindication to thrombolytic therapy.
With blood thinners, we can prevent further clot formation and further brain strokes, but it does not remove the pre-existing blood clot.
Clinical recovery of the patient always happens, but it is most often incomplete. Recovery depends on good physiotherapy, good family support and maintaining positive outlook in & around the patient.
Best wishes,
Dr Sudhir Kumar MD DM (Neurology)

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