Post-Stroke Surgery: When Is It Necessary?

The Necessity of Surgery After a Stroke

We are primarily familiar with two types of stroke: 'Hemorrhagic' and 'Ischemic'. Hemorrhagic stroke is also known as a brain hemorrhage. In this type, a blood vessel in the brain ruptures, which can cause the condition to become critical within moments. On the other hand, in an Ischemic stroke, blood flow to the brain is obstructed or even completely stopped.

Simply put, when the blood supply to a part of the brain is cut off, damaging the brain cells, it is called an Ischemic stroke. The treatment for a stroke can sometimes be straightforward, while at other times it can be somewhat complex. However, this depends on the patient's condition and immediate actions taken. If a patient becomes unconscious after a stroke, one should not panic but instead seek immediate medical advice or take the patient to the nearest hospital.

Initial Steps:
Some initial steps can be taken, the most important of which is to ensure the airway, breathing, and blood circulation (ABC) are maintained. Additionally, it is necessary to place the patient on their side, without a pillow, and with the head lowered, monitor their eyes, care for the bladder, and use a catheter if needed. By taking these primary steps, the patient can be protected from any major complications.

However, if surgery is required depending on the patient's condition, it should not be neglected. Surgery is primarily needed for middle-aged patients or those under 40. If a blood clot forms, a craniectomy (surgically opening the skull) must be performed as soon as possible to remove it carefully; otherwise, the risk increases. Many patients do not follow the initial guidelines, which puts them at health risk. Therefore, these matters must not be ignored.

The Role of Physiotherapy:
Physiotherapy is a key treatment method in stroke cases. Often, it is seen that awareness about physiotherapy is very low, especially in rural or marginalized areas. Many patients experience bent or contracted limbs after a stroke and remain that way for the rest of their lives. Physiotherapy is extremely beneficial for these patients. Many think that physiotherapy treatment is ineffective. However, this notion is completely wrong. But it is essential to receive treatment at the right place and in the correct manner.

---

Dr. Md. Anisul Islam Khan
Senior Consultant & Co-ordinator, Department of Neurosurgery
Evercare Hospital Chattogram