Stroke Treatment Options

Based on the results of the tests described above, doctors will decide what treatment is needed at the time of stroke, as well as after the stroke, to prevent recurrence.

The key to successful treatment of stroke when it is occurring is getting help as soon as possible. It is essential that you seek immediate medical help as soon as you recognize any symptoms of stroke in yourself or someone you are with. Receiving faster medical care results in a greater chance of recovery and minimizing brain damage. The type of stroke that has occurred, as well as the length of time between when the stroke occurred and treatment is initiated determine which therapies doctors can use. Both factors also impact how effective those treatments are likely to be.

Different sorts of damage to the cerebral arteries cause ischemic and hemorrhagic strokes. Given that there are different causes, there are also different treatments for the two types of stroke.

Acute Ischemic Strokes:

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The goals of treatments for ischemic stroke are to remove blockage and restore blood flow to the brain as quickly as possible. Doctors may use one or more of the following techniques in the service of these goals: 

  • "Clot Buster" Medications (e.g., TPA or tissue plasminagen activators). Clot busting drugs (otherwise known as "thrombolytics") work to dissolve blood clots that can block arteries, decreasing the disability caused by a stroke. In order to work, they must be administered within three hours of the onset of stoke symptoms. Unfortunately, most stroke patients don't recognize the seriousness of their condition and do not get medical care immediately, and will not benefit from this type of medication.The major risk of using thrombolytics is internal bleeding. As a result, there are strict criteria for the use of TPA in order to minimize the chance of bleeding and associated complications. For example, thromboytics are not given if a patient has had a hemorrhagic stroke; takes blood thinners; or recently had surgery, bleeding or a head injury.
  • Aspirin: Aspirin blocks the ability of platelets to clot, which might decrease the chance of death or disability from stroke. As described several times throughout the article, blood clots can narrow arteries, and can break off and form emboli, which can trigger an ischemic stroke.
  • Other Treatments: Immediately during and following a stroke, your blood pressure, oxygen, and glucose levels will be monitored. Often, people with stroke have difficulty swallowing. If this is the case, precautions will be taken to decrease the chance of aspiration (i.e. food entering your lungs instead of the stomach).

Acute Hemorrhagic Strokes:

The goals of hemorrhagic stroke treatment are to seal off the ruptured artery to prevent further blood loss, and to prevent uncontained blood from contacting brain tissue. Doctors use the following techniques in the service of these goals:

  • Surgery. In many instances of hemorrhagic stroke, surgery will be necessary to seal the ruptured artery. During surgery, metal clips are placed on the affected artery so as to pinch off the areas immediately adjacent to the rupture. Surgery also allows removal of the extra blood, so pressure does not increase in the brain and cause damage.
  • Endovascular Treatment. In this procedure, doctors insert a tube called a catheter into a major artery (usually the femoral artery in the leg). The tube is guided through the blood vessel until it reaches the affected area in the brain at risk for rupture. Using the catheter, a stabilizer (normally in the shape of a coil) is inserted into the arterial wall, making a rupture less likely. Endovascular treatment is a much less invasive procedure than hemorrhagic surgery, but it is most useful as a preventative measure (rather than a treatment for a stroke that has already occurred).

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