Treating a stroke may involve drugs, surgery, or other therapies.
Treatments for stroke vary depending on whether the stroke is caused by a blood clot (ischemic stroke) or a brain bleed (hemorrhagic stroke).
Not matter the type of stroke, acting fast and seeking treatment as quickly as possible is key to reducing the risk of permanent brain damage.
Treatment for Ischemic Stroke
Ischemic strokes happen when a blood clot in an artery blocks the flow of blood and oxygen to a portion of the brain.
With this type of stroke, the goal is to restore blood flow to the brain as quickly as possible.
A number of medications may be given at the hospital to help break up the clot and prevent the formation of new clots.
These medications may include:
Tissue plasminogen activator (tPA, alteplase):Alteplase or tPA is a thrombolytic medication, often referred to as a “clot buster.”
These drugs must be started within a few hours after stroke symptoms first appear.
They will quickly break up or dissolve blood clots that are blocking blood flow to the brain.
This type of medicine is given through a catheter or IV tube in the arm.
Aspirin: Aspirin won’t dissolve existing blood clots, but it will help to prevent new clots from forming.
Doctors may give aspirin within 48 hours of the start of stroke symptoms.
Anticoagulants: Anticoagulants, such as heparin, may be used to help prevent more blood clots from forming.
Treatment for Hemorrhagic Stroke
Hemorrhagic strokes happen when blood vessels in or around the brain rupture or leak.
This puts too much pressure on the surrounding brain tissue, cutting off circulation and starving the brain of oxygen.
Treatment for hemorrhagic stroke will depend on the cause of the bleeding and what part of the brain is affected.
Bleeding around the brain is often caused by abnormally formed blood vessels, called aneurysms.
Bleeding in the brain is often caused by high blood pressure.
Non-surgical treatments for hemorrhagic stroke may include:
- Controlling blood pressure
- Stopping any medications that could increase bleeding (e.g., warfarin, aspirin)
- Blood transfusions with blood clotting factors to stop ongoing bleeding
- Measuring pressure within the brain using a device called a ventriculostomy tube that’s inserted in the skull
Surgical treatments for hemorrhagic stroke may include:
Endovascular treatment: A long tube is slid into a blood vessel in an arm or leg, and passed all the way up to the blood vessels in the brain, where a coil or clip is placed to prevent further bleeding.
Revascularization refers to procedures that restore blood flow through a blocked artery.
Aneurysm treatment: This may involve removing a small piece of the skull to locate the aneurysm and put a small clamp around it to stop the bleeding.
An aneurysm may also be treated by placing a small tube or catheter into a blood vessel in the groin. The catheter is then guided through the blood vessel to the location of the aneurysm.
A small coil may be placed within the aneurysm to block blood flow and prevent it from rupturing again.
Decompressive craniotomy: If a patient’s life is in danger, the doctor may consider opening the skull to remove blood and release pressure on the brain.