Medications and Treatment

Stroke is a medical emergency that requires taking an ambulance to the hospital so that medical personnel can begin life-saving treatment on the way to the emergency room. Emergency medical treatment for stroke depends on whether it’s an ischemic stroke or a hemorrhagic stroke. Treatment for ischemic stroke aims to clear the blockage in a blood vessel, whereas treatment for hemorrhagic stroke is aimed at stopping leakage of blood from blood vessels into the brain.

After emergency treatment for stroke, you will need to follow up with a doctor for treatment of stroke risk factors and any complications from the stroke. This may involve changes to diet and lifestyle, exercise, medications, and physical or occupational therapy for disabilities resulting from the stroke.

Treatment for Ischemic Stroke

Medications

  • Tissue plasminogen activator (tPA): This medicine works by breaking up blood clots in the arteries of the brain. It is injected into a vein in the arm, and must be given within four hours of the time stroke symptoms appear, if not sooner.
  • Anti-platelet agents: These medicines help stop platelets in the blood from clumping together to form blood clots.
  • Anti-coagulant agents (blood thinners): These medicines work by keeping blood clots from getting larger and preventing new blood clots from forming.

Surgical Procedures

  • Carotid endarterectomy: This is a surgical procedure to clear a blockage in the carotid artery, the main supply of blood to the brain. The procedure involves making incisions in the neck and the carotid artery itself to remove fatty deposits that are blocking blood flow to the brain.
  • Carotid artery angioplasty: This is a less-invasive procedure to clear a blockage in the carotid artery, the main supply of blood to the brain. A tube called a catheter is inserted into an artery in the groin and threaded through the arteries to the blockage in the carotid artery. Another catheter with a very small balloon on the end is pushed into the blockage and inflated to open up the artery so blood flow can resume. A wire mesh tube called a stent may also be placed in the blocked area to keep the artery open.

Treatment for Hemorrhagic Stroke

Anti-hypertensive agents: These medicines work by lowering a person’s blood pressure. They may be prescribed if high blood pressure is causing bleeding in the brain.

Surgical Procedures

  • Aneurysm clipping: This surgery helps prevent further leakage of blood from an aneurysm by blocking off the aneurysm from the blood vessels in the brain. The procedure involves making an incision in the brain and placing a tiny clamp at the base of the aneurysm.
  • Coil embolization: This surgery helps prevent further leakage of blood from an aneurysm. A tube called a catheter is inserted into an artery in the groin and threaded through the arteries up to the site of the aneurysm. A tiny coil is pushed through the tube and into the aneurysm causing a blood clot to form and block blood flow through the aneurysm.
  • Arteriovenous malformation (AVM) repair: This surgery prevents further bleeding in the brain by repairing an AVM—a tangle of faulty blood vessels within the brain that can rupture. This procedure may involve surgery to remove the AVM, injection of a substance into the AVM to block blood flow, or radiation to shrink the AVM blood vessels.
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