Stroke Treatment

Stroke treatment depends on the type of stroke. Medications or surgery to dissolve a clot, stop bleeding, or fix a damaged blood vessel may be used.

The treatment for a stroke depends on what type of stroke the patient is having. Because brain tissue begins to die when it’s deprived of the oxygen and nutrients in blood, and because brain cells that are killed do not grow back, it’s crucial that treatment is initiated as early as possible, to save as much brain as possible. However, the doctors do need to invest some time in tests to make sure that you get the right treatment, because the wrong treatment will cause even more damage.

Some of the treatments that are used for strokes include:

• Medications that dissolve blood clots
• Direct removal of a blood clot
• Surgical repair of a ruptured artery, and/or surgery to drain out blood that has built up inside the head
• Medications to control blood pressure and swelling of the brain
• Other medications, such as for blood sugar control and seizure prevention

Which of these treatments you receive will depend on what type of stroke you had. In general, there are two types of strokes. Ischemic (iss-KEE-mic) strokes are caused by a blood clot that blocks an artery. Hemorrhagic (hem-oh-RAH-jick) strokes are caused by a blood vessel that bursts open.

For an ischemic stroke, treatment is focused on removing the clot that’s causing the problem. This may be done in one of two main ways. One way is to give a medication that dissolves clots in the body generally. A common one is known as TPA, and it is given intravenously (through a needle in your arm). This is a very powerful clot-dissolving medicine. It must be given within a few hours after symptoms begin to be effective.

In some cases, TPA can be put directly on the clot itself, through a long flexible tube inserted through a small incision near the groin, and then passed into the affected arteries. Aspirin may also be given; this medication prevents blood clots from forming.

In some cases, the clot can be directly removed from the body through a catheter. This is useful for people who can’t receive TPA; for instance, they may have a wound elsewhere in the body that could begin bleeding. This is done in the same way that TPA is put directly onto a clot.

For a hemorrhagic stroke, treatment is focused on stopping the bleeding and preventing the build-up of too much blood in the brain. You may be given medications that counteract any blood thinners you take, so your body can form a clot and stop the bleeding. You may also be given medications that lower your blood pressure and lower the pressure in your brain.

Sometimes, too much blood builds up in the head. The excessive pressure of the blood pressing on the brain can be life-threatening and can cause further brain damage. Surgery may be needed to get this extra blood out of your head.

Surgery may also be used to repair the blood vessel. A surgeon may place a clamp at the base of an aneurysm, which is a weakened bulge in the wall of an artery. Sometimes, abnormal blood vessels may be removed from the brain. A long flexible tube may also be used to place small coils into the aneurysm, which causes clots to form there so that the bleeding will stop.

In some cases, you may need to receive rehabilitation after your stroke. This may take place within a rehabilitation unit, a nursing home, or you may be discharged to your home. Several different professionals will be involved in helping you learn to function as well as possible after your stroke. This process may take months or even years, and many people never recover completely. However, the brain is very adaptable, and can often learn new ways of functioning to make up for the lost brain cells.

References

Centers for Disease Control and Prevention (CDC). “Stroke: Stroke Treatments.” CDC website (2014). http://www.cdc.gov/stroke/treatments.htm

National Institute of Neurological Disorders and Stroke (NINDS). “NINDS Stroke Information Page.” NINDS website (2015). http://www.ninds.nih.gov/disorders/stroke/stroke.htm

Mayo Clinic Staff. “Stroke: Treatment.” Mayo Clinic website (2015). http://www.mayoclinic.org/diseases-conditions/stroke/diagnosis-treatment/treatment/txc-20117296

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