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Stroke Treatments

EMT technicians and a physician outside of an ambulance.

If someone you know shows signs of stroke, call 9-1-1 right away.

If you have a stroke, you may receive emergency care, treatment to prevent another stroke, rehabilitation to treat the side effects of stroke, or all three.

Emergency Treatment

Your emergency treatment starts in the ambulance. The emergency workers may take you to a specialized stroke center to ensure that you receive the quickest possible diagnosis and treatment.

At the hospital, health care providers will ask about your medical history and about the time your symptoms started. Brain scans will show what type of stroke you had. You may also work with a neurologist who treats brain disorders, a neurosurgeon that performs surgery on the brain, or a specialist in another area of medicine.

If you get to the hospital within 3 hours of the first symptoms of an ischemic stroke, a health care provider may give you a type of medicine called a thrombolytic (a "clot-busting" drug) to break up blood clots. Tissue plasminogen activator (tPA) is a thrombolytic.

tPA improves the chances of recovering from a stroke. Studies have shown that patients with ischemic strokes who received tPA are more likely to recover fully or have less disability than patients who do not receive the drug.1,2 In addition, patients treated with tPA are less likely to need long-term care in a nursing home.3 Unfortunately, many stroke victims don’t get to the hospital in time for tPA treatment. This is why it’s so important to identify a stroke immediately.

Medicine, surgery, or other procedures may be needed to stop the bleeding and save brain tissue. For example:

  • Endovascular procedures. Endovascular procedures may be used to treat certain hemorrhagic strokes. These procedures are less invasive and less dangerous for the patient than surgical treatments. The doctor inserts a long tube through a major artery in the leg or arm and then guides the tube to the site of the weak spot or break in a blood vessel. The tube is then used to install a device, such as a coil, to repair the damage or prevent bleeding.4
  • Surgical treatment. Hemorrhagic strokes may be treated with surgery. If the bleeding is caused by a ruptured aneurysm, a metal clip may be put in place to stop the blood loss.4

Preventing Another Stroke

If you have had a , you are at high risk for another stroke:

  • 1 of 4 stroke survivors has another stroke within 5 years.5
  • The risk of stroke within 90 days of a TIA may be as high as 17%, with the greatest risk during the first week.6

That's why it's important to treat the underlying causes of stroke, including heart disease, high blood pressure, atrial fibrillation (fast, irregular heartbeat), high cholesterol, and diabetes. Your doctor may give you medications or tell you to change your diet, exercise, or adopt other healthy lifestyle habits. Surgery may also be helpful in some cases.

Stroke Rehabilitation

After a stroke, you may need rehabilitation (rehab) to help you recover. Rehab can include working with speech, physical, and occupational therapists:

  • Speech therapy helps people who have problems producing or understanding speech.
  • Physical therapy uses exercises to help you relearn movement and coordination skills you may have lost because of the stroke.
  • Occupational therapy focuses on improving daily activities, such as eating, drinking, dressing, bathing, reading, and writing.

Therapy and medications may help with depression or other mental health conditions following a stroke. Joining a patient support group may help you adjust to life after a stroke. Talk with your health care team about local support groups, or check with an area medical center.

Support from family and friends can also help relieve fear and anxiety following a stroke. Let your loved ones know how you feel and what they can do to help you.

Learn more about recovering from stroke.

References

  1. National Institute of Neurological Disorders and Stroke rt-PAStroke Study Group. Tissue plasminogen activator for acute ischemic stroke. N Engl J Med. 1995;333:1581–7.
  2. Marler JR, Tilley BC, Lu M, Brott TG, Lyden PC, Grotta JC, et al. Early stroke treatment associated with better stroke outcome: the NINDS rt-PA stroke study. Neurology. 2000;55:1649–55.
  3. National Institute of Neurological Disorders and Stroke. Stroke: Challenges, Progress, and Promise. Bethesda, MD: National Institutes of Health; 2009.
  4. American Heart Association/American Stroke Association. Stroke Treatments. 2013.
  5. Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Borden WB, et al. Heart disease and stroke statistics—2013 update: a report from the American Heart Association. Circulation. 2012:e2–241.
  6. Lambert M. Practice Guidelines: AHA/ASA guidelines on prevention of recurrent stroke. Am Fam Physician. 2011;83(8):993–1001.
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