Key points
- If someone you know shows signs of stroke, call 9-1-1 right away.
- If you have had a stroke, you are at high risk for another stroke.
Overview
If someone you know shows signs of stroke, call 9-1-1 right away.
Your stroke treatment begins the moment emergency medical services (EMS) arrive to take you to the hospital.
Once at the hospital, you may receive emergency care, treatment to prevent another stroke, rehabilitation to treat the side effects of stroke, and/or all three.
Stroke
A stroke, sometimes called a brain attack, occurs when something blocks blood supply to part of the brain or when a blood vessel in the brain bursts.
In either case, parts of the brain become damaged or die. A stroke can cause lasting brain damage, long-term disability, or even death.
How is stroke treated?
On the way to the hospital
Calling 9-1-1 for an ambulance means that medical staff can begin life-saving treatment on the way to the emergency room.
Do not drive to the hospital or let someone else drive you. The key to stroke treatment and recovery is getting to the hospital quickly.
Stroke patients who are taken to the hospital in an ambulance may get diagnosed and treated more quickly than people who do not arrive in an ambulance.1 This is because emergency treatment starts on the way to the hospital. The emergency workers may take you to a specialized stroke center to ensure that you receive the quickest possible diagnosis and treatment.
The emergency workers will also collect valuable information that guides treatment and alert hospital medical staff before you arrive at the emergency room, giving them time to prepare.
Learn more about the important role EMS plays in improving stroke care.
At the hospital
At the hospital, health professionals will ask about your medical history and the time your symptoms started.
Brain scans will show what type of stroke you had. You may also be seen by a neurologist who treats brain disorders, a neurosurgeon who performs surgery on the brain, or a specialist in another area of medicine.
Treating ischemic stroke
If you get to the hospital within 3 hours of the first symptoms of an ischemic stroke, you may get 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 show that patients with ischemic strokes who receive tPA are more likely to recover fully or have less disability than patients who do not receive the drug.23 Patients treated with tPA are also less likely to need long-term care in a nursing home.4
Recognizing the signs and symptoms and seeking immediate medical attention (by calling 9-1-1) is essential to prevent stroke related disability or death.
Doctors may also treat ischemic stroke with other medicines, such as blood thinners, as well as surgery to remove the clot.
Ischemic Stroke
Most strokes are ischemic strokes. 5An ischemic stroke occurs when blood clots or other particles block the blood vessels to the brain.
Fatty deposits called plaque can also build up in the blood vessels causing blockages.
Treating hemorrhagic stroke
Other medicines, surgery, or procedures may be needed to stop the bleeding from hemorrhagic stroke and save brain tissue. For example:
- Endovascular procedures. Endovascular procedures, which can help repair a weak spot or break in a blood vessel, may be used to treat certain hemorrhagic strokes. Learn more about the procedure.
- 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.
Hemorrhagic Stroke
A hemorrhagic stroke happens when an artery in the brain leaks blood or ruptures (breaks open). The leaked blood puts too much pressure on brain cells, which damages them.
High blood pressure and aneurysms—balloon-like bulges in an artery that can stretch and burst—are examples of conditions that can cause a hemorrhagic stroke.
What happens after stroke treatment?
If you have had a stroke, you are at high risk for another stroke.
- 1 in 4 stroke survivors has another stroke within 5 years.5
- The risk of stroke within 90 days of a transient ischemic attack (TIA) may be as high as 17%, with the greatest risk during the first week.6
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. That's why it's important to treat the underlying causes of stroke.
Prevention
If you have had a stroke, you are at high risk for another stroke. That's why it's important to treat the causes of stroke, including
- Heart disease.
- High blood pressure.
- Atrial fibrillation (fast, irregular heartbeat).
- High cholesterol.
- Diabetes.
You and your health care team can work together to prevent or treat the medical conditions that lead to stroke. Discuss your treatment plan regularly and bring a list of questions to your appointments. Your treatment plan will include medicine or surgery and lifestyle changes to lower your risk for another stroke. Be sure to take your medicine as directed and follow your doctor's instructions.
Learn how to find the right doctor for you from the "Live to the Beat" campaign.
Recovery
Recovering from stroke: stroke rehabilitation
Rehabilitation after a stroke begins in the hospital, often within a day or 2 after the stroke. Rehab helps ease the transition from hospital to home and can help prevent another stroke.
Recovery time after a stroke is different for everyone—it can take weeks, months, or even years. Some people recover fully, but others have long-term or lifelong disabilities.
What to expect after a stroke
If you have had a stroke, you can make great progress in regaining your independence. However, some problems may continue:
- Paralysis (inability to move some parts of the body), weakness, or both on one side of the body.
- Trouble with thinking, awareness, attention, learning, judgment, and memory.
- Problems understanding or forming speech.
- Trouble controlling or expressing emotions.
- Numbness or strange sensations.
- Pain in the hands and feet that worsens with movement and temperature changes.
- Trouble with chewing and swallowing.
- Problems with bladder and bowel control.
- Depression.
You and your health care team can discuss what to expect after a stroke. Your health care team will work with you to prevent further strokes.
What is stroke rehabilitation?
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 medicine 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.
Resources
CDC
Other organizations
- National Institute of Neurological Disorders and Stroke: Stroke Information Page
- National Institutes of Health: Know Stroke Campaign
- National Institutes of Health: Mind Your Risks®
- MedlinePlus: Stroke
- Ekundayo OJ, Saver JL, Fonarow GC, et al. Patterns of emergency medical services use and its association with timely stroke treatment: findings from Get With the Guidelines–Stroke. Circ Cardiovasc Qual Outcomes. 2013;6:262–269.
- National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. Tissue plasminogen activator for acute ischemic stroke. N Engl J Med. 1995;333(24):1581–1587.
- Marler JR, Tilley BC, Lu M, et al. Early stroke treatment associated with better stroke outcome: the NINDS rt-PA stroke study. Neurology. 2000;55(11):1649–1655.
- National Institute of Neurological Disorders and Stroke. Stroke: Challenges, Progress, and Promise. National Institutes of Health; 2009. https://www.govinfo.gov/content/pkg/GOVPUB-HE20-PURL-gpo18272/pdf/GOVPUB-HE20-PURL-gpo18272.pdf
- Tsao CW, Aday AW, Almarzooq ZI, et al. Heart disease and stroke statistics—2023 update: a report from the American Heart Association. Circulation. 2023;147:e93–e621.
- Lambert M. Practice guidelines: AHA/ASA guidelines on prevention of recurrent stroke. Am Fam Physician. 2011;83(8):993–1001.