Stroke Treatments

Updated:May 29,2013

A stroke occurs when a vessel in the brain ruptures or is blocked by a blood clot. Stroke medical treatments work to either open the blockage or treat the rupture. Medical advances have greatly improved survival rates from stroke treatments during the last decade. But the chances of survival are even better if the stroke is identified and treated immediately. This section will outline some possible ways to prevent and treat a stroke.

Stroke Prevention
When a Stroke Occurs: Quick Stroke Treatment Can Save Lives
Ischemic Stroke Treatment
Hemorrhagic Stroke Treatment

Female family members cooking togetherStroke Prevention
The good news is that 80 percent of all strokes are preventable. It starts with managing key risk factors, including high blood pressure, cigarette smoking, atrial fibrillation and physical inactivity. More than half of all strokes are caused by uncontrolled hypertension or high blood pressure, making it the most important risk factor to control.

Medical treatments may be used to control high blood pressure and/or manage atrial fibrillation among high-risk patients. Those medicines include:
  • Anticoagulants/Antiplatelets
    Antiplatelet agents such as aspirin and anticoagulants, such as warfarin, interfere with the blood's ability to clot and can play an important role in preventing stroke. Read more about anticoagulants.  
     
  • Antihypertensives
    Antihypertensives are medications that treat high blood pressure. Depending on the type of medication, they can lower blood pressure by opening the blood vessels, decreasing blood volume or decreasing the rate and/or force of heart contraction. Learn about the types of antihypertensives.

Additionally, when arteries show plaque buildup or blockage, medical procedures may be needed. Such as:

  • carotid artery surgeryCarotid Endarterectomy
    Carotid endarterectomy, also called carotid artery surgery, is a procedure in which blood vessel blockage (fatty plaque) is surgically removed from the carotid artery.
    View a detailed illustration of carotid endarterectomy.
     
  • Angioplasty/Stents
    Doctors sometimes use balloon angioplasty and implantable steel screens called stents to treat cardiovascular disease and help open up the blocked blood vessel.

     

When a Stroke Occurs: Quick Stroke Treatment Can Save Lives
If you’re having a stroke, it’s critical that you get medical attention right away. Immediate treatment may minimize the long-term effects of a stroke and prevent death.

There are two types of strokes: hemorrhagic or ischemic. An ischemic stroke occurs as a result of an obstruction within a blood vessel supplying blood to the brain. It accounts for 87 percent of all stroke cases. A hemorrhagic stroke occurs when a weakened blood vessel ruptures and spills blood into brain tissue. The most common cause for the rupture is uncontrolled hypertension (high blood pressure). There are two other types of weakened blood vessels that also cause hemorrhagic stroke: aneurysms and arteriovenous malformations (AVMs). Treatment differs depending on the type of stroke.

Ischemic Stroke Treatment

tPA, the Gold Standard
The only FDA approved treatment for ischemic strokes is tissue plasminogen activator (tPA, also known as IV rtPA, given through an IV in the arm). tPA works by dissolving the clot and improving blood flow to the part of the brain being deprived of blood flow. If administered within 3 hours(and up to 4.5 hours in certain eligible patients), tPA may improve the chances of recovering from a stroke. A significant number of 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.

Endovascular Device Removing Clot
Endovascular device removing the clot*

Endovascular Procedures
Another treatment option is an endovascular procedure* in which specially trained doctors try removing the blood clot by sending a catheter to the site of the blocked blood vessel in the brain. Sometimes these procedures involve tPA being administered directly into the blood clot (called intra-arterial treatment) to help dissolve the blockage. In other procedures, the doctor may attempt to remove the clot. Researchers are still conducting research to determine the best clinical protocols for endovascular procedures. 
*Note: Patients must meet certain criteria to be eligible for this procedure.

Image courtesy of Covidien.

Hemorrhagic Stroke Treatment

Endovascular Procedures
Endovascular procedures may be used to treat certain hemorrhagic strokes similar to the way the procedure is used for treating an ischemic stroke. These procedures are less invasive than surgical treatments, and involve the use of a catheter introduced through a major artery in the leg or arm, then guided to the aneurysm or AVM; it then deposits a mechanical agent, such as a coil, to prevent rupture.

Surgical Treatment
For strokes caused by a bleed within the brain (hemorrhagic stroke), or by an abnormal tangle of blood vessels (AVM), surgical treatment may be done to stop the bleeding. If the bleed is caused by a ruptured aneurysm (swelling of the vessel that breaks), a metal clip may be placed surgically at the base of the aneurysm to secure it.

Related Links:

Clinical Trials
Medical treatments continue to evolve and improve, thanks in part to clinical trials (research). These are scientific studies that determine if a possible new medical advance can help people and whether it has harmful side effects. Find answers to common questions about clinical trials in our Guide to Understanding Clinical Trials.


This content was last reviewed on 05/23/13.