Stroke Treatment


Stroke used to rank fourth in leading causes of U.S. death. Now it's fifth.

The higher survival rates are largely due to medical treatment advances. The right care — right away — can save both lives and quality of life.

The type of treatment depends on the type of stroke.

Ischemic stroke

happens when a clot blocks a vessel supplying blood to the brain. It's the most common type, accounting for 87% of all strokes. The treatment goal is to bust or remove the clot.

Hemorrhagic stroke

is caused by a rupture in a blood vessel within the brain. Fewer strokes happen as the result of a rupture. The treatment goal is to stop the bleeding.

Medication Treatment with Alteplase IV r-tPA

  • Considered the gold standard, tissue plasminogen activator (or Alteplase IV r-tPA) is an FDA-approved treatment for ischemic strokes.
  • When promptly administered, it can save lives and reduce the long-term effects of stroke.
  • Alteplase IV r-tPA is given through an IV in the arm, also known tPA, and works by dissolving the clot and improving blood flow to the part of the brain being deprived of blood flow.
  • Alteplase IV r-tPA needs to be used within three hours of having a stroke or up to 4.5 hours in certain eligible patients.
  • Many people miss this key brain-saving treatment because they don't arrive at the hospital in time for alteplase treatment, which is why it's so important to identify a stroke and seek treatment immediately for the best possible chance at a full recovery.

Mechanical Treatment to Physically Remove the Clot

Mechanical Treatment to Physically Remove the Clot
  • Physical removal of a large blood clot, called an endovascular procedure or a mechanical thrombectomy, is another strongly recommended treatment option.
  • Thrombectomy allows trained doctors to use a wire-cage device called a stent retriever to remove a large blood clot.
  • To remove the clot, doctors thread a catheter through an artery in the groin up to the blocked artery in the brain. The stent opens and grabs the clot, allowing doctors to then remove the stent with the trapped clot.
  • Special suction tubes may also be used to remove the clot.
  • The procedure should be done within six hours of onset of acute stroke symptoms. For selected patients under certain conditions, the procedure can be beneficial if done even within 24 hours of onset. Patients who are eligible for IV alteplase should receive the drug, even if the clot removal procedure is considered.
  • Patients must meet certain criteria to be eligible for this procedure.
When a weakened blood vessel ruptures and spills blood into brain tissue, it’s called a hemorrhagic stroke. The most common cause for the rupture is uncontrolled hypertension (high blood pressure). There are two other types of weakened blood vessels that can also cause hemorrhagic stroke: aneurysms (swellings within vessels) and arteriovenous malformations or AVMs (abnormal tangles of blood vessels).

Mechanical Treatment

  • A small tube called a catheter can sometimes be threaded up through a major artery in an arm or leg and guided into the brain tissue, allowing the surgeon to use camera technology to help fix the problem.
  • Once the catheter is guided to the source of the bleeding, it deposits a mechanical agent, such as a coil, to prevent further rupture.
  • This type of procedure is endovascular, meaning that the surgeon gains access via the vascular system, making it less invasive than conventional surgical treatment.
  • Sometimes surgery is required to secure a blood vessel at the base of the aneurysm.

Treatment to Maximize Recovery

  • Your medical professional can tell you which treatment options you are eligible for and address any concerns you may have.
  • Steps taken after your stroke are important in helping you achieve the best possible recovery and independence.
  • A number of types of therapy may be prove helpful in post-stroke recovery.
  • Some people are left with disabilities that may linger permanently.
  • Learn more about effects of stroke that may be treatable during recovery.
  • Visit our Life After Stroke section for support and to learn more.

Treatment to Lower Risks of Having Another Stroke

Updated Guidelines for Treating Acute Ischemic Strokes

The guidelines have changed. Learn about the update and use our Acute Ischemic Stroke Toolkit to put them to work.

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Stroke Resources for Your Patients

Discover stroke prevention, treatment and recovery resources for your patients and community.

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Recent Stroke? You Don't Have to Do It Alone.

Many people do recover from stroke. Learn from those who met their recovery goals and find post- stroke resources.

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