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.
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.
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 the only 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
- 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 acute stroke symptoms and only after a patient receives alteplase.
- Patients must meet certain criteria to be eligible for this procedure.
- 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
- The good news is that 80% of strokes in adults are preventable, however after having a stroke, risks are much higher for having another one. Preventing a second stroke can be the most important treatment of all.
- Adopting healthy lifestyle habits and managing key risk factors, including high blood pressure, cigarette smoking and atrial fibrillation can make all the difference.
- More than half of all strokes are caused by uncontrolled hypertension or high blood pressure, making it the most significant risk factor to control.
- Medical treatments may include:
- - Medications to control high blood pressure.
- - Medications to manage atrial fibrillation among high-risk patients.
- - Medications to lower the chances of forming a clot (Antiplatelet agents or anticoagulants, such as warfarin, interfere with the blood's ability to clot and can play an important role in preventing stroke).
- - Procedures to remove plaque buildup or open blockages.