How are strokes treated?
Treating a stroke depends on many different factors. The most important factor in determining treatment is what kind of stroke a person has.
- Ischemic: With ischemic strokes, the top priority is restoring circulation to affected brain areas. If this happens fast enough, it’s sometimes possible to prevent permanent damage or at least limit a stroke’s severity. Restoring circulation usually involves a certain medication type called thrombolytics, but may also involve a catheterization procedure.
- Hemorrhagic: With hemorrhagic strokes, treatment depends on the location and severity of the bleeding. Reducing blood pressure is often the top priority because this will reduce the amount of bleeding and keep it from getting worse. Another treatment option is to improve clotting so the bleeding will stop. Surgery is sometimes necessary to relieve pressure on your brain from accumulated blood.
What medications or treatments are used?
The medications and treatments used vary depending on the type of stroke and how soon a person receives treatment after the stroke. There are also long-term treatments for stroke. These happen in the days and months after emergency treatment deals with a stroke’s immediate threat.
Overall, your healthcare provider is the best person to tell you what kind of treatment(s) they recommend. They can tailor the information they provide to your specific case, including your medical history, personal circ*mstances and more.
Some examples of treatments for stroke are as follows:
| Ischemic stroke | Hemorrhagic stroke |
|---|---|
| Thrombolytic drugs (within three to four and a half hours). | Blood pressure management. |
| Thrombectomy (within 24 hours if there’s no significant brain damage). | Reversal of any medication that might increase bleeding. |
| Blood pressure management. | Use of medications or surgery to reduce pressure inside your skull. |
| Ischemic stroke | |
| Thrombolytic drugs (within three to four and a half hours). | |
| Hemorrhagic stroke | |
| Blood pressure management. | |
| Thrombectomy (within 24 hours if there’s no significant brain damage). | |
| Hemorrhagic stroke | |
| Reversal of any medication that might increase bleeding. | |
| Blood pressure management. | |
| Hemorrhagic stroke | |
| Use of medications or surgery to reduce pressure inside your skull. |
Thrombolytic drugs
Thrombolytic drugs (their name is a combination of the Greek words “thrombus,” which means “clot,” and “lysis,” which means “loosening/dissolving”) are an option within the first three hours after stroke symptoms start. These medications dissolve existing clots. But they’re only an option within that three- to four-and-a-half hour time frame because after that, they increase the risk of dangerous bleeding complications.
Mechanical thrombectomy
In some cases, especially ones where thrombolytic drugs aren’t an option, a catheterization procedure known as mechanical thrombectomy is an option. Thrombectomy procedures are also time-sensitive, and the best window for these procedures is within 24 hours after symptoms start. This procedure involves inserting a catheter (tube-like) device into a major blood vessel and steering it up to the clot in your brain. Once there, the catheter has a tool at its tip that can remove the clot.
Blood pressure management
Because high blood pressure is usually why hemorrhagic strokes happen, lowering blood pressure is a key part of treating them. Lowering blood pressure limits bleeding and makes it easier for clotting to seal the damaged blood vessel.
Clotting support
Your body’s clotting ability relies on a process called hemostasis to stop bleeding and repair injuries. Supporting hemostasis involves infusion of medications or blood factors that make it easier for clotting to happen. Examples include vitamin K therapy, prothrombin or clotting factor infusions, and more. This treatment is most common with hemorrhagic strokes, and can help control bleeding (especially for people who take blood-thinning medications).
Surgery
In some cases, surgery is necessary to relieve the pressure on your brain. This is especially true with subarachnoid hemorrhages, which are easier to reach because they’re on the outer surface of your brain.
Supportive treatments and other methods
There are several other ways that stroke treatment can happen. Some of these treatments are supportive directly, while others help avoid complications. Your healthcare provider can tell you more about these other treatments and which ones they recommend and why.
Stroke rehabilitation
One of the most important ways to treat stroke is to help a person recover or adapt to the changes in their brain. That’s especially true when it comes to helping them regain abilities they had before the stroke. Stroke rehabilitation is a major part of recovery for most people who have a stroke. That rehabilitation can take many forms, including:
- Speech therapy: This can help you regain language and speaking abilities and improve your ability to control muscles that help you breathe, eat, drink and swallow.
- Physical therapy: This can help you improve or regain the ability to use your hands, arms, feet and legs. This can also help with balance issues, muscle weakness and more.
- Occupational therapy: This can help retrain your brain so you can go about your activities of daily life. This therapy is especially helpful with improving precise hand movements and muscle control.
- Cognitive therapy: This can be helpful if you’re having memory problems. It can also help if you have difficulty with activities that require focus or concentration that you could do before.
Other therapies are possible, depending on your case and circ*mstances. Your healthcare provider is the best person to tell you what kind of treatments can benefit you.
Complications/side effects of the treatment
The side effects of stroke treatments depend greatly on the type of stroke, the treatments used, your medical history and more. Your healthcare provider can tell you more about the side effects you can or should expect and what you can do to manage or even prevent them.
How can I take care of myself or manage the symptoms?
A stroke is a life-threatening medical emergency, and you shouldn't try to self-diagnose or self-treat it. If you have — or someone with you has — stroke symptoms, you should immediately call 911 (or your local emergency services number). The longer it takes for stroke treatment to begin, the greater the risk of permanent brain damage or death.
How soon after treatment will I feel better?
The recovery time and how long it takes to feel better after treatment both depend on many factors. Your healthcare provider is the best person to tell you what you can expect and the likely timeline for your recovery.
