Cerebrovascular disease; CVA; Cerebral infarction; Cerebral hemorrhage; Ischemic stroke; Stroke - ischemic; Cerebrovascular accident; Stroke - hemorrhagic

A stroke is a medical emergency. Immediate treatment can save lives and reduce disability. Call 911 or your local emergency number or seek immediate medical care at the first signs of a stroke.

It is very important for people who are having stroke symptoms to get to a hospital as quickly as possible. If the stroke is caused by a blood clot, a clot-busting drug may be given to dissolve the clot.

Most of the time, patients must reach a hospital within 3 hours after symptoms begin. Some people may be able to receive these drugs for up to 4 - 5 hours after symptoms begin.

Treatment depends on the severity and cause of the stroke. A hospital stay is required for most strokes.

TREATMENT IN THE HOSPITAL

Clot-busting drugs (thrombolytic therapy) may be used if the stroke is caused by a blood clot. Such medicine breaks up blood clots and helps restore blood flow to the damaged area. However, not everyone can receive this type of medicine.

• For these drugs to work, a person must be seen and treatment must begin within 3 hours of when the symptoms first started. A CT scan must be done to see whether the stroke is from a clot or from bleeding.
• If the stroke is caused by bleeding rather than clotting, clot-busting drugs (thrombolytics) can cause more bleeding.

Other treatments depend on the cause of the stroke:

• Blood thinners such as heparin or warfarin (Coumadin) may be used to treat strokes due to blood clots. Aspirin or clopidogrel (Plavix) may also be used.
• Other medications may be needed to control other symptoms, including high blood pressure. Painkillers may be given to control severe headache.
• In some situations, a special stroke team and skilled radiologists may be able to use angiography to highlight the clogged blood vessel and open it up.
• For hemorrhagic stroke, surgery is often required to remove blood from around the brain and to repair damaged blood vessels.
• Surgery on the carotid artery may be needed.

Images

Right cerebral hemisphere - function

Brainstem function

Circle of Willis

Endarterectomy

Carotid stenosis, X-ray of the left artery

Plaque buildup in arteries

Carotid stenosis, X-ray of the right artery

Brain

Stroke

Left cerebral hemisphere - function

Stroke

Stroke - secondary to cardiogenic embolism

Hypertension - overview

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Review Date: 06/15/2010
Reviewed By: Daniel B. Hoch, PhD, MD, Assistant Professor of Neurology, Harvard Medical School, Department of Neurology, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)