Treatment

The most effective treatment for stroke must be given immediately - within three hours after symptoms begin. For this reason, the medical community has been devoting significant resources to educating the public about stroke symptoms and the need for immediate emergency care. A clot-dissolving medication called tissue plasminogen activator (t-PA) can restore blood flow and oxygen to brain tissue affected by a stroke. Patients who receive this medication have less long-term disability following a stroke. In treating thrombotic stroke, clot-prevention medications, such as heparin, are used in later hours after a stroke, to prevent existing blood clots from getting bigger and to prevent new clots from forming. After a stroke has stabilized, aspirin or another mild blood-thinning agent (such as ticlopidine or clopidogrel) is usually prescribed daily to prevent another stroke.

However, t-PA is not helpful to treat hemorrhagic stroke. Sometimes, the hemorrhaged blood may have to be removed through surgery to relieve pressure on the brain. Occasionally, testing reveals an abnormality of a blood vessel (such as a ballooning blood vessel wall, known as an aneurysm). If a blood vessel abnormality is identified, it may require treatment with surgery in order to prevent another stroke.

A person who has experienced a significant stroke of any type usually is hospitalized so he or she can be observed in case symptoms worsen. A severe stroke can affect breathing, and some patients may need a mechanical ventilator. Stroke patients also may need help with self-care or feeding. Early intervention by an occupational therapist and physical therapist is helpful. These therapists are professionals who can assist a patient to work around a new disability and to regain strength after brain injury. Commonly, hospitalization is followed by a period of residence at a rehabilitation center, where additional therapy may be provided intensively. The goal of rehabilitation is to maximize recovery.