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Emergency treatments for stroke

Time is brain! The potential to save brain cells depends on how soon treatment is received.

Ischemic stroke treatments 

Medications

If a stroke is identified immediately, tissue plasminogen activator (tPA), a clot-busting drug, can be administered. This dissolves the blood clot, restores blood flow and can reduce the risk of permanent damage. It must be given within four and a half hours of when the symptoms began. The sooner it is given, the better the outcome. 

Surgical treatments 

Severe strokes may require more invasive treatments. A skilled interventional neuroradiologist can use advanced imaging technology to determine the exact location of the blockage. A surgeon can then can attempt to remove the clot from the blood vessel.

What to expect

To determine what treatment is best, you will have a cerebral angiogram. A catheter (small tube) is threaded from a main artery in the groin up through the body to the vessels in the brain. A dye is injected so the physician can see the clot and determine the best treatment to remove it.

  • Medication: Clot-busting medication can be injected in an attempt to dissolve it.
  • Balloon angioplasty: A small balloon temporarily inflated inside the vessel will expand the narrowed area and restore normal blood flow through the vessel. 
  • Stent placement: Using the same expanding technique as the balloon angioplasty, a stent (wire mesh tube) can be placed within the blood vessel at the area of narrowing. The stent remains in the vessel permanently, holding it open and improving blood flow in the brain. 
  • Clot retrieval device: This procedure may use suction, corkscrew and/or ultrasound technology to remove blockages from the brain.

Hemorrhagic stroke treatments 

Intercerebral hemorrhage

Treatment is focused on reducing bleeding and lowering the blood pressure. Surgically removing the blood and damaged tissue from the brain may be necessary in some cases. 

Subarachnoid hemorrhage

Treatment is focused on sealing the aneurysm — often through surgery —  to prevent further bleeding, lowering the blood pressure and preventing other complications.