Treatments

Brain cells usually die within minutes to a few hours after the stroke starts. Other brain cells in the area of the stroke may also be affected, but have a chance of being saved. The ability for these surrounding brain cells to recover will depend on the type of treatment received and how soon it is obtained. Physicians now believe that early stroke treatment is most effective when the person is able to get to a hospital in less than 4 hours of the onset of symptoms.

Medications

• Thrombolytics. (Clot-busting or clot-dissolving drugs).  These help to restore blood flow to the brain and prevent or lessen the damage by dissolving the clots. For maximum benefit, it must be given within a certain timeframe after the stroke symptoms start (generally about 3 hours). TPA or tissue plasminogen activator is one example of this type of medication. It has been shown to be effective in improving recovery after stroke. Patients must meet certain criteria to be eligible for TPA.
• Antiplatelets (such as aspirin). These help to prevent blood clotting by preventing platelet function. Platelets are the part of the blood that have the capability of sticking to each other or to parts of the vessel wall, causing clots to form. There are several antiplatelet medications available. Some may have minor side effects.  These should not be used without your doctor’s recommendation.
• Anticoagulants (such as Herparin and Warfarin). These work to delay blood clotting. They do this by interfering with the production of certain blood components that are necessary for the formation of blood clots. They tend to work by slowing down the blood clots from getting larger. This helps to prevent the current stroke from getting worse. It also helps to prevent new strokes from occurring.
• Antihypertensives (high blood pressure medication):

When used for stroke prevention:  Studies have shown that lowering blood pressure to normal ranges can greatly decrease the risk of stroke. There are several antihypertensive medications available. Each work in different ways and have various side effects.
When used for acute stroke treatment: Adequate blood flow to the injured brain during a stroke is very important. So it is often necessary to allow blood pressure to run higher than normal during the first days after stroke. This is done so that oxygen and nutrients can reach the affected areas of the brain.
Experimental/research medication.  Several different types of medications are being tested for their effectiveness in stroke prevention and treatment. Certain criteria must be met before patients may be considered for any of the research studies in progress.

Other treatments for stroke:
Maintenance of blood chemistry.  Further injury to brain tissue after stroke can be limited by control of blood chemicals such as magnesium, calcium, glucose, and sodium. Monitoring of blood chemistry may be ongoing until the physician recommends otherwise.
Supportive measures.  More patients die from complications of stroke than from the stroke itself. High quality patient care with careful attention to known stroke complications (such as respiratory difficulties, lung infections, or blood clots in the legs) and early rehabilitation efforts have been shown to improve recovery and increase survival.
Surgical intervention.  The carotid arteries, located on each side of the neck, are the main arteries that supply the brain with blood. Over time a build-up of fatty deposits may occur in these arteries and cause a narrowing or blockage. If the blockage is severe enough, it may cause a stroke by preventing the passage of blood up into the brain. An operation called a carotid endarterectomy may be recommended to remove the blockage and reduce the risk of having a stroke or stroke symptoms. 

Other types of treatment involve removing blood clots or arteriovenous malformations. Clipping or coiling aneurysms to prevent further bleeding, and placing stents inside narrowed blood vessels may also be suggested or recommended.