Stroke Health Center

Initial treatment for a stroke happens in the hospital. The sooner you get treatment, the better. The worst damage from a stroke often occurs within the first few hours. The faster you receive treatment, the less damage will occur.

In the hospital

Your treatment will depend on whether the stroke is caused by a blood clot (ischemic) or by bleeding in the brain (hemorrhagic). Treatment focuses on restoring blood flow for an ischemic stroke or controlling bleeding for a hemorrhagic stroke.

Before starting treatment, your doctor will use a computed tomography (CT) scan or magnetic resonance imaging (MRI) of your head to diagnose the type of stroke you've had. For more information about these and other tests, see Exams and Tests.

Ischemic stroke

Emergency treatment for an ischemic stroke depends on the location and cause of the clot. Measures will be taken to stabilize your vital signs, including giving you medicines.

• If your stroke is diagnosed soon enough after the start of symptoms, you may be given a clot-dissolving medicine called tissue plasminogen activator (t-PA), which can increase your chances of survival and recovery.
• You may also receive aspirin or another antiplatelet medicine.

Hemorrhagic stroke

Treatment for hemorrhagic stroke includes efforts to control bleeding, reduce pressure in the brain, and stabilize vital signs, especially blood pressure.

• You will be closely monitored for signs of increased pressure on the brain, such as restlessness, confusion, difficulty following commands, and headache. Other measures will be taken to keep you from straining from excessive coughing, vomiting, or lifting, or straining to pass stool or change position.
• If the bleeding is due to a ruptured brain aneurysm, surgery to repair the aneurysm may be done. Repair may include:
  • Using a metal clip to clamp off the aneurysm to prevent renewed bleeding.
  • Inserting a small coil into the aneurysm to block it off (endovascular coil embolization).
• In some cases, medicines may be given to control blood pressure, brain swelling, blood sugar levels, fever, and seizures.
• If a large amount of bleeding has occurred and the person is rapidly getting worse, surgery may be needed to remove the blood that has built up inside the brain and to lower pressure inside the head.

Preventing another stroke

After emergency treatment for stroke, and when your condition has stabilized, treatment focuses on preventing another stroke. It will be important to control your risk factors for stroke, such as high blood pressure, atrial fibrillation, high cholesterol, and diabetes. Your doctor will probably want you to take one or more medicines to prevent another stroke. For more information on the medicines you may have to take after a stroke, see Medications.

Changes in lifestyle will also be an important part of your treatment to reduce your risk of having another stroke:

• Do not smoke or allow others to smoke around you.
• Limit alcohol to 2 drinks a day for men and 1 drink a day for women.
• Stay at a healthy weight.
• Do activities that raise your heart rate. Get at least 30 minutes of exercise on most days of the week. Walking is a good choice.
• Eat a balanced diet that is low in cholesterol, saturated fats, and salt. What kind of diet you use(What is a PDF document?) depends on your individual risks, your doctor's recommendation, and your preference. Here are some options:
  • Dietary Approaches to Stop Hypertension (DASH) diet
  • Therapeutic Lifestyle Changes (TLC) diet
  • American Heart Association diet
  • Mediterranean-style diet