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.
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
another antiplatelet medicine.
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
- 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,
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.
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: