Treating a Stroke
Stroke treatment depends on the type, how quickly it’s caught, and the facilities available.
First Steps
All stroke patients need to be stabilised as soon as possible, to control any problems that may impair recovery. This includes careful management of hydration, nutrition, and swallowing problems, as well as measures to prevent pneumonia and blood clots forming in the veins of the legs. High blood pressure and blood sugar levels may also require treatment, and a patient may need oxygen for breathing problems.
After the acute phase of treatment, the focus shifts to rehabilitation and preventing another stroke from occurring. Once the type of stroke has been correctly diagnosed, some specialised treatments may be considered depending on the patient's condition and the services available.
Getting a Diagnosis
1
Ambulance staff or doctors check vital signs such as blood pressure, heart rate, and respiration, and begin stabilising the patient.
2
Tests help determine the type and severity of the stroke, alongside a check of heart rhythm and function.
3
CT or MRI scans of the brain, and a carotid doppler ultrasound, show blood flow and help confirm the type of stroke.
4.5 hrs
tPA "Clot-Buster" Window
Must be given within 4.5 hours of symptom onset, and only for clot-caused strokes.
6 hrs
Thrombectomy Window
Mechanical clot removal can typically only be attempted within 6 hours of a stroke occurring.
Treatment Options
Treatment depends heavily on which type of stroke occurred, and how quickly it's diagnosed.
Tissue plasminogen activator (tPA), commonly known as "clot-buster" treatment, is a medication that can dissolve or break up the clot obstructing an artery. It can only be given to patients having a clot-caused stroke, at hospitals with stroke units and scanning facilities, and must be given within four-and-a-half hours of symptom onset. In some cases, tPA cannot be used.
A large blood clot can sometimes be physically removed during a procedure called a mechanical thrombectomy. This can only be done at very specialist centres with the correct scanning equipment, treatment facilities, and trained specialists — and is typically only attempted within 6 hours of the stroke occurring.
The aim after a haemorrhagic stroke is to stop the bleeding and stabilise the patient. In some cases, surgery may be needed to remove blood that has pooled in the brain. Very specialised procedures can sometimes be undertaken to fix burst blood vessels.
An operation called a carotid endarterectomy may be carried out by specialist doctors on narrowed blood vessels in the neck. If you need this operation, a specialist will explain what's involved. Most people, however, are given tablets and asked to change their lifestyle to help prevent further strokes — in most cases of TIA, surgery isn't necessary.
Watch: A Visual Explanation of Carotid EndarterectomyOnce a patient is stabilised, the focus shifts to rehabilitation and preventing further strokes. Recovery looks different for everyone — explore our Life After a Stroke page for support, recovery resources, and guidance on adjusting to life after a stroke.
