For patients
Patients' rights A Patient is a person who has applied for help to a healthcare facility or healthcare specialist. read more
Prevention Certain risk factors can increase your chances of having a stroke. If you have identified personal risk factors, work with your doctor to reduce your personal risk. Also try to eliminate some risk factors. read more
Rehabilitation The goal of stroke rehabilitation is to help you relearn skills you lost when a stroke affected part of your brain. Stroke rehabilitation can help you regain independence and improve your quality of life. read more
Treatment for stroke Care on a stroke unit is one of the most effective ways of treating a person after a stroke. A stroke unit is an area in a hospital where there is a specialized stroke team. read more
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Treatment for stroke

Care on a stroke unit is one of the most effective ways of treating a person after a stroke. A stroke unit is an area in a hospital where there is a specialized stroke team.

Unfortunately, not all hospitals have a specialized stroke unit, so a patient may be treated in a general hospital ward.

When a patient is brought to hospital, the tests are performed to find out the type of stroke: computer (CT) or magnetic resonance imaging (MRI) of the head, blood tests and an electrocardiogram.

Treating ischemic strokes

A combination of medications to treat the condition and prevent it happening again is usually recommended to a person with ischemic stroke. Some of these medications need to be taken immediately and only for a short time, while others may only be started once the stroke has been treated and may need to be taken long term.

Thrombolysis

An emergency treatment of ischemic stroke - an injection of alteplase, a medication that dissolves blood clots and restores blood supply to the brain. This method is effective in eliminating or reducing the amount of brain damage. But the patient has to meet some criteria, and time from the first symptoms of a stroke should not exceed 4.5 hours. The sooner the treatment starts, the more effective it will be. To evaluate the possibility of using thrombolysis it's very important to confirm the diagnosis, therefore a brain scan is carried out (CT and MRI).

Thrombectomy

A small proportion of severe ischemic strokes can be treated by an emergency procedure known as thrombectomy - a mechanical removal of blood clots to restore blood supply to the brain. Thrombectomy is only effective at treating ischemic strokes caused by a blood clot in a large artery in the brain. It's most effective when started as soon as possible after a stroke, usually within 6 hours after the first symptoms. The procedure can be carried out under local or general anesthetic.

Antiplatelets

Antiplatelets

Most people will be offered a regular dose of aspirin, because it reduces the chances of another clot forming.

In addition to aspirin, other antiplatelet medicines are also available, such as clopidogrel and dipyridamole.

Anticoagulants

Some people may be offered an anticoagulant to help reduce their risk of developing further blood clots in the future.

Warfarin, apixaban, dabigatran, edoxaban and rivaroxaban are examples of anticoagulants for long-term use.

There are also a number of anticoagulants called heparins, which can only be given by injection and are used short term.

Anticoagulants may be offered if a patient:

  • has a type of irregular heartbeat called atrial fibrillation, which can cause blood clots
  • has a history of blood clots
  • develops a blood clot in the leg veins (deep vein thrombosis, or DVT) because a stroke has left the patient unable to move one of the legs

Antihypertensives

If the blood pressure is too high, a patient may be offered medicines to lower it.

Commonly used medicines include:

  • thiazide diuretics
  • angiotensin-converting enzyme (ACE) inhibitors
  • calcium channel blockers
  • beta-blockers
  • alpha-blockers

Statins

In case of high cholesterol level in the blood, a patient will be advised to take statins.

Statins reduce the level of cholesterol by blocking a chemical (enzyme) in the liver that produces cholesterol.

A patient may be offered a statin even if cholesterol level is not particularly high, as it may help reduce the risk of stroke whatever cholesterol level is.

Carotid endarterectomy

Some ischemic strokes are caused by narrowing of an artery in the neck called the carotid artery, which carries blood to the brain. The narrowing, known as carotid stenosis, is caused by a build-up of fatty plaques. If the carotid stenosis is particularly severe, surgery may be offered to unblock the artery. This is done using a surgical technique called a carotid endarterectomy. It involves the surgeon making a cut in the neck to open up the carotid artery and remove the fatty deposits.

Treating hemorrhagic strokes

As with ischemic strokes, some people who have had a hemorrhagic stroke will also be offered medication to lower their blood pressure and prevent further strokes.

If you were taking anticoagulants before you had your stroke, you may also need treatment to reverse the effects of the medication and reduce your risk of further bleeding.

Surgery

Occasionally, emergency surgery may be needed to remove any blood from the brain and repair any burst blood vessels. This is usually done using a surgical procedure known as a craniotomy.

During a craniotomy, a section of the skull is cut away to allow the surgeon access to the cause of the bleeding.

The surgeon will repair any damaged blood vessels and ensure there are no blood clots present that may restrict the blood flow to the brain.

Surgery for hydrocephalus

Surgery can also be carried out to treat a complication of hemorrhagic strokes called hydrocephalus.

This is where damage resulting from a stroke causes cerebrospinal fluid to build up in the cavities (ventricles) of the brain, causing symptoms such as headaches, sickness, drowsiness, vomiting and loss of balance.

Hydrocephalus can be treated by surgically placing an artificial tube called a shunt into the brain to allow the fluid to drain properly.

https://www.nhs.uk/conditions/stroke/treatment/