Stroke Treatment: 9 Common Options

Stroke treatment may include medications such as blood pressure medicines and blood thinners, thrombolysis, cerebral catheterization, and hemostatic therapy, depending on the type of stroke and how severe it is. The goal is to restore or protect brain function as quickly as possible while reducing the risk of complications.

It is important to start stroke treatment as soon as the first symptoms are recognized. The sooner treatment begins, the lower the risk of long-term effects such as paralysis or trouble speaking.

If a stroke is suspected, emergency medical help should be sought immediately. Treatment may begin in the ambulance on the way to the hospital with medications to stabilize blood pressure and heart rate, oxygen to make breathing easier, and close monitoring of vital signs.

Treatment options

The main treatment options for stroke are:

1. Medications

Blood pressure medicines may be used in stroke treatment to control very high blood pressure. This is especially important in hemorrhagic stroke, because controlling blood pressure can help prevent the bleeding from getting worse.

In hemorrhagic stroke, other medications may also be used, such as mannitol to help control intracranial pressure and anticonvulsants in people who have seizures.

If the stroke is ischemic, antiplatelet medicines such as aspirin may be used after the medical team considers when symptoms started and what treatment has already been given. Clopidogrel may also be used in some cases, but anticoagulants are not usually part of the initial treatment for acute ischemic stroke.

2. Thrombolysis

Thrombolysis is a treatment for ischemic stroke that is usually done within the first 4.5 hours after symptoms begin.

According to the American Heart Association/American Stroke Association, thrombolysis with medicines such as alteplase and tenecteplase may be used in eligible patients to dissolve the clot blocking a blood vessel in the brain.

3. Cerebral catheterization

Cerebral catheterization may be recommended in some cases of ischemic stroke. It involves inserting a thin, flexible tube through an artery in the groin to reach the blocked blood vessel in the brain and remove the clot.

When indicated, cerebral catheterization should be done as early as possible and may still be considered in selected patients within 6 to 24 hours after symptoms begin. In some cases, it may also be used together with thrombolysis.

4. Hemostatic therapy

Hemostatic therapy works by correcting problems with blood clotting through treatments such as vitamin K, fresh frozen plasma (FFP), and other reversal measures when needed.

According to the American Heart Association/American Stroke Association, these reversal measures may be recommended to help prevent bleeding from worsening in hemorrhagic stroke, while platelet transfusion is not routinely used in all cases and is generally reserved for specific situations.

5. Brain surgery

In some cases, treatment for hemorrhagic stroke may involve brain surgery to remove the hematoma caused by the bleeding. This is most often recommended in more severe cases or when the bleeding is extensive.

6. Physical therapy

Physical therapy for people who have had a stroke helps strengthen the muscles. It can support recovery or help maintain movement and improve quality of life.

7. Speech therapy

Speech therapy sessions can help improve speech and swallowing in people whose abilities were affected by a stroke.

8. Occupational therapy

Occupational therapy is a complementary part of stroke treatment that helps the person and their family develop strategies to reduce the effects of stroke-related limitations on daily activities.

It usually includes exercises, recommendations for adapting the home and/or bathroom, and activities to help improve thinking skills and movement.

9. Healthy diet

Following a healthy, balanced diet after a stroke is important to support recovery, prevent malnutrition, and reduce the risk of another stroke.

In cases where a feeding tube is needed, a dietitian will calculate the exact amount of food required and explain how to prepare it properly.

Recovery time

Once the initial symptoms are under control, it is common for a person who has had a stroke to stay in the hospital for a period of time, depending on their overall condition. This allows the medical team to monitor early recovery and check for possible complications.

After discharge, stroke recovery may take months or even years in some cases. Depending on how severely the brain was affected, the person may not recover completely.

Some long-term effects that may remain after a stroke include trouble speaking, weakness on one side of the body, difficulty swallowing, loss of bladder and/or bowel control, and changes in thinking or memory.