A stroke occurs when a vessel in the brain ruptures or is blocked by a blood clot. Stroke medical treatments work to either open the blockage or treat the rupture. Medical advances have greatly improved survival rates from stroke treatments during the last decade. But the chances of survival are even better if the stroke is identified and treated immediately. This section will outline some possible ways to prevent and treat a stroke.
The good news is that 80 percent of all strokes are preventable. It starts with managing key risk factors, including high blood pressure, cigarette smoking, atrial fibrillation and physical inactivity. More than half of all strokes are caused by uncontrolled hypertension or high blood pressure, making it the most important risk factor to control.
Medical treatments may be used to control high blood pressure and/or manage atrial fibrillation among high-risk patients. Those medicines include:
Antiplatelet agents such as aspirin and anticoagulants, such as warfarin, interfere with the blood’s ability to clot and can play an important role in preventing stroke. Read more about anticoagulants.
Antihypertensives are medications that treat high blood pressure. Depending on the type of medication, they can lower blood pressure by opening the blood vessels, decreasing blood volume or decreasing the rate and/or force of heart contraction. Learn about the types of antihypertensives.
Additionally, when arteries show plaque buildup or blockage, medical procedures may be needed. Such as:
- Carotid Endarterectomy
Carotid endarterectomy, also called carotid artery surgery, is a procedure in which blood vessel blockage (fatty plaque) is surgically removed from the carotid artery.
View a detailed illustration of carotid endarterectomy (opens in new window).
Doctors sometimes use balloon angioplasty and implantable steel screens called stents to treat cardiovascular disease and help open up the blocked blood vessel.
If you’re having a stroke, it’s critical that you get medical attention right away. Immediate treatment may minimize the long-term effects of a stroke and prevent death.
There are two types of strokes: hemorrhagic or ischemic. An ischemic stroke occurs as a result of an obstruction within a blood vessel supplying blood to the brain. It accounts for 87 percent of all stroke cases. A hemorrhagic stroke occurs when a weakened blood vessel ruptures and spills blood into brain tissue. The most common cause for the rupture is uncontrolled hypertension (high blood pressure). There are two other types of weakened blood vessels that also cause hemorrhagic stroke: aneurysms and arteriovenous malformations (AVMs). Treatment differs depending on the type of stroke.
tPA, the Gold Standard
The only FDA approved treatment for ischemic strokes is tissue plasminogen activator (tPA, also known as IV rtPA, given through an IV in the arm). tPA works by dissolving the clot and improving blood flow to the part of the brain being deprived of blood flow. If administered within 3 hours(and up to 4.5 hours in certain eligible patients), tPA may improve the chances of recovering from a stroke. A significant number of stroke victims don’t get to the hospital in time for tPA treatment; this is why it’s so important to identify a stroke immediately.Endovascular Procedures
Another treatment option is an endovascular procedure* called mechanical thrombectomy, strongly recommended, in which trained doctors try removing a large blood clot by sending a wired-caged device called a stent retriever, to the site of the blocked blood vessel in the brain. To remove the brain clot, doctors thread a catheter through an artery in the groin up to the blocked artery in the brain. The stent opens and grabs the clot, allowing doctors to remove the stent with the trapped clot. Special suction tubes may also be used. The procedure should be done within six hours of acute stroke symptoms, and only after a patient receives tPA.
*Note: Patients must meet certain criteria to be eligible for this procedure.
Image courtesy of Medtronic
Endovascular procedures may be used to treat certain hemorrhagic strokes similar to the way the procedure is used for treating an ischemic stroke. These procedures are less invasive than surgical treatments, and involve the use of a catheter introduced through a major artery in the leg or arm, then guided to the aneurysm or AVM; it then deposits a mechanical agent, such as a coil, to prevent rupture.
For strokes caused by a bleed within the brain (hemorrhagic stroke), or by an abnormal tangle of blood vessels (AVM), surgical treatment may be done to stop the bleeding. If the bleed is caused by a ruptured aneurysm (swelling of the vessel that breaks), a metal clip may be placed surgically at the base of the aneurysm to secure it.
- Related stroke survivor stories
- Patient information sheets
- Guidelines urge new approach to treating worst strokes
- Clot-removing devices provide better outcomes for stroke survivors
- Learn more about stroke
Medical treatments continue to evolve and improve, thanks in part to clinical trials (research). These are scientific studies that determine if a possible new medical advance can help people and whether it has harmful side effects. Find answers to common questions about clinical trials in our Guide to Understanding Clinical Trials.