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Treatment for ischemic stroke

The type of stroke, as well as its severity and effects, helps determine the best treatment approach.

A stroke is always an emergency. The sooner treatment starts, the more likely it is that major brain damage or death can be avoided.

Throughout treatment, the doctor will consider the type of stroke, how severe it is, and the general health of the person having the stroke.

According to the American Stroke Association, about 87 percent of strokes are caused by an obstruction that blocks blood flow to the brain (called ischemic strokes).

Stroke treatment may include medicines, surgery and rehabilitation, notes the National Institute of Neurological Disorders and Stroke (NINDS).

Medications

A medicine called tissue plasminogen activator (tPA) is often used to treat strokes caused by blocked blood vessels. This medicine is injected directly into a vein and dissolves blood clots that are cutting off blood supply. TPA must be given within three hours (or up to 4.5 hours for some people) of the start of stroke symptoms.

Medicines may also be used long term, after the stroke has ended, to prevent a second stroke. These medicines prevent blood clots from forming. They include anticoagulants and antiplatelet agents such as aspirin, warfarin and heparin.

Surgery

A surgery called carotid endarterectomy can restore blood flow by removing the fatty buildup that's clogging an artery. The artery is cut open, the plaque is scraped out and the artery is sewn back together.

Cerebral angioplasty is another option for widening a narrowed artery. This procedure is done with a long, flexible tube that has a balloon on the tip. The balloon is threaded into the artery and inflated in the narrowed section to widen it. A tiny mesh tube called a stent may also be mounted on the balloon and left inside the artery to prop it open.

Another type of cerebral angioplasty releases a metal coil into a weakened section of an artery to prevent it from bursting. The metal coil sets off an immune response that strengthens the weakened section of artery.

Rehabilitation

Stroke is a leading cause of serious, long-term disability in adults, according to the NINDS. Brain damage from stroke can lead to difficulties with movement, coordination, balance, speech, awareness, memory, depression, frustration and anxiety.

Physical, occupational, speech and psychological therapies can help people overcome or cope with the long-term effects of stroke.

reviewed 9/5/2019

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