For ischemic strokes, the goal of early treatment is to remove the blockage in the artery and restore blood flow to the struggling brain. This can be done in a few ways.
The “clot breaking drug,” or t-PA, is a medication that can be given through an IV and is designed to break blood clots. It must be given within three hours of the first stroke symptoms, which means arriving at the ER within closer to two hours of symptom onset in order to have enough time to do the necessary testing and get the medication going. That same t-PA can be given directly into the artery and the timeframe is a little longer for this method, but the risks are higher. Still, t-PA is a good treatment and is saving many from lost brain tissue.
Some strokes can be treated by directly using a corkscrew-like device and going directly into the artery and pulling the blockage out. This is a new type of treatment that is becoming more widely available in the local community. Medications are then given to help keep the artery open.
After three hours
Even if someone arrives later than three hours, or for other reasons cannot get t-PA, there is still treatment for stroke. In order to give brain tissue the best chance for survival, body temperature and blood sugar must be tightly controlled. The same goes for blood pressure. Also, damaged brain tissue can swell just like any other damaged tissue, and sometimes this swelling can be life-threatening or cause worsening stroke symptoms. Medications or even surgery are sometimes needed to control this swelling.
Finally, bleeding strokes (up to 20% of all strokes) must be treated very carefully. While clot-breaking medication cannot be given, the other treatments for blood pressure, blood sugar and others just mentioned are important. Surgery also becomes necessary for many hemorrhagic strokes, and early intervention is always best.
Find out what happens after stroke treatment.
Olympia Neurology Stroke Program and Stroke Services