Aging & Health A to Z
Stroke
Care & Treatment
Stroke is a life-threatening situation. You must call 911 or go directly to the hospital if you have stroke or TIA symptoms. The healthcare professionals at the hospital will start treatment as soon as they evaluate your condition.
General Medical Support
You will probably receive some or all of the following supports:
- oxygen
- an intravenous line to prevent or treat dehydration
- medicines to control underlying problems such as high blood pressure, abnormal sugar levels, infection, or atrial fibrillation.
Treatment for Blood Clots
If a blood clot is causing the stroke, or if you are at risk of more clots, your doctors may treat you with a blood thinner (anticoagulant) (aspirin, heparin, or warfarin) or a “clot-busting” drug (such as tissue plasminogen activator or TPA). This depends on your age (used less for people over the age of 75), how quickly you have made it to the hospital (if within three to possibly five hours of first symptoms), and whether you are able to move around. If there is a risk of bleeding, the blood thinner will probably not be used.
Carotid Surgery
For patients whose carotid arteries have become narrow due to a build-up of cholesterol and plaque (atherosclerosis), your physician may recommend surgery. This operation, called carotid endarterectomy, removes the narrowed areas and restores unobstructed blood flow to the brain.
Other Surgery
Occasionally, surgery may be done to remove the blood clot from your brain if it can be localized well by CT scan and is accessible. When there is bleeding in or around the brain, doctors may operate to remove the blood. Small “stents” may also be used in stroke surgery to keep narrowed blood vessels open.
Long-term Therapy
If you have been given blood thinners, you will continue taking them in pill form for at least a few months. This will also require regular blood tests.
Rehabilitation
Depending on your disabilities, you will probably benefit from the continuation of the therapy that was started in the hospital. Most people with disabilities from the stroke will spend some time in a rehabilitation facility. Support may include:
- physiotherapy
- occupational therapy
- speech therapy
- swallowing therapy.
Prognosis
Every stroke is different, and patients recover at different rates, often completely. For many people, disabilities slowly disappear over a period of weeks to months, or even years. About half of people who have had a stroke are able to function at home, independently. Your physical health before the stroke is an important factor in recovery. Unfortunately, about two-thirds of stroke patients suffer some kind of long-term disability, and many will need long-term care.
The risk of a repeat stroke declines sharply after the first few months.
Updated: March 2012
Posted: March 2012