Stroke

Care & Treatment

Stroke is a life-threatening situation. Call 911 or go directly to the hospital if you have stroke or TIA symptoms. Do not drive yourself.

The healthcare professionals at the hospital will start treatment as soon as they evaluate your condition.

General Medical Support

Someone experiencing symptoms of stroke will receive some or all of the following supports:

  • Oxygen
  • An intravenous (IV) 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 there is a risk of more clots, it may be treated with a blood thinner such as aspirin, heparin, or warfarin (these medications are also known as anticoagulants). The emergency room healthcare providers may also use a “clot-dissolving” drug (named tissue plasminogen activator or TPA). The use of TPA depends on factors such as age (these medications are used less frequently for people over the age of 80), how quickly the patient arrived at the hospital (for example, if arrival was within three to five hours of the first symptoms), and whether the patient is 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), a specialist in neurology may recommend surgery. This surgery, called carotid endarterectomy, removes the narrowed areas and restores unobstructed blood flow to the brain.  

Other Surgeries

Occasionally, surgery may be done to remove the blood clot from the brain, if the clot is accessible and can be localized well by a CT scan. When there is bleeding in or around the brain, a neurosurgeon 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 a person has been given blood thinners, the medication will continue to be prescribed in pill form for at least a few months. This will also require regular blood tests.  

Rehabilitation

Depending on the nature of their disabilities caused by stroke, a patient may benefit from the continuation of the therapy that was started in the hospital. Most people with disabilities from a stroke will spend some time in a rehabilitation facility. Stroke patients at any age can benefit from formal rehabilitation. Support may include:

  • Physiotherapy
  • Occupational therapy
  • Speech therapy
  • Swallowing therapy

Prognosis

Every stroke is different, and patients recover at different rates. 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. A person’s 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.

Last Updated September 2020