Stroke

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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 many 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 blood sugar levels, infection, or atrial fibrillation

Treatments for Blood Clots

If a blood clot is causing the stroke, or there is a risk of more clots, a person may get a blood thinner such as aspirin, heparin, or warfarin.

The emergency room healthcare providers may also use a “clot-dissolving” drug (named recombinant tissue plasminogen activator or rt-PA). The use of rt-PA depends on:

  • Age. People age 80 and over are less likely to get rt-PA.
  • When the person arrived at the hospital. Treatment with rt-PA is more likely when a person arrives within three to five hours of the first stroke symptoms.
  • Whether the person is able to move around.
  • If there is a risk of bleeding, rt-PA and blood thinners will not likely be used.  

Carotid Surgery

This surgery is for people whose carotid arteries have become too narrow because of atherosclerosis. This surgery, called carotid endarterectomy, removes the narrowed areas and restores full blood flow to the brain.  

Other Surgeries

Other surgeries may be possible. They include:

  • Removing the blood clot from the brain or blood vessels leading to the brain. This is possible when it is relatively easy to locate and remove the blood clot.
  • Doing surgery that places small “stents” that keep narrowed blood vessels open.

Short-term Therapy

Treatment of the person with stroke needs to involve:

  • Giving the right amount of fluids
  • Controlling high blood pressure, if needed
  • Treating any heart disease
  • Starting long-term therapy with blood thinners, if needed
  • Evaluating the person for any problems with swallowing

Long-term Therapy

If a person takes blood thinners after a stroke, the medication will continue for at least a few months. Regular blood tests will be necessary to help control side effects.  

Rehabilitation

A person who has had a stroke likely will benefit from rehabilitation therapy, often in a facility that specializes in this service. Support may include:

  • Physical therapy
  • Occupational therapy (help relearning daily activities)
  • Speech therapy
  • Swallowing therapy

Prognosis

People with stroke may experience:

  • Paralysis or weakness of some muscles, often only on one side of the body or face.  This can cause falls and problems getting around.
  • Problems with talking or swallowing.
  • Memory loss, confusion, difficulty understanding concepts, dementia.
  • Sensory changes, including pain, numbness, tingling, abnormal reactions to temperature changes.
  • Depression, behavioral, and mood changes including withdrawal from social life, difficulty looking after daily self-care, malnutrition.

Every stroke is different and people recover at different rates. A person’s good physical health before the stroke is an important part of their ability to recover.

  • 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 live independently at home.
  • About two-thirds of people who have strokes have a long-term disability
  • Many people will need long-term care, sometimes in a nursing home

 

Last Updated March 2023

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