The treatment of a stroke is complicated and involves:
- dealing with the immediate cause of the stroke – i.e. treating a blood clot or a bleed in or around the brain
- monitoring for and treating any immediate complications
- rehabilitation to recover from any ongoing effects of a stroke
- reducing the risk of another stroke
Treatment of an ischaemic stroke
Treatment of blood clots: there are two options for getting rid of the clot that has caused an ischaemic stroke:
This is when medication is given to break up a clot. The medication is given through a small plastic tube which goes into a blood vessel (vein) in the arm.
This is when a blood clot is physically removed from an artery. A thin wire is put into a blood vessel in the groin and threaded up to the blocked artery. The wire is used to pull the blood clot out. Thrombectomy is done under local anaesthetic, meaning that people are awake but have a medicine injected into the skin to make it numb.
Treatment for blood clots has to be done very soon after the stroke happens. This is one of the reasons why a stroke is a medical emergency. The stroke team will give advice as to which is the best treatment.
Treatment of a haemorrhagic stroke
The leakage of blood can irritate the blood vessels in the brain causing them to suddenly to contract and get narrower. This reduces this amount of blood getting to the brain even more. Blood around or inside the brain can also put pressure directly on to the brain.
These effects are treated with:
What happens after a stroke?
For the first few days, people are monitored very closely and may need support with all normal activities. Improvements can start within the first day, although it often takes longer.
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Rehabilitation usually begins in the first 24 hours after a stroke has happened. The stroke team (see below) will make an assessment of the problems caused by a stroke. The team use this assessment to decide what forms of therapy are needed. The team will start therapy as soon as possible. |
Every hospital has a stroke team who treat and support people. The exact members of the team will vary but generally include doctors, specialist nurses, pharmacists, physiotherapists, speech and language therapists, healthcare assistants, rehabilitation assistants, occupational therapists, dieticians, psychologists and social workers.
The effects of a stroke and longer-term recovery will depend on which areas of the brain have been affected and how much damage there has been. Some people are left with long term disability, whilst for others the effects are less, and improvement can continue for months or years.
Longer term effects of a stroke can include problems with:
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The exact treatment and support that you may need after a stroke will depend on the effect that the stroke has had.
Treatment to reduce the risk of another stroke
In addition to treating the stroke itself, it is vital to do everything possible to try to stop another stroke.
Most people need a combination of different medications, including:
- Blood thinning (after an ischaemic stroke): medication to reduce the risk of blood clots. Usually, this will need to be taken for life.
- Blood pressure lowering
- Cholesterol lowering
In addition, some people with atrial fibrillation need medication to control the rate or rhythm of the heart.
All medication can have side effects. The stroke team will work with you to find the right combination that balances potential side effects with the benefits of particular treatments.
If the arterial doppler has shown a narrowing of the arteries in the neck, then it is sometimes possible to have an operation to open up the artery.
Non-drug treatments
Most people who have had a stroke will need long term medication to treat the effects of the stroke and to reduce the risk of another stroke. However, making changes to day to day activities can improve symptoms as well as reducing the risk of further strokes.
Healthy Living
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Stopping smoking Smoking any form of tobacco (cigarettes, cigars, pipes, shisha) as well as chewing tobacco causes narrowing of blood vessels. Stopping smoking, even if you have smoked for many years, will have immediate benefits. |
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Healthy eating There are some simple things you can do to make what you eat day to day healthier:
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Alcohol Alcohol can contribute to narrowing of blood vessels by causing high blood pressure. Drinking too much alcohol can trigger atrial fibrillation; an irregular heart beat that causes strokes. Although there is a feeling that a small amount of alcohol is beneficial, the evidence for this is not clear. If you do choose to drink alcohol the guidelines are:
If you have had a stroke or TIA and you wish to drink alcohol, you should ask your stroke team for advice. Alcohol may interact with some of the medication that you take. Alcohol can also affect your balance, your mood, your memory and your ability to think clearly; potentially worsening the effects of a stroke. |
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Move more All forms of physical activity and exercise help to keep you healthy. This doesn’t mean you have to go to the gym. It is more about choosing something that you enjoy which also makes your heart beat a bit faster and makes you breathe a bit harder. Carrying heavy shopping, housework and gardening all count as physical activity. A stroke can have a significant effect on your mobility. However, getting active after a stroke is an important part of rehabilitation and can reduce the chance of another stroke. The activity that you choose will depend on the effect that the stroke has had. If your mobility has been affected, there are many bed and chair-based activities that can help. The physiotherapists and other members of the stroke team can guide and support you in getting moving. |
