Stroke Treatment

Our stroke care team understands that a fast diagnosis gives patients a better chance at a full recovery. When patients seek treatment immediately following the onset of their symptoms, doctors have more options in using the most advanced technology available. Your stroke treatment will be determined by the kind of stroke, the severity of symptoms and your overall health.

Emergency treatment

At the emergency room, you will receive a general physical and neurological examination. Your doctor will order a CT scan of your head to find out if you are in fact having a stroke and its specific type. This evaluation will help determine the best treatment for your condition.

Treatment for ischemic stroke

"Clot-busting" drug - Intravenous (IV)

Ischemic strokes can be treated with a clot-busting drug known as tPA (tissue plasminogen activator). This drug helps to dissolve the blood clot. When given through an IV (usually in the arm), the medication travels through the bloodstream directly to the blockage. It must be administered within three hours of the onset of stroke symptoms.

"Clot-busting" drug - Intra-arterial

This method delivers clot-busting tPA directly to the blockage. During the procedure, the interventional neuroradiologist inserts a thin, flexible catheter into an artery (usually in the groin area) and guides it up to the clot in the brain. The tPA is then administered through the catheter. While this method can expand the treatment time window, it is more invasive than the IV procedure.

Clot retriever device

The National Brain Aneurysm Center also offers a clot retrieval device that "grabs" clots and restores blood flow to the brain. The clot retriever is the first medical device to be cleared by the U.S. Food and Drug Administration (FDA) for patients experiencing an ischemic stroke. The clot retriever is inserted into an artery in the groin and carefully led up to the blockage in the brain. It restores blood flow by capturing and removing the clot.

Treatment for hemorrhagic stroke (intracerebral)

Intracerebral hemorrhages are most often caused by high blood pressure. Doctors choose the best treatment option for each patient and take into account the location and severity of the bleeding.

Observation

When undergoing observation, patients are closely monitored in the hospital, but no direct action (surgery) is taken.

Surgery

A neurosurgeon opens the skull and performs surgery to remove the clot.

Treatment for hemorrhagic stroke (subarachnoid)

Treatments for hemorrhagic strokes caused by ruptured aneurysms include clipping and coiling. Both procedures stop bleeding in the brain.

Clipping

During this surgery, a neurosurgeon opens the skull and separates the aneurysm from surrounding tissue. A small titanium clip will then be placed around the base of the aneurysm so that blood can no longer flow into it. The surgeon then drains the remaining blood out of the aneurysm and the empty aneurysm sac will shrink with time. When clipped correctly, the aneurysm should not return.

Coiling

Coiling is a newer, less invasive form of surgery. Unlike clipping, it does not require a craniotomy (opening of the skull). During the procedure, the interventional neuroradiologist inserts a catheter into the groin area and guides it up into the brain. The doctor then performs an angiogram to view the blood flow in the blood vessels in the brain. A fine wire is threaded into the catheter and carefully guided into the aneurysm. In the aneurysm, the wire twists into small coils. The doctor continues until the aneurysm is full of the tiny coils, causing the aneurysm sac to clot. After a coiling procedure, regular follow-up angiograms are required.