Stroke Prevention and Treatment
Eighty percent of all strokes are preventable. Managing key risk factors, including high blood pressure, cigarette smoking, atrial fibrillation and physical inactivity can decrease your stroke risk. More than half of all strokes are caused by uncontrolled hypertension or high blood pressure, making it the most important risk factor to control.
There are 3 main types of stroke treatment – tPA (tissue plasminogen activator), surgery and non-surgical treatment. The type of treatment you receive will depend on the type of stroke as well as other factors such as the severity of the stroke, your age and health and how quickly you arrive at the hospital.
Ischemic Stroke Treatment
The majority of strokes are ischemic and occur as a result of an obstruction within a blood vessel supplying blood to the brain. Ischemic strokes fall into 2 main categories:
- Thrombotic stroke is caused by a blood clot that forms in an artery directly leading to the brain
- Embolic stroke which occurs when a clot develops elsewhere and travels to the brain
These types of strokes are typically treated with tPA or endovascular procedures.
tPA (Tissue Plasminogen Activator)
Thrombolytic drugs such as tissue plasminogen activator (tPA) are commonly known as “clot busters”. tPA, is given through an IV in the arm and works by dissolving the clot and improving blood flow to the part of the brain being deprived of blood flow. If administered within 3 hours (and up to 4.5 hours in certain eligible patients), tPA may improve the chances of recovering from a stroke. A significant number of stroke victims do not get to the hospital in time for tPA treatment; this is why it’s so important to identify a stroke immediately.
Endovascular Procedures Another treatment option is a mechanical thrombectomy in which doctors try removing a large blood clot by sending a stent retriever to the site of the blocked blood vessel in the brain. To remove the brain clot, doctors thread a catheter through an artery in the groin up to the blocked artery in the brain. The stent opens and grabs the clot, allowing doctors to remove the stent with the trapped clot. Special suction tubes may also be used.
Hemorrhagic Stroke Treatment
Hemorrhagic stroke results from a weakened blood vessel or brain aneurysm that ruptures. The blood from the ruptured vessel accumulates and puts pressure on the surrounding brain tissue. The two types of hemorrhagic strokes are intracerebral (within the brain) hemorrhage and subarachnoid hemorrhage.
Hemorrhagic strokes are typically treated with endovascular procedures or surgical treatments.
Endovascular Procedures Endovascular procedures may be used to treat certain hemorrhagic strokes similar to the way the procedure is used for treating an ischemic stroke. These procedures are less invasive than surgical treatments, and involve the use of a catheter introduced through a major artery in the leg or arm, then guided to the aneurysm. It then deposits a mechanical agent, such as a coil, to prevent rupture.
Surgical Treatment For strokes caused by a bleed within the brain (hemorrhagic stroke), or by an abnormal tangle of blood vessels, surgical treatment may be done to stop the bleeding. If the bleed is caused by a ruptured aneurysm, a metal clip may be placed surgically at the base of the aneurysm to secure it.