A stroke is a reduction or loss of oxygen and other nutrients to the brain caused by a clot blockage of a blood vessel to the brain (ischemic), or a hemorrhage of a blood vessel to the brain (hemorrhagic), or a mini- stroke (transient ischemic). All of these cause brain cells to die quickly.

There are two phases of stroke care: the lifesaving treatment when the person is first admitted to the hospital, and then the longer-term recovery phase in which the stroke survivor rehabilitates from the brain injury.

Emergency Stroke Treatment

A doctor’s first priority, when a patient with suspected stroke comes in, is to stabilize their basic vitals and establish that it actually is a cerebrovascular event. Imaging technology is used to uncover what kind of stroke it is and where the obstruction or bleed has happened.

In the case of an Ischemic stroke, the clot has to be removed to stop the progression of damage in the brain. If the person got to the emergency room promptly, clot-busting medicines (tissue plasminogen activators) or antiplatelet drugs (such as aspirin) are given. In the case of a serious blockage of the carotid artery, surgery may be used. This is only done in the most severe cases as the surgery itself may trigger another stroke.

Hemorrhagic strokes are more complicated to treat. Doctors balance between controlling the bleeding within the skull, reducing the pressure on the brain tissues, and lowering the blood pressure and stabilizing other vital signs. These are accomplished with a combination of medications and emergency surgery. The patient is first operated on to seal off the aneurysm or malformed blood vessels that are bleeding, and then sometimes there is a second surgery to remove the spilled blood that is pressing on the brain.

In either case, the doctor’s concern then shifts to preventing a second, devastating stroke right after the first one. This is done through a multi-pronged approach. High blood pressure is lowered, ideally to the normal range, through medications and diet. Aspirin and other antiplatelet drugs are given to prevent more clots from forming. Other stroke risk factors, such as diabetes, are brought under control.