Ischemic stroke treatments require that blood flow be restored to the brain. A blood thinning medicine, usually aspirin, is given to treat ischemic strokes. Other types of ischemic stroke treatments include removing the clot or blockage manually or giving the patient tissue plasminogen activator (TPA), either through an intravenous line or a catheter. These types of strokes are usually treated as an emergency.
When a patient suffers an ischemic stroke, an artery in the brain becomes blocked, so blood cannot flow freely. There are typically two types of ischemic strokes. A thrombotic stroke occurs when a clot forms in the brain, while an embolic stroke happens when a clot forms elsewhere in the body and makes its way to the brain. Treatments are most effective when they occur within a few hours after symptoms first appear.
Blood thinners are commonly given to treat ischemic strokes. The medication must be administered within four and a half hours of the beginning of the stroke, or else another treatment should be used. Aspirin is the most common medication given for ischemic stroke treatments. It also reduces a patient's chances of having a second stroke.
If aspirin is not given as treatment, a patient may receive a different type of blood thinner, such as warfarin or clopidogrel. Some ischemic stroke treatments include intravenous administration of TPA, which will break up the clot and restore blood flow. TPA is used in place of aspirin, but must also be given intravenously within a short time frame after the stroke begins.
In some cases, TPA may be given through a catheter into an artery, which delivers the mediation directly to the brain. While intravenous TPA must be given within a few hours of the stroke, a catheter can be inserted up to 18 hours after the stroke began. Some patients, such as those who take warfarin or other blood thinners, should not receive TPA. Patients who have had a hemorrhagic stroke in the past or who have a history of bleeding shouldn't receive TPA either.
Surgery can also be performed to treat ischemic strokes. A surgeon may need to remove a clot in the brain manually during emergency treatment. After initial treatment, a doctor may wish to perform surgery to attempt to prevent future strokes.
A carotid endarterectomy is often performed to remove blockages and clots from the carotid artery. While the procedure can reduce a patient's risk of future stroke, it can also trigger another stroke if not performed properly. Another surgical option is angioplasty, which widens the carotid or other arteries in the brain.
