Treatment: Ischemic Stroke
The main goal in treating ischemic stroke is to restore blood flow to the brain.

Treatment with medications

• Aspirin. An antiplatelet medication that decreases blood clot formation by preventing the smallest blood cells (platelets) from sticking together. Aspirin is the best treatment immediately after a stroke to prevent further stroke. Ischemic stroke patients are typically given aspirin in the emergency room.
• Heparin and warfarin (Coumadin). Anticoagulants that help prevent clots from forming
• Tissue plasminogen activator (TPA). A potent clot-busting drug that may improve chances of recovery for some patients

Surgical and nonsurgical procedures

• Carotid endarterectomy. This surgery aims to reduce the risk of future strokes. An incision is made in the carotid artery, and plaques that have formed there are removed using a dissecting tool. There is a low risk of stroke following the surgery. There is also a risk of arterial restenosis (reblockage) and temporary nerve injury, leading to hoarseness, difficulty with swallowing, or numbness.
• Angioplasty and stents. An option that may be appropriate if the patient can't undergo surgery. A balloon-tipped catheter is inserted in an artery, usually near the groin, and threaded up to the narrowed artery. This may be either a carotid artery or a brain artery. The balloon is inflated to widen the artery, and a stent (a tube reinforced with a metal mesh) is left in place to keep the artery open. Umbrella stents have tiny, umbrella-like filters attached to one end to catch any debris that may have been loosened by the procedure. The umbrella is removed after the procedure is completed. Angioplasty is considered less risky than cerebral surgery, but there are still the risks of bleeding, infection, and damage to artery.

Treatment: Hemorrhagic Stroke

• Aneurysm clipping. A tiny, permanent clamp is placed at the base of the aneurysm, cutting it off from the blood supply in order to keep it from bleeding. If the aneurysm has recently ruptured, the clip may be used to prevent rebleeding.
• Aneurysm embolization, or coiling. A catheter is threaded into the aneurysm, and a tiny coil is pushed through it and deposited inside the aneurysm. The coil causes clotting and so seals off the aneurysm from connecting arteries.
• Surgical arteriovenous malformation (AVM) removal. AVMs are areas of malformed blood vessels that lack capillaries. They may be surgically removed from accessible parts of the brain, reducing the risk of hemorrhagic stroke.

Risks of Cerebral Surgery
If the cerebral aneurysm is small, less than 1/2 inch (1 cm), then the doctor may advise only monitoring to detect growth or onset of symptoms. Cerebral surgery is risky. It can pose some of the same dangers that a ruptured aneurysm can, if the aneurysm ruptures during surgery and bleeding cannot be controlled: stroke, disability, and death.

More on this topic

What Is Stroke? (VIDEO)
Your Brain Needs Oxygen
Clogged Carotids
Degree of Blockage
Types of Stroke
Risk Factors
Symptoms, Test & Diagnosis
Treating Stroke
Life After Stroke

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