Stroke

Stroke

Signs and Symptoms
Diagnosis
Treatment

Acute Treatment for Ischemic Stroke

The neurology team at UCSF Medical Center, along with your primary care doctor, will design a treatment plan tailored to your medical condition, state of health and individual needs. You may need more than one kind of treatment and treatment may require several visits to UCSF. You may be referred to additional doctors or other medical professionals.

It is critical to come to the hospital immediately if you experience a stroke because treatments might reduce or completely reverse the brain injury from stroke. These treatments must be given within the first few hours of stroke symptoms, so call 911 to get transportation to the Emergency Room quickly. These treatments may include administration of a tissue plasminogen activator or t-PA — a FDA-approved clot-busting drug that may open blocked blood vessels, increasing the rate of survival and helping reduce damage to the brain cells if given within three hours of the onset of a stroke. Your physician may also recommend the use of FDA-approved mechanical devices to remove the clot from the brain using a catheter (See catheter arteriography in the Diagnosis section).

The next step in treating a stroke is to carefully control and monitor your blood pressure. Once your blood pressure is under control, we focus on cholesterol, smoking cessation, control of diabetes and analysis of any heart conditions you may have.

Preventative Treatment for Ischemic Stroke

There are several medications that can help reduce your risk of having another ischemic stroke or TIA. anti-platelet drugs cause your blood platelets to be less sticky and less likely to clot. Aspirin is a common anti-platelet drug, but if you are unable to take aspirin, other anti-platelet drugs are available. Anticoagulants, such as heparin and warfarin (Coumadin) may also be prescribed if you have a blood clotting disorded, arterial abnormalities or heart problems. You should work with your doctor to monitor the use of these anticoagulants.

The next step in treating a stroke is to carefully control and monitor your blood pressure. Once your blood pressure is under control, we focus on cholesterol, smoking cessation, control of diabetes and analysis of any heart conditions you may have.

Also, there are surgical techniques that may be used to prevent stroke including:

• Carotid Endarterectomy — This surgery is used to remove plaque from carotid arteries to help prevent strokes.

• Angioplasty and Stenting — During this procedure, your surgeon places a small wire tube down a narrowed artery. A balloon attached to the tube is then inflated, which works to widen the artery. An implantable steel screen called a stent may be left within the widened artery to help keep it from closing up in the future.

Treatment for Hemorrhagic Stroke

Treatment for hemorrhagic stroke is designed to allow the brain to heal safely and prevent further hemorrhage. This may involve using medications to reduce swelling of brain tissue and to control blood pressure. Occasionally, surgery is needed for removal of hematoma and to relieve intracranial pressure. If you have an aneurysm, it can be repaired either by clipping which requires open surgery or by coiling, a technique that eliminates the aneurysm from inside the vessel with the help of catheter arteriography. Your physician will discuss these options with you and your family as there are advantages and disadvantages to each. Also, a treatment plan for every case needs to be individualized. UCSF Medical Center is one of the premier institutions for treating patients with cerebral aneurysms and subarachnoid hemorrhage.

Reviewed by health care specialists at UCSF Medical Center.
Last updated January 31, 2008