Your stroke treatment begins the moment emergency medical services (EMS) arrives to take you to the hospital. Once at the hospital, you may receive emergency care, treatment to prevent another stroke, rehabilitation to treat the side effects of stroke, or all three.
On the way to the hospital
If someone you know shows signs of stroke, call 9-1-1 right away.
Do not drive to the hospital or let someone else drive you. The key to stroke treatment and recovery is getting to the hospital quickly. Yet one in three stroke patients never calls 9-1-1. Calling an ambulance means that medical staff can begin life-saving treatment on the way to the emergency room.
Stroke patients who are taken to the hospital in an ambulance may get diagnosed and treated more quickly than people who do not arrive in an ambulance. This is because emergency treatment starts on the way to the hospital. The emergency workers may take you to a specialized stroke center to ensure that you receive the quickest possible diagnosis and treatment. The emergency workers will also collect valuable information that guides treatment and alert hospital medical staff before you arrive at the emergency room, giving them time to prepare.
What happens at the hospital
At the hospital, health professionals will ask about your medical history and about the time your symptoms started. Brain scans will show what type of stroke you had. You may also work with a neurologist who treats brain disorders, a neurosurgeon that performs surgery on the brain, or a specialist in another area of medicine.
If you get to the hospital within three hours of the first symptoms of an ischemic stroke, you may get a type of medicine called a thrombolytic (a "clot-busting" drug) to break up blood clots. Tissue plasminogen activator (tPA) is a thrombolytic.
tPA improves the chances of recovering from a stroke. Studies show that patients with ischemic strokes who receive tPA are more likely to recover fully or have less disability than patients who do not receive the drug. Patients treated with tPA are also less likely to need long-term care in a nursing home. Unfortunately, many stroke victims don't get to the hospital in time for tPA treatment. This is why it's so important to recognize the signs and symptoms of stroke right away and call 9-1-1.
Medicine, surgery, or other procedures may be needed to stop the bleeding and save brain tissue. For example:
- Endovascular procedures: Endovascular procedures may be used to treat certain hemorrhagic strokes. The doctor inserts a long tube through a major artery in the leg or arm and then guides the tube to the site of the weak spot or break in a blood vessel. The tube is then used to install a device, such as a coil, to repair the damage or prevent bleeding.
- Surgical treatment: Hemorrhagic strokes may be treated with surgery. If the bleeding is caused by a ruptured aneurysm, a metal clip may be put in place to stop the blood loss.
What happens next
If you had a stroke, you are at a high risk for another stroke:
- One of four stroke survivors has another stroke within five years.
- The risk of stroke within 90 days of TIA may be as high as 17%, with the greatest risk during the first week.
That's why it's important to treat the underlying causes of stroke, including heart disease, high blood pressure, atrial fibrillation (fast irregular heartbeat), high cholesterol, and diabetes. Your doctor may give you medications or tell you to change your diet, exercise, or adopt other healthy lifestyle habits. Surgery may also be helpful in some cases.
After a stroke, you may need rehabilitation (rehab) to help you recover. Before you are discharged from the hospital, social workers can help you find a care services and caregiver support to continue your long-term recovery. It is important to work with your health care team to find out the reasons for your stroke and take steps to prevent another stroke.
- Ekundayo OJ, Saver JL, Fonarow GC, Schwamm LH, Xian Y, Zhao X, et al. Patterns of emergency medical services use and its association with timely stroke treatment: findings from Get With the Guidelines-Stroke. Circulation: Cardiovascular Quality and Outcomes. 2013;6:262-269.
- National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. Tissue plasminogen activator for acute ischemic stroke. N Engl J Med 1995;333(24):1581–7.
- Marler JR, Tilley BC, Lu M, Brott TG, Lyden PC, Grotta JC, et al. Early stroke treatment associated with better stroke outcome: the NINDS rt-PA stroke study. Neurology 2000;55(11):1649–55.
- National Institute of Neurological Disorders and Stroke. (2009). Stroke: challenges, progress, and promise. Bethesda, MD: National Institutes of Health.
- American Heart Association (AHA), Heart Disease and Stroke Statistics – 2010 Update. http://circ.ahajournals.org/content/121/7/e46#sec-23.
- Lambert M. Practice Guidelines: AHA/ASA guidelines on prevention of recurrent stroke. Am Fam Physician 2011;83(8):993–1001.
Content last updated on November 14, 2019