Thrombolytics, such as tPA, may be given if the stroke is caused by a blood clot. Such medicine breaks up blood clots and helps restore blood flow to the damaged area.
Persons who receive thrombolytics are less likely to have long-term stroke-related problems. However, not everyone can receive this type of medicine. The most important rule is that the person be examined and treated by a specialized stroke team within 3 hours of when the symptoms start. If the stroke is caused by bleeding rather than clotting, thrombolytics can make the damage worse -- so care is needed to diagnose the cause before giving treatment.
The decision to give the drug is based upon:
- A brain CT scan to make sure there is no bleeding
- A physical exam that shows a significant stroke
- Your medical history
Thrombolytics are not given to someone who is having a hemorrhagic stroke . They could worsen the stroke by causing increased bleeding.
A thrombus is a blood clot that forms in a vessel and remains there. An embolism is a clot that travels from the site where it formed to another location in the body. Thrombi or emboli can lodge in a blood vessel and block the flow of blood in that location depriving tissues of normal blood flow and oxygen. This can result in damage, destruction (infarction), or even death of the tissues (necrosis) in that area.
In other circumstances, blood thinners such as heparin and Coumadin are used to treat strokes due to blood clots. Aspirin may also be used.
Other medications may be needed to control other symptoms, including high blood pressure. Painkillers may be given to control severe headache.
In some situations, a special stroke team and skilled radiologists may be able to use angiography to highlight the clogged blood vessel and open it up.
Nutrients and fluids may be necessary, especially if the person has swallowing difficulties. These may be given through a vein ( intravenously ) or a feeding tube in the stomach (gastrostomy tube ). Swallowing difficulties may be temporary or permanent.