When strokes occur, quick treatment can save lives
We offer an integrated and coordinated approach for the treatment of stroke. From the emergency room through discharge, highly trained stroke nurses work with a multidisciplinary team to design an individualized plan of care and are able to answer questions and keep patients and their families informed.
Endovascular and neurovascular surgeries can help save lives, and our neurovascular surgeons have experience in pediatric procedures and minimally-invasive techniques to treat aneurysms, strokes and other vascular injuries.
If you’re having a stroke, it’s critical that you get medical attention right away. Immediate treatment may minimize the long-term effects of a stroke and prevent death.
There are two types of strokes: ischemic or hemorrhagic. An ischemic stroke occurs as a result of an obstruction within a blood vessel supplying blood to the brain and accounts for 87% of strokes. A hemorrhagic stroke occurs when a weakened blood vessel ruptures and blood enters the brain tissue. The most common cause of this stroke is high blood pressure.
There are two other types of weakened blood vessels that also cause hemorrhagic stroke: aneurysms and arteriovenous malformations (AVMs), and treatment differs between the two.
Ischemic stroke treatment
- tPA, The gold standard
The only FDA-approved treatment for ischemic strokes is tissue plasminogen activator (tPA, also known as IV rtPA, given through an IV in the arm). tPA works by dissolving the clot and improving blood flow to the part of the brain that needs it. If administered within 3–4.5 hours, tPA may improve the chances of recovering from a stroke. A significant number of stroke victims don’t get to the hospital in time for tPA treatment, which is why it’s so important to identify a stroke immediately.
- Endovascular procedures*
Also called mechanical thrombectomy, this procedure involves inserting a wired-caged device, called a stent retriever, to the site of the blocked blood vessel through an artery in the groin. The stent opens and grabs the clot, allowing doctors to remove the stent with the trapped clot. It’s typically complete within six hours.
*Note: Patients must meet certain criteria to be eligible for this procedure
Hemorrhagic stroke treatment
- Endovascular procedures
Used to treat certain hemorrhagic strokes, these procedures involve the use of a catheter through a major artery in the leg or arm, then guided to the aneurysm or AVM. It then deposits a mechanical agent, such as a coil or liquid embolic agent, to prevent further rupture.
- Surgical treatment
For strokes caused by a bleed within the brain (hemorrhagic stroke), or by an abnormal tangle of blood vessels (AVM), surgical treatment may be done to stop the bleeding. If it’s caused by a ruptured aneurysm, a metal clip may be placed surgically at the base of the aneurysm to secure it.
Various clinical factors will be used to determine which of these treatments is best for each patient.
Possible Stroke Treatment
- What is Alteplase-Activase®?
Alteplase-Activase® is a medication that dissolves blood clots and is an intravenous or IV medication usually given through a catheter in the arm.
- What type of Stroke is Alteplase-Activase® used for?
It’s approved by the FDA to treat ischemic strokes within within 4.5 hours. Alteplase-Activase® is given to help dissolve the clot quickly and restore the blood flow to the brain tissue. A CT scan or MRI of the head is done to confirm there is no bleeding in the brain before Alteplase-Activase® is given.
- When is Alteplase-Activase® used?
Alteplase-Activase® has been approved to treat brain attacks in the 3–4.5 hours following the onset of symptoms. If given promptly, 1/3 of patients resolve their symptoms or have major improvement in their stroke symptoms after 90 days.
- What are the risks of Alteplase-Activase®?
Bleeding in the brain or in other parts of the body is the most common risk that can occur. In 6/100 patients, bleeding may occur in the brain and cause further injury. For 1/6 of those patients, it may cause death or long-term, serious disability. Advanced age and more severe stroke symptoms are associated with an increased risk of bleeding.
- Should everyone receive Alteplase-Activase® therapy?
No. People who cannot be treated within 4.5 hours of their first symptom, patients with certain medical conditions, and patients with certain types of strokes do not qualify for this time-sensitive treatment.
Inform your physician if you have had any of the following:
- Recent heart attack
- Serious head trauma within the last three months
- Bleeding from the stomach or urinary tract within the last 21 days
- Major surgery within previous 14 days
- Bleeding disorders
- Use of blood thinners, such as warfarin
- Uncontrolled high blood pressure
Adapted from OS St Francis Medical Center, Form No 966-0041
AHA Guidelines for the Early Management of Patients with Ischemic Stroke, 2005
Early Treatment Confirmed as Key to Stroke Recovery. The Lancet, March 2004;363:768-774.
Saver, J. Hemorrhage After Thrombolytic Therapy for Stroke. 2007;38:2279-2283
Demaerschalk, B. Thrombolytic Therapy for Acute Ischemic Stroke, The Likelihood of Begin Helped Versus Harmed. ETC> Stroke. 2007;38:2215-2216