Stroke Treatment

When a Stroke Occurs: Rapid Stroke Treatment Can Save Lives

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: hemorrhagic or ischemic. 

An ischemic stroke occurs as a result of an obstruction within a blood vessel supplying blood to the brain. It accounts for 87 percent of all stroke cases. 

A hemorrhagic stroke occurs when a weakened blood vessel ruptures and spills blood into brain tissue. The most common cause for the rupture is uncontrolled hypertension (high blood pressure). There are two other types of weakened blood vessels that also cause hemorrhagic stroke: aneurysms and arteriovenous malformations (AVMs). Treatment differs depending on the type of stroke.

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 being deprived of blood flow. 

If administered within three hours (and up to 4.5 hours in certain eligible patients), 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; this is why it’s so important to identify a stroke immediately.

Endovascular Procedures

Another treatment option is an endovascular procedure in which specially trained doctors at Cooper University Hospital try removing the blood clot by sending a catheter to the site of the blocked blood vessel in the brain within an 8 hour window. 

Sometimes these procedures involve tPA being administered directly into the blood clot (called intra-arterial treatment) to help dissolve the blockage. In other procedures, the doctor may attempt to remove the clot using a combination of state of the art mechanical thrombectomy devices such as Trevo (Stryker), Solitaire (Covidien) and Penumbra Aspiration device. 

Hemorrhagic Stroke Treatment

Endovascular Procedures

Endovascular procedures may be used to treat certain hemorrhagic strokes similar to the way the procedure is used for treating an ischemic stroke. These procedures are less invasive than surgical treatments, and involve the use of a catheter introduced 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, to prevent rupture. Stents and balloon-assisted treatment can also be performed at Cooper University Hospital. For AVM treatment, liquid embolization with special glue or Onyx (covidien) material can be placed followed by radiosurgery or open vascular surgery.

Surgical Treatment

For strokes caused by a bleed within the brain (hemorrhagic stroke) or by an abnormal tangle of blood vessels (arteriovascular malformation or AVM), surgical treatment may be done to stop the bleeding. If the bleed is caused by a ruptured aneurysm (swelling of the vessel that breaks), a metal clip may be placed surgically at the base of the aneurysm to secure it.