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Management can be divided into emergency treatment and the prevention of recurrences. It is critical to seek medical attention as fast as possible. A stroke is a brain attack and this type of stroke is one in which rapid medical attention can be the difference between life and death or between mild and severe disability.
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When the patient arrives at the hospital within 3 hours after the onset of symptoms, the use of a medication called t-PA may be considered. This medication, known as a clot-buster, is given intravenously (injected into the veins), and has been shown to improve the chances of a meaningful recovery.
Unfortunately, t-PA is a potentially dangerous drug because it can cause bleeding in the brain. Since it can be hard to tell whether a stroke has been caused by a clot or by bleeding, and since giving this medication in the case of a stroke caused by bleeding could be fatal, careful evaluation must be done. Physicians must order several tests and do careful physical examinations to make sure that t-PA is the right treatment.
In some cases, physicians may deliver the clot-buster using a small catheter inserted through the skin, which is then advanced to the blocked area of the brain circulation with the aid of x-ray angiography.
This may be tried when the patient arrives too late for the 3-hour window required for the intravenous t-PA. It is unclear at this time, however, if this is better than using other treatments.
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