Early treatment after a stroke

Early treatment after a stroke is vital, as the faster you can get treatment the more brain can be saved.

There is no medical treatment that will repair the brain damage from the stroke.

To minimise the damage caused by an ischaemic stroke, some people may be suitable for thrombolysis and endovascular clot retrieval.

Thrombolysis is the process where rt-PA is administered. rt-PA is a clot-busting drug that breaks down a blood clot. This allows blood flow to return to the brain.

Endovascular clot retrieval or intra-arterial thrombectomy is another treatment used to return blood flow to the brain, often in conjunction with thrombolysis. After the clot has been pinpointed by a brain scan, a tiny tube is fed into the blocked blood vessel, usually inserted through an artery in the leg and fed up through the body into the brain. A wire stent or suction device captures the blood clot and allows it to be pulled back out.

These procedures are not suitable in every case. This is because:

  • They can only be performed if you have had a stroke caused by a blood clot (ischaemic stroke). You need an urgent CT scan to check the type of stroke you have had (see early testing).
  • Thrombolysis and endovascular clot retrieval must be performed within a few hours after your stroke. The stroke team will decide whether you are likely to benefit from these procedures and will discuss this with you.
  • Although these procedures improve your recovery after stroke, they can also cause bleeding in the brain. Therefore, it can be risky for some people.
  • Thrombolysis and endovascular clot retrieval should be performed by a doctor who is trained in these techniques. Ideally they should be performed in a hospital with a stroke unit or an organised stroke service. Therefore these procedures are not performed at all hospitals.

Reducing the risk of stroke

There are other early treatments you might receive to help you recover. For example, aspirin should be taken in the first 48 hours after stroke by all who had a stroke due to a clot (ischaemic stroke). Aspirin may also be taken long term to prevent another stroke.

Your health professionals will work with you to ensure you make the best recovery possible. Everyone progresses differently in the first few days after a stroke.

Some people will make a good recovery quite early in their stroke, while other people may make slower progress. Some people will suffer complications after their stroke, however most people will survive and go on to make improvements in their function.

This next stage of recovery and improvement is known as stroke rehabilitation.