What Are the Treatments for Stroke?

 Pretty useless! NOTHING ON 100% RECOVERY PROTOCOLS! The only goal in stroke! Since they don't mention them, I can only assume incompetency!

What Are the Treatments for Stroke?

Treatment begins at the first symptoms and depends on the type of stroke

---

By

Kimberly Goad,

 

AARP

Reviewed by

K. Michael Welch, M.D.

Published May 30, 2025 

Getty Images

• Facebook
• Twitter
• LinkedIn

If you or someone you love has had a stroke, you’ve probably heard: Time is brain. For every minute a stroke goes untreated, nearly 2 million brain cells die. “The impact of the damage from stroke on a person’s life cannot be overstated,” says Laura K. Stein, M.D., a vascular neurologist, stroke health services researcher and associate professor of neurology at the Icahn School of Medicine at Mount Sinai. “Every minute that goes by increases the chance of permanent brain damage and that a patient will not be able to do the things we take for granted every day,” such as getting dressed, eating, walking and talking.

Given the race against time, you might assume that the treatment options are few to none for the approximately 795,000 U.S. adults who have a stroke each year. Not so. Treatment following a stroke usually occurs in three stages: immediate medical or surgical care(NOT RECOVERY!) to minimize the extent of damage to the brain; treatment to prevent another stroke; and rehabilitation to manage the changes in ability.What is the best treatment for stroke?

Treatment options depend on the type of stroke: ischemic or hemorrhagic. An ischemic stroke, by far the more common of the two, occurs when blood flow to the brain is blocked or reduced. The blockage could come from a blood clot in an artery wall or an embolism, typically caused when a blood clot breaks off from another site and travels up into the brain, depriving the brain of oxygen and the nutrients it needs. A hemorrhagic stroke happens when a weakened blood vessel bursts in or on the surface of the brain, damaging brain cells as a result.

Independent of whether the stroke is ischemic or hemorrhagic, however, treatment for a stroke quite literally can’t begin soon enough. So it’s important to call 911 right away if you see any signs of a stroke, rather than try to drive yourself or have someone else drive you to the hospital. “Calling 911 is strongly recommended if you suspect a stroke, and one major reason is that EMTs [emergency medical technicians] can begin critical prehospital care(NOT RECOVERY!) immediately, which can make a big difference in outcomes,” says Jayne Zhang, M.D., attending physician of neurology at Johns Hopkins School of Medicine.

For instance, the EMT can monitor blood pressure, oxygen levels, heart rhythm and blood glucose (since low blood sugar can mimic stroke symptoms), assess symptoms using tools — like the Cincinnati Prehospital Stroke Scale, or what’s known as B.E.F.A.S.T. (short for “balance, eyes, face drooping, arm weakness, speech, time”) to quickly identify signs of stroke — and possibly begin treatment, Zhang says. If that’s not possible, “EMTs can alert the hospital stroke team before arrival so they’re ready with a stroke protocol, shaving off critical minutes.”

Treatments for ischemic stroke

The goal of treatment for an ischemic stroke is to restore blood flow to the brain. To that end, doctors will typically use one of two methods to remove the blockage: medication to dissolve it or surgery to remove it. Much of their decision comes down to how quickly you get to the hospital.

Typically, if you arrive within 4½ hours from the onset of stroke symptoms, the team will evaluate you as a candidate for a type of clot-busting drug called tPA (short for “tissue plasminogen activator”). There are two forms of tPA, and both are given through an IV in the arm, but tenecteplase is administered as a quick IV injection, while alteplase is given intravenously over the course of an hour. Research shows both are equally effective.

Most Popular

ARTICLE CONTINUES AFTER ADVERTISEMENT

If you get to the hospital outside that 4½-hour window, or if doctors determine you aren’t a good candidate for one of the clot-busting drugs (the main side effect of these meds is bleeding), you may be given a blood-thinning medication to keep blood clots from getting larger or stop new ones from forming.

Depending on your medical history and the size and location of the blood clot, you may qualify for a mechanical thrombectomy, a procedure that involves threading a catheter through an artery in the groin up to the blocked artery to grab the clot and retrieve it. “This procedure can be performed up to 24 hours after symptom onset for patients with blockages in major brain blood vessels,” says Deepak Gulati, M.D., a vascular neurologist who specializes in stroke care(NOT RECOVERY!) at The Ohio State University.Both treatments have dramatically changed what it means for people who’ve had an ischemic stroke. A 2023 report in the journal Stroke suggests that treatment with a tPA results in a greater chance of positive outcomes compared to supportive medical therapy alone, and that treatment with mechanical thrombectomy results in a 20 to 27 percent improvement in regaining independence following stroke.

“When we give clot-busting medications or pull out a clot in the brain of someone having an ischemic, or clotting, stroke, we’re trying to rapidly restore blood flow to the brain cells and minimize the damage,” says Stein. “We’re trying to prevent the cells at risk of dying from fully dying.”

Treatments for hemorrhagic stroke

A stroke that causes the brain to hemorrhage, or bleed, is more difficult to treat and has a poorer prognosis than an ischemic stroke. About half of adults who experience a hemorrhagic stroke die within weeks. Those who survive may never recover to their prestroke selves.

Treatment is aimed at controlling the bleeding and reducing pressure in the brain caused by the buildup of fluid. How doctors go about doing that depends on the part of the brain that’s bleeding and how much. But as with ischemic stroke, getting treatment as quickly as possible is key to a full recovery. The first 24 to 48 hours following a hemorrhagic stroke are crucial for stabilizing the patient. Blood pressure is aggressively managed to minimize further bleeding, and oxygen levels and heart rate are monitored to prevent further brain damage, says Gulati. “Depending on the severity, treatment may involve medications or, in severe cases, surgery [such as a craniotomy to open the skull] to relieve pressure or repair a ruptured blood vessel.”

The patient’s overall health also plays a role in determining the stroke treatment — no matter which type of stroke . “Conditions such as high blood pressure, diabetes and high cholesterol are major stroke risk factors and can influence treatment options,” Gulati says. Heart diseases, including atrial fibrillation, are factors that can also influence management. “The preexisting use of blood thinners or other medications can complicate treatment, especially in hemorrhagic strokes, where bleeding is a concern,” he adds.

Rehab and recovery from a stroke

Neuroplasticity is the brain’s ability to change and adapt. “This remarkable ability allows healthy brain cells to reorganize and take on functions of the damaged areas, paving the way for recovery,” Gulati says.

That’s where rehab comes in.(But where are the 100% recovery protocols? Are you even working on them?

You'll want recovery when you are the 1 in 4 per WHO that has a stroke)

“Rehabilitation therapies play a critical role in activating neuroplasticity, helping individuals reclaim lost skills and improve their quality of life,” says Gulati. “Researchers are also investigating innovative approaches, such as neuroprotective drugs and advanced techniques, to promote brain healing. Although these developments are still in progress, they hold promise for transforming stroke recovery in the future. Early treatment and dedicated rehabilitation remain key to overcoming the impact of stroke.”

It may seem separate from treatment, but rehab is as critical to your recovery as any medication or procedure. A review of studies published in 2024 in the Journal of Clinical Medicine shows just how important early rehab is for patients who’ve had the most common type of hemorrhagic stroke — what’s known as an intracerebral stroke, or bleeding within the brain. Not only does early rehab improve the odds of recovery (the 30-day mortality rate for an intracerebral stroke is 34 to 50 percent), but waiting can also raise your risk of permanent disability or death.

No matter the type of stroke, rehab begins in the hospital, often as soon as the next day, and can last for months or years, depending on the severity of the stroke and the area of the brain that’s been affected. “There isn’t a single patient who can’t benefit from rehab,” Stein says. “This is the ultimate interdisciplinary team effort, with physical therapists, occupational therapists, speech therapists and cognitive therapists. The importance of this interdisciplinary team cannot be overstated.”

The multipronged approach includes some combination of:

• Occupational therapy to relearn the activities of daily life, such as dressing, cooking, bathing.
• Speech therapy to help with swallowing and regaining the ability to speak, or developing new ways of communicating if speaking is difficult.
• Psychotherapy to help with depression or anxiety post-stroke.
• Physical therapy to regain strength, balance and walking ability. “I tell my patients that exercise is the only wonder drug we have,” says Stein. In one study, published in 2021 in Cerebrovascular Diseases, stroke survivors who did a mix of aerobic activity, like brisk walking and strength training, had significantly better health outcomes two years after their stroke than the non-exercisers.  

“Intensive rehabilitation — as well as, hopefully in the future, new neuromodulation techniques can help the brain adapt and develop new ways of doing everyday things made difficult by the damage from a stroke,” adds Stein.

Kimberly Goad is a New York-based journalist who has covered health for some of the nation’s top consumer publications. Her work has appeared in Women’s Health, Prevention, Health and Reader's Digest.

K. Michael Welch, M.D., is a vascular neurologist and oversaw the first study establishing the effectiveness of the clot-busting drug tPA for acute ischemic stroke. He was the principal investigator of the SPARCL (Stroke Prevention by Aggressive Reduction in Cholesterol Levels) trial, which established the importance of statins in secondary stroke prevention. At retirement in 2018, Dr. Welch was president and CEO of Rosalind Franklin University in North Chicago, Illinois.