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Stroke Treatment Options
Early treatment can help reduce brain damage caused by a stroke. In cases of acute ischemic stroke, aspirin, warfarin and other blood thinners, such as heparin, help to treat blood clots.
Tissue plasminogen activator or tPA - is another important tool used to treat acute ischemic stroke. tPA is a genetically engineered protein that works as a “clot buster”. tPA is delivered intravenously to patients who reach the emergency room within 3 hours of the onset of stroke symptoms and are determined to be suitable candidates. This is why it is important to seek immediate emergency medical attention when signs and symptoms of a stroke occur. tPA can dissolve clots and restore blood flow to brain tissue before a blockage results in damage or death of the surrounding tissue. When tPA dissolves a clot, some or all of the brain may be rescued and reduce the amount of disability that results from the stroke.
tPA Therapy Considerations
- There is a 3-hour "onset-to-treatment" window
- tPA only dissolves the clot about half of the time
- Only a small percentage (about 2 % to 6 %) of all stroke patients meet the criteria to receive tPA therapy
- the risk for a hemorrhage or bleeding in the brain increases as tPA is administered
- tPA has a strong thinning reaction that takes place in the blood and can also increase the chances of bleeding somewhere else in the body
Facts on Thrombolytic Therapy
- 31% - 50% of the patients treated with tPA have favorable outcomes defined as complete or nearly complete neurological recovery 3 months after a stroke.
- 20% - 38% of patients not treated with tPA have favorable outcomes 3 months after a stroke.
- Death rates of stroke patients who receive tPA are approximately the same as those patients who do not.
- In a recent study, 6% of patients who received tPA therapy had bleeding in the brain and 5% had bleeding somewhere else in the body.
The decision to receive tPA is a difficult one that can be made with your attending physician only after patients and their family members understand all of the benefits and risks of therapy.
After hemorrhagic stroke, surgery is often necessary to remove blood from around the brain and repair damaged blood vessels. To repair clogged arteries, radiologists sometimes use angiography to define clogged blood vessels and open them up for repair. Surgery is also sometimes necessary to repair the carotid artery in the neck.