An ischemic stroke is a serious life-threatening condition that requires emergency medical attention. The sooner a person gets treatment, the less damage to the brain will occur. People with ischemic strokes are often given aspirin or anticoagulants to help increase blood flow in the brain. Another drug, tissue plasminogen activator (TPA), is also quite effective. TPA helps to dissolve blood clots to improve blood flow. In some cases, doctors may perform surgery to help remove blockages from an artery, too.
Ischemic Stroke Treatment
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Dr. Steven A. Meyers, MD , Diagnostic Radiology, answered on behalf of NorthShore University HealthSystemSee All 2 AnswersStroke revascularization means restoring blood flow to an area of the brain. During a stroke blood flow is blocked and revascularization is the process of correcting this. This is a relatively new type of treatment and may be accomplished through the use of clot busting medications or a variety of surgical techniques. These techniques work best only if used very soon after a stroke begins. -
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Discovery Health answeredWhen treating an ischemic stroke, doctors seek to break up blood clots and restore blood flow. The only drug the Federal Drug Administration has approved for this purpose is known as tissue plasminogen activator or tPA (it is also known as Activase). The drug dissolves clots with the goal of restoring blood flow and minimizing damage to the brain. However, only one in five stroke victims who would benefit from the drug receives it. That is because there is only a three-hour window in which the drug has shown to be effective and most patients do not make it in time. This reinforces the fact that every minute counts when stroke symptoms begin.
Doctors also can be hesitant to administer tPA. Testing of the drug has shown that about 6 percent of patients experienced excessive bleeding in the brain, and after three hours the risk of excessive bleeding increased.
This can be particularly problematic for a patient suffering a hemorrhagic stroke, in which case tPA would only compound the bleeding in the brain.
The decision to administer tPA has been complicated even further in recent years as doctors have learned more about microbleeds, which are tiny drops of blood on the brain, that have leaked from blood vessels.
Experts have estimated that microbleeds may be present in as many as one in five people over age 60. Administered the drug tPA or another anticlotting drug could result in a hemorrhagic stroke, which is what happened in 2005 to Israeli prime minister Ariel Sharon.
Other treatments used for an ischemic stroke include making sure the patient's blood pressure is not so high that it damages the organs and not so low that it slows blood flow to the brain. Doctors also work to reduce any sign of a fever, which also can increase the chance of brain damage.If the stroke was caused by atrial fibrillation, anticoagulants may eventually be introduced, as well as drugs that help the heart's function.