Stroke

Your doctor will create a stroke treatment plan for you that will vary based on many factors, including the type of stroke, when and where it occurred, its severity, and your overall health and medical history.

Ischemic stroke treatment

To treat an ischemic stroke, a doctor will attempt to restore blood flow to the brain as quickly as possible by alleviating the blockage in your blood vessel. Methods that may be used include:

• IV medications: Medicines that can dissolve a blood clot and restore blood flow to the brain can improve your chances of surviving a stroke and decrease your risk of complications. These drugs, called tissue plasminogen activators (tPA), are administered through an IV and must be given within 4.5 hours of the stroke to be effective.
• Emergency endovascular procedures: Endovascular treatment is used for ischemic strokes that do not resolve with tPA, or in patients for whom tPA is no longer a treatment option. A doctor can use "mechanical clot extraction," inserting a special device through a flexible tube to remove the clot and restore blood flow.
• Carotid endarterectomy: This procedure removes a buildup of plaque inside the carotid artery (the artery running along the neck that supplies blood to the brain)
• Angioplasty and stents: During this procedure, your physician will thread a catheter into the carotid artery and inflate a balloon to widen the narrowed blood vessel. They will then insert a stent to support the newly widened artery.

Hemorrhagic stroke treatment

Treating hemorrhagic stroke revolves around reducing excess blood in the brain, along with relieving pressure in the brain caused by the extra fluid. Treatment methods include:

• Drug therapies: To enhance healing and recovery for patients with hemorrhagic stroke, your care team will work to control high blood pressure, normalize blood clotting, control brain swelling, enhance the flow of oxygen-rich blood to brain tissue near the injury, and regulate brain temperature to normal or below-normal levels to protect brain tissue with various types of medicines
• Traditional surgery: For patients with large brain hemorrhages, a doctor will perform surgery to relieve pressure in the skull caused by bleeding. If the stroke resulted from a weakened area in a blood vessel wall (an aneurysm) or a defective blood vessel, the surgeon will repair these areas to prevent further strokes. They may also be able to redirect blood flow to other vessels that supply blood to the same region of the brain.
• Surgical clipping: A doctor may place a surgical clamp at the site of the hemorrhage to stop the bleeding
• Coiling (endovascular embolization): A physician threads a catheter to the brain through the groin and places several small coils at the site of an aneurysm that caused the stroke. This can block blood flow and encourage blood clotting at the site of the hemorrhage.
• Surgical AVM removal: If your stroke was caused by an arteriovenous malformation (AVM), your doctor may choose to remove it surgically if it is in an accessible part of the brain. This will lower the risk of hemorrhagic stroke and eliminate the possibility of rupture.

Rehabilitation

The Center for Stroke Rehabilitation at NewYork-Presbyterian Hospital is devoted to providing advanced stroke rehabilitation and developing innovative, effective treatments for stroke survivors. We are committed to providing state-of-the-art treatments that are not widely available at other centers in the New York metropolitan area, and creating and assessing new treatments to improve the lives of people living with the effects of stroke. We believe that introducing a rehabilitation plan as early as possible offers patients the best chance at a successful recovery.

Our multidisciplinary rehabilitation team includes physical therapists, occupational therapists, speech therapists, recreational therapists, and physicians who are fellowship-trained in neurological rehabilitation. Rehabilitation goals may include regaining lost function, building strength and endurance, and improving communication in patients who have lost some ability to speak and gesture.

Rehabilitation is offered on both an inpatient and an outpatient basis, depending on each patient's diagnosis and personal needs, which may require physical therapy, speech therapy, occupational therapy, or other approaches.