What treatments are available? Patsy Westcott Find out the ways in which a stroke is diagnosed and the treatment options available to help aid the recovery of sufferers

In this article

Diagnosing stroke

Treatment

Rehabilitation

Although between 20 and 40 per cent of people who have had strokes are treated at home, research has now conclusively proved that organised stroke care in a dedicated stroke unit saves lives and reduces disability.

A number of tests may be performed to pinpoint the type of stroke and help the professionals decide on the most appropriate treatment. They may include:

• Blood pressure measurement
• Blood sampling
• X-rays
• Electrocardiogram (ECG) to assess the heart's rhythm
• Echocardiogram, to look at the heart's structure and ability to function
• Brain scans, such as magnetic resonance imaging (MRI) and computed tomography (CT), to check the kind of stroke and view the extent of damage
• Carotid ultrasound scanning or transcranial doppler ultrasonography (a type of ultrasound scan) to assess blood flow to the brain

Drug treatments are designed to tackle the effects of stroke, prevent complications and help treat risk factors in the hope of preventing a further stroke occurring. There are hundreds of drugs that may be used. They may include:

• Anti-platelet drugs (such as aspirin), which make the blood less sticky and help reduce its tendency to clot (always consult your GP)
• Clot-dissolving drugs, if appropriate
• Anti-coagulant drugs, which reduce clotting factors in the blood so it's less likely to clot
• Cholesterol-lowering drugs to reduce high cholesterol levels
• Anti-hypertensive drugs that lower blood pressure
• Drugs designed to limit the extent of damage to the brain tissue

Surgery

Some people who've had a transient ischaemic attack (TIA) or stroke caused by severe narrowing of the carotid artery in the neck may benefit from an operation called carotid endartectomy to remove the narrowing, or insertion of a stent (a short stainless steel mesh tube) into the artery to help keep the artery open. This may significantly reduce the risk of having a full-blown or another stroke.

Of people who survive a stroke, around half will be left with significant disability.

However, the brain is remarkably adaptable and in the months or years after a stroke many cells that have sustained damage recover some of their function. At the same time, other areas of the brain take over the functions performed by the cells that have died.

The time it takes to recover is extremely variable. Commonly, people have a surge of recovery in the weeks after a stroke, followed by a slower recovery over the next year to 18 months.

The aim of rehabilitation is to encourage and enhance this process. It may include:

• Help to aid physical recovery
• Assistance in managing the physical, emotional and social effects of stroke
• Aids and encouragement to let you become as independent as possible
• Medical help to prevent potential medical or psychological complications

The process of rehabilitation may include physiotherapy, speech and language therapy, occupational therapy and psychological help. It may involve a number of different experts and should begin in a specialised stroke unit, in hospital or at home.

Starting rehabilitation as early as possible can substantially improve recovery and reduce the effects of disability. The charity Connect offers counselling and support for those living with stroke and aphasia.

This article was last medically reviewed by Dr Rob Hicks in July 2007.
First published in January 2000.