Effective treatment of stroke can prevent long-term disability and save lives. The specific treatments recommended depend on whether a stroke is caused by:

• a blood clot blocking the flow of blood to the brain (ischaemic stroke)
• bleeding in or around the brain (haemorrhagic stroke)

Treatment usually involves taking 1 or more different medicines, although some people may also need surgery.

Treating ischaemic strokes

If you have had an ischaemic stroke, a combination of medicines to treat the condition and prevent it happening again is usually recommended.

Some of these medicines need to be taken immediately and only for a short time, while others may only be started once the stroke has been treated and may need to be taken long term.

Thrombolysis – "clot buster" medicine

Ischaemic strokes can often be treated using injections of a medicine called alteplase, which dissolves blood clots and restores blood flow to the brain. This use of "clot-busting" medicine is known as thrombolysis.

Thrombectomy

A small number of severe ischaemic strokes can be treated by an emergency procedure called a thrombectomy. This removes blood clots and helps restore blood flow to the brain. Thrombectomy is only effective at treating ischaemic strokes caused by a blood clot in a large artery in the brain.

Aspirin and other antiplatelets

Most people will be offered a regular dose of aspirin. As well as being a painkiller, aspirin is an antiplatelet, which reduces the chances of another clot forming. Other antiplatelet medicines may be used, such as clopidogrel and dipyridamole.

Anticoagulants

Some people may be offered an anticoagulant to help reduce their risk of developing new blood clots in the future. Anticoagulants prevent blood clots by changing the chemical composition of the blood in a way that prevents clots from forming. Warfarin, apixaban, dabigatran, edoxaban and rivaroxaban are examples of anticoagulants for long-term use.

Treating haemorrhagic strokes

As with ischaemic strokes, some people who have had a haemorrhagic stroke will also be offered medicine to lower their blood pressure and prevent further strokes.

If you were taking anticoagulants before you had your stroke, you may also need treatment to reverse the effects of the medicine and reduce your risk of further bleeding.

Surgery

Occasionally, emergency surgery may be needed to remove any blood from the brain and repair any burst blood vessels. This is usually done using a surgical procedure known as a craniotomy.

The surgeon will repair any damaged blood vessels and ensure there are no blood clots present that may restrict the blood flow to the brain.

Supportive treatments

You may need further short-term treatment to help manage some of the problems that can affect people who have had a stroke.

For example, you may require:

• a feeding tube inserted into your stomach through your nose (nasogastric tube) to provide nutrition if you have difficulty swallowing (dysphagia)
• nutritional supplements if you're malnourished
• fluids given directly into a vein (intravenously) if you're at risk of dehydration
• oxygen through a nasal tube or face mask if you have low levels of oxygen in your blood
• compression stockings to prevent blood clots in the legs (DVT)