An ischemic stroke occurs when a blood vessel in the brain becomes blocked. Treatment focuses on opening the blood vessel and restoring blood flow. The way we do this depends on how long it’s been since symptoms began. 

A medication called tissue plasminogen activator (tPA) can effectively dissolve a clot if given within three hours of a stroke. In some cases, we can administer this treatment up to four and a half hours after stroke onset. 

If you don’t get to the hospital in time to receive tPA, we may recommend minimally invasive neurointerventional surgery. With this treatment, an interventional neurosurgeon:

• Inserts a catheter (thin tube) into an artery in your wrist or groin to access the blood vessels in your brain.
• Passes tools through the catheter to open the artery. Examples include a suction tube or wire mesh device that traps the clot. Another technique is angioplasty with stenting. The surgeon inflates a balloon inside the artery to open it, then installs a mesh tube (stent) to keep it open.

Neurointerventional surgery is usually only an option within 24 hours of a stroke. After this timeframe, we focus on providing supportive treatments to ease symptoms.  

In a hemorrhagic stroke, a weak blood vessel in the brain bursts and bleeds. The most common causes of hemorrhagic stroke are: 

• Brain aneurysms 
• Arteriovenous malformations (AVMs) 

Strategies to stop the bleeding depend on the size and location of the hemorrhage and what caused it. Treatment may include: 

• Medications: Medications help lower blood pressure and speed up clotting, which reduces bleeding. We also give medications to relieve headaches, reduce swelling and prevent seizures.
• Neurointerventional surgery: This minimally invasive approach allows us to repair a damaged artery from the inside. It involves inserting a thin tube in an artery in the wrist or groin and guiding it to the brain. The surgeon uses materials such as glue, coils or a stent to stabilize the artery.
• Open surgery: We may perform open surgery to repair an aneurysm, remove an AVM or reduce pressure inside the skull.
• Radiation therapy (CyberKnife®): In this high-tech treatment, we aim precise beams of radiation at an AVM to shrink it.  

Treatment for a TIA focuses on preventing a future stroke through medications and lifestyle changes. In some cases, we may recommend a surgical procedure. At Memorial Neuroscience Institute, we work with you closely to safeguard your health.