Because their mechanisms are different, the treatments for the types of stroke are different:

• Ischemic stroke is treated by removing obstruction and restoring blood flow to the brain.
  
• In hemorrhagic stroke, doctors introduce an obstruction to prevent rupture and bleeding of aneurysms and arteriovenous malformations.

Ischemic Stroke

Acute Treatment

• Clot busters, e.g., tPA  
  The most promising treatment for ischemic stroke is the FDA-approved clot-busting drug tPA (tissue plasminogen activator), which must be administered within a three-hour window from the onset of symptoms to work best. Administering tPA or other clot-dissolving agents is complex and is done through an intravenous (IV) line in the arm by hospital personnel. If given promptly, tPA can significantly reduce the effects of stroke and reduce permanent disability. Generally, only 3 to 5 percent of those who suffer a stroke reach the hospital in time to be considered for this treatment.

Preventive Treatment

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  Anticoagulants/Antiplatelets
  Antiplatelet agents such as aspirin and anticoagulants such as warfarin interfere with the blood's ability to clot and can play an important role in preventing stroke. Read more about anticoagulants.   

• Carotid Endarterectomy 
  Carotid endarterectomy is a procedure in which blood vessel blockage is surgically removed from the carotid artery. View a detailed illustration of carotid endarterectomy.

• Angioplasty/Stents
  Doctors sometimes use balloon angioplasty and implantable steel screens called stents to treat cardiovascular disease and reduce fatty buildup clogging a vessel. View a detailed illustration of carotid stent.

Hemorrhagic Stroke (Subarachnoid hemorrhage or AVM)

• Surgical Intervention
  For hemorrhagic stroke (specifically for a subarachnoid hemorrhage), surgical treatment is often recommended to either place a metal clip at the base, called the neck, of the aneurysm or to remove the abnormal vessels comprising an arteriovenous malformation (AVM). Learn more about AVM.

• Endovascular Procedures, e.g., "coils"
  Endovascular procedures are less invasive and involve the use of a catheter introduced through a major artery in the leg or arm, guided to the aneurysm or AVM where it deposits a mechanical agent, such as a coil, to prevent rupture. Learn more about aneurysms. 

This content is reviewed regularly. Last updated 06/16/09.