Stroke prevention, treatment and rehabilitation
Emergency Treatment for a Stroke
At the hospital, health care providers will ask about your medical history and about the time your symptoms started. Brain scans will show what type of stroke you had. You may also work with a neurologist who treats brain disorders, a neurosurgeon that performs surgery on the brain, or a specialist in another area of medicine.
If you get to the hospital within 3 hours of the first symptoms of an ischemic stroke, a health care provider may give you a type of medicine called a thrombolytic (a “clot-busting” drug) to break up blood clots. Tissue plasminogen activator (tPA) is a thrombolytic.
tPA improves the chances of recovering from a stroke. Studies have shown that patients with ischemic strokes who received tPA are more likely to recover fully or have less disability than patients who do not receive the drug.1,2 In addition, patients treated with tPA are less likely to need long-term care in a nursing home.3 Unfortunately, many stroke victims don’t get to the hospital in time for tPA treatment. This is why it’s so important to identify a stroke immediately.
Medicine, surgery, or other procedures may be needed to stop the bleeding and save brain tissue. For example:
- Endovascular procedures. Endovascular procedures may be used to treat certain hemorrhagic strokes. These procedures are less invasive and less dangerous for the patient than surgical treatments. The doctor inserts a long tube through a major artery in the leg or arm and then guides the tube to the site of the weak spot or break in a blood vessel. The tube is then used to install a device, such as a coil, to repair the damage or prevent bleeding.4
- Surgical treatment. Hemorrhagic strokes may be treated with surgery. If the bleeding is caused by a ruptured aneurysm, a metal clip may be put in place to stop the blood loss.4
Recovery time after a stroke varies—it can take weeks, months, or even years. Some people recover fully, but others have long-term or lifelong disabilities. If you have had a stroke, you can make great progress in regaining your independence. However, some problems may continue:
- Paralysis (inability to move some parts of the body), weakness, or both on one side of the body.
- Trouble with thinking, awareness, attention, learning, judgment, and memory.
- Problems understanding or forming speech.
- Trouble controlling or expressing emotions.
- Numbness or strange sensations.
- Pain in the hands and feet that worsens with movement and temperature changes.
- Trouble with chewing and swallowing.
- Problems with bladder and bowel control.
After a stroke, you may need rehabilitation (rehab) to help you recover. Rehab can include working with speech, physical, and occupational therapists:
- Speech therapy helps people who have problems producing or understanding speech.
- Physical therapy uses exercises to help you relearn movement and coordination skills you may have lost because of the stroke.
- Occupational therapy focuses on improving daily activities, such as eating, drinking, dressing, bathing, reading, and writing.
Therapy and medications may help with depression or other mental health conditions following a stroke. Joining a patient support group may help you adjust to life after a stroke. Talk with your health care team about local support groups, or check with an area medical center.
Support from family and friends can also help relieve fear and anxiety following a stroke. Let your loved ones know how you feel and what they can do to help you.
If you have had a stroke you are at high risk for another stroke:
- 1 of 4 stroke survivors has another stroke within 5 years.5
- The risk of stroke within 90 days of a TIA may be as high as 17%, with the greatest risk during the first week.6
Prevention First-Make those healthy lifestyle choices that could prevent a stroke.
You can help prevent stroke by making healthy lifestyle choices. A healthy lifestyle includes the following:
- Eating a healthy diet.
- Maintaining a healthy weight.
- Getting enough exercise.
- Not smoking.
- Limiting alcohol use.
Choosing healthy meal and snack options can help you avoid stroke and its complications. Be sure to eat plenty of fresh fruits and vegetables.
Eating foods low in saturated fats, trans fat, and cholesterol and high in fiber can help prevent high cholesterol. Limiting salt (sodium) in your diet also can lower your blood pressure.
For more information on healthy diet and nutrition, see CDC’s Nutrition, Physical Activity, and Obesity Program Web site.
Being overweight or obese increases your risk for stroke. To determine whether your weight is in a healthy range, doctors often calculate your body mass index (BMI). If you know your weight and height, you can calculate your BMI at CDC’s Assessing Your Weight Web site. Doctors sometimes also use waist and hip measurements to measure excess body fat.
Physical activity can help you maintain a healthy weight and lower your cholesterol and blood pressure levels. For adults, the Surgeon General recommends 2 hours and 30 minutes of moderate-intensity exercise, like brisk walking or bicycling, every week. Children and adolescents should get 1 hour of physical activity every day.
For more information, see CDC’s Division of Nutrition, Physical Activity, and Obesity Web site.
Cigarette smoking greatly increases your risk for stroke. If you don’t smoke, don’t start. If you do smoke, quitting will lower your risk for stroke. Your doctor can suggest ways to help you quit.
For more information about tobacco use and quitting, see CDC’s Smoking & Tobacco Use Web site.
Avoid drinking too much alcohol, which can raise your blood pressure. Men should have no more than 2 drinks per day, and women only 1. For more information, visit CDC’s Alcohol and Public Health Web site.
If you have heart disease, high cholesterol, high blood pressure, or diabetes you can take steps to lower your risk for stroke.
Your health care provider should test your cholesterol levels at least once every 5 years. Talk with your health care team about this simple blood test. If you have high cholesterol, medications and lifestyle changes can help reduce your risk for stroke.
Control Blood Pressure
High blood pressure usually has no symptoms, so be sure to have it checked on a regular basis. Talk to your health care team about how often you should check your levels. You can check your blood pressure at home, at a doctor’s office, or at a pharmacy.
If you have high blood pressure, your doctor might prescribe medication, recommend some changes in your lifestyle, or advise you to lower the levels of salt in your diet.
If your health care provider thinks you have symptoms of diabetes, he or she may recommend that you get tested. If you have diabetes, monitor your blood sugar levels carefully. Talk with your health care team about treatment options. Your doctor may recommend certain lifestyle changes to help keep your blood sugar under good control—those actions will help reduce your risk for stroke.
Manage Heart Disease
If you have certain heart conditions, such as atrial fibrillation (irregular heartbeat), your health care team may recommend medical treatment or surgery. Taking care of heart problems can help prevent stroke.
Having worked for decades as a speech language pathologist I understand the possible devasting consequences of communication impairments due to a stroke. These include language processing, motor speech function and cognitive functions along with language use.