For an Ischemic Stroke
If your stroke is diagnosed within three hours of the start of symptoms, you may be given a clot-dissolving medication called tissue plasminogen activator (t-PA), which can increase your chances of survival and recovery. However, if you experienced a hemorrhagic stroke, use of t-PA would be life-threatening. If IV t-PA doesn’t work, t-PA and other clot-dissolving agents can be delivered directly to the area of blockage with the angiogram technique and very small catheters. If these medications don’t work, the clot can potentially be removed with fine-grasping instruments or the blocked vessel can be re-opened with stents.

For a Hemorrhagic Stroke
Initial treatment of a hemorrhagic stroke is difficult. Efforts are made to control bleeding, reduce pressure in the brain, and stabilize vital signs, especially blood pressure. There are few medications available to treat hemorrhagic stroke. Surgery generally is not used to control mild to moderate bleeding resulting from a hemorrhagic stroke. However, if a large amount of bleeding has occurred and the person is rapidly getting worse, surgery may be needed to remove the blood that has built up inside the brain and to lower pressure inside the head. If bleeding is due to a ruptured aneurysm, whether surgery can be done depends on the location of the aneurysm and the person’s condition following the stroke. Surgery can involve clipping the aneurysm in an open-brain procedure. Another option is sealing the aneurysm with coils delivered through the angiogram technique. This is the less invasive option, but is not yet suitable for all aneurysms.