Both the type and success of stroke treatment depends on quick recognition of stroke symptoms and getting to the hospital as soon as possible.  At the hospital, a dedicated stroke team of doctors and nurses will work quickly to diagnose whether you are having a stroke and what type. 

There are different treatments for the two different types of stroke.

Ischemic stroke

For the more common type, ischemic stroke, doctors need to restore blood flow to the affected area of the brain.  This can be done in several ways:

• Clot-busting drugs, such as tPA (tissue Plasminogen Activator) can be given within three to six hours from the time stroke symptoms appear. 
  
  This drug can be given through an IV into your bloodstream to dissolve a blood clot if treatment occurs within three hours from the onset of symptoms.  It can also be given directly into the brain through a catheter that is inserted into your groin and fed through your blood vessels into your brain. This option expands the window of treatment time to up to six hours.  Administered either way, the clot-busting drug can greatly increase your chance of recovery, but can only be given within three to six hours from the onset of symptoms or the risks of complications outweigh the benefits.
  
• The Mechanical Embolus Retrieval in Cerebral Ischemia (MERCI) Retrieval System, more commonly known as the MERCI® Retriever, is the first device approved by the FDA for use in the treatment of stroke.  The MERCI Retriever nearly triples the time window for stroke treatment to up to 8 hours from the time symptoms appear. 
  
  It has the ability to actually reverse a stroke in progress by removing the entire clot using a catheter and corkscrew-like device. 
  
  
  
  Riverside Methodist Hospital was selected as the only Ohio hospital for the initial FDA trial and currently has more experience than any other Ohio hospital in using this lifesaving device. 
  
  A similar treatment option is the Penumbra System, another catheter-based device that uses suction to grab the blood clot and remove it from the body.  This technique, which has been performed in about 100 patients nationwide, is currently in clinical trials. 
  
  This trial is one of more than 15 ongoing stroke treatment and prevention trials at Riverside.
  
• Surgical procedures, such as angioplasty or carotid endarterectomy, can also be used to treat an ischemic stroke. In a carotid endarterectomy, a surgeon will make an incision in your neck to clean out any plaque in your carotid artery that is blocking normal blood flow. 
  
• In an angioplasty, a catheter is directed into the blocked vessel your brain and a mesh tube, called a stent, is placed in the artery to restore blood flow andprevent the vessel from clogging again. 
  
  The Wingspan™ Stent System with Gateway™ PTA Balloon Catheter is a new type of stent recently approved by the FDA as a Humanitarian Device Exemption (HDE).  It is specially designed for the brain’s fragile vessels to open narrowed arteries.   Riverside Methodist Hospital was the first hospital in central Ohio to use this device for the treatment of blocked arteries in the brain. 

Hemorrhagic stroke

In the case of hemorrhagic stroke, doctors have to stop the bleeding in the brain and try to prevent bleeding from occurring in the future.  The most common treatments are intensive blood pressure control, aneurysm clipping, coiling and surgical removal of arteriovenous malformation (AVM).

• Aneurysm clipping is when doctors place a tiny clamp on the aneurysm to prevent it from bursting or continuing to bleed.
  
• In coiling procedures, doctors use a catheter to reach the aneurysm and insert a tiny coil inside the aneurysm to fill and “seal” it to prevent continuous bleeding. 
  
• Surgical removal of an AVM is possible if the AVM is small and located in an easily-accessible part of the brain.  If surgery is not possible, radiation is also a treatment option.