Stroke Treatment

Treatment for a stroke depends on whether you’ve been diagnosed with an ischemic or hemorrhagic stroke, how long it’s been since your stroke occurred, and other factors. Your doctor will recommend the best treatment for you.

Treatments for Ischemic Stroke

Timing is critical when treating patients with ischemic stroke, which happens when a blood clot blocks the flow of blood to an area of the brain. Without prompt treatment, a stroke can result in long-term disability or even death. Michigan Medicine has consistently exceeded the American Heart Association goals and national and state benchmarks for expedited treatment, which may include:

  • tPA Clot-Busting Medication: Tissue plasminogen activator (tPA) is a clot-busting medication that can be administered within 4.5 hours of the first stroke symptoms. This brain-saving treatment, which is administered via an IV in the arm, can reduce long-term disability after stroke.
  • Endovascular Thrombectomy: Endovascular thrombectomy is a minimally invasive procedure that uses a stent retriever to trap and remove the blood clot that is causing the stroke. Doctors thread a catheter through an artery in the groin or arm up to the blocked artery in the brain. The stent retriever is then inserted through the catheter to open and "grab" the clot, allowing doctors to remove the stent with the trapped clot. The procedure typically takes 60 to 90 minutes. In some cases, a thrombectomy can benefit a patient under certain conditions up to 24 hours after the onset of symptoms, but earlier treatment (within six hours of the onset of symptoms) is preferred.

Visit the Stroke Outcomes page for more information on benchmarks and outcomes.

Illustration showing a surgical clip inserted at the bottom of a brain aneurysm
Clipping

Treatments for Hemorrhagic Stroke

A hemorrhagic stroke happens when a weak blood vessel bursts and bleeds into the brain. A hemorrhagic stroke is less common than an ischemic stroke, making up about 15 percent of stroke cases. Treatment, which is based on the patient’s condition and cause of the brain hemorrhage, may include:

  • Clipping (aneurysm): An aneurysm is a ballooning of the artery from a weak artery wall. One surgical treatment of brain aneurysms involves placing a surgical clip at the bottom of the aneurysm to remove the blood flow and reduce the risk of rupture.
  • Coiling (aneurysm):  Another treatment of brain aneurysm may include filling it with detachable coils to reduce the risk of rupture.
  • Craniectomy: In this procedure a surgeon removes a section of the skull to reduce pressure on the brain caused by swelling.
Illustration showing detachable coils filling an aneurysm
Coiling

Visit the Stroke Outcomes page for more information about clipping and coiling benchmarks and outcomes.

Procedures to Prevent Stroke

Some procedures that have been successful in preventing a stroke or recurrent stroke include:

  • Carotid Endarterectomy:  A surgery to remove fatty deposits from the carotid artery to prevent a stroke.
  • Carotid Stent Placement: A procedure in which a meshwork tube is inserted to widen a narrow artery. The procedure is usually done to prevent stroke or recurrent stroke.
  • Patent Foramen Ovale Closure: A cardiac procedure performed to prevent recurrent stroke when the patent foramen ovale is thought to have caused a first stroke.
  • Left Atrial Appendage Closure: A cardiac procedure performed in patients with atrial fibrillation who are not safe for oral anticoagulation.

Visit the Stroke Outcomes page for more information about carotid procedure outcomes.

The University of Michigan Stroke Program

The U-M Stroke Program is accredited as a Comprehensive Stroke Center by the Joint Commission. We have repeatedly been designated as an American Heart Association Gold Plus stroke hospital, the highest stroke quality designation. We also surpass state and national benchmarks for tPA treatment prevalence and treatment time.

Stroke patients at Michigan Medicine are cared for in a dedicated Stroke Unit and Neuro-Intensive Care Unit (NICU). During the patient’s stay, vascular neurologists, neurosurgeons, neuroscience nurses with advanced training in stroke care, stroke-trained therapists, and a medical team of experts in stroke treatment and complications all work together so patients can have optimal recovery for their individual situation.

For more information about our center, accreditations and awards, visit the About the U-M Comprehensive Stroke Center page.

Next Steps

For Patients: If you think you or a loved one might be having a stroke, call 911. If you have had a stroke in the past or think you might be at risk for one, call us at 1-888-287-1082 to make an appointment for a consultation. Visit our Stroke Patient Resources page for more information about stroke, including videos and care guides.

For Physicians: If you are a physician and want to refer a patient, call M-LINE at 800-962-3555.

For Stroke Coordinators: If you are a stroke coordinator and want to find out more about our process or have questions, please contact our Comprehensive Stroke Center at  CSC-comprehensive-stroke-program@med.umich.edu.