Chapter 4

Medical and Surgical Treatment of Stroke

Bruce C.V. Campbell and Stephen M. Davis

Abstract

Treatment of stroke patients should occur in dedicated stroke units with experienced medical, nursing and allied health staff to minimize morbidity and mortality. Specific treatment strategies depend on the type of stroke, which is determined by urgent brain imaging. The key treatment for ischaemic stroke, caused by a blocked blood vessel, is to restore blood flow using clot-dissolving medicine or minimally invasive surgery via angiogram. Both treatments are time critical as effectiveness reduces rapidly over the first few hours after stroke onset. Specific treatment options for intracerebral haemorrhage (bleeding into the brain) are limited, but lowering blood pressure may have some benefit and research into minimally invasive surgery is ongoing. In addition to lifestyle modification, prevention of further strokes requires lowering blood pressure and, for ischaemic stroke, lowering cholesterol and medications to reduce clotting (e.g. aspirin). Access to proven stroke therapies is highly variable and gaps lead to unnecessary disability, death and health costs.

Total Pages: 63-80 (18)

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