Acute Stroke Treatments

How are transient ischemic attacks treated?

Because transient ischemic attacks (TIAs) are considered to be “mini strokes,” the general approach to treating and preventing TIAs is the same as that used to treat and prevent strokes.

Drug treatments based on specific medical findings include:

  • If your recent stroke or TIA (within 30 days) was caused by severe narrowing of a major artery in the brain, your doctor may recommend you take the aspirin and clopidogrel (Plavix®) for 90 days.
  • If you have an irregular heartbeat (atrial fibrillation), your doctor may recommend treatment with an anticoagulant drug such as warfarin (Coumadin®), apixaban (Eliquis®), rivaroxaban, (Xarelto®), or dabigatran (Pradaxa®).

If atherosclerosis (fatty deposits/“plaques”) are found in the carotid arteries -- the artery that supplies blood to the brain, carotid surgery may be recommended. One of two surgical approaches might be recommended:

  • Carotid endarterectomy — surgical removal of the plaque within the carotid artery.
  • Carotid angioplasty and stenting procedure —a less invasive alternative treatment appropriate for some patients who have a carotid artery blockage. The procedure involves flattening the build up of fatty plaque or blockage against the walls of the artery, which then allows increased blood flow. The stent (a small, metal mesh tube) remains in place as a permanent scaffold to keep the artery open.

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