Stroke Care

When you first arrive at the hospital after a stroke, a healthcare provider will do a neurological exam. They’ll want to know about your symptoms, and they may ask you to do certain tasks. They’ll also run some tests, which may include:

• Blood tests.
• CT scan.
• Cerebral angiogram.
• MRI.
• Electrocardiogram (ECG/EKG).
• Electroencephalogram (EEG).

These tests can help us know if you had a stroke and, if so, what kind. And then we can work on finding the best treatment for you.

Types of stroke

Generally, a stroke is a life-threatening condition that happens when part of your brain doesn’t have enough blood flow. But there are several types of strokes, and your treatment will depend on the type you had:

• Ischemic.
• Hemorrhagic.
• Transient ischemic attack (TIA or mini stroke).

What to expect at your first visit

Chances are, you’ve already received emergency stroke care. But you might be wondering what’s next. When you come in for your first treatment planning visit, we’ll talk with you in detail about how you’re feeling. We’ll ask about your symptoms and go over your treatment options. But most of all, we’ll want to know what’s important to you as you begin your recovery.

Meet Our Stroke Care Team

When you choose Cleveland Clinic, we’ll handpick a team of specialists based on your specific needs. Your healthcare team could include:

• Neurologists.
• Neurosurgeons.
• Cardiologists.
• Radiologists.
• Psychologists.
• Psychiatrists.
• Speech therapists.
• Physical therapists.
• Occupational therapists.
• Social workers.

When you have a stroke, treating it as quickly as possible is key. The treatment that’s right for you depends on the type of stroke you had and how much time has passed since your symptoms began.

A stroke is an emergency. If you develop stroke symptoms or notice them in someone else, call 911 immediately. If you live in the Cleveland area, the 911 dispatcher can send our Mobile Stroke Unit to get you the care you need as soon as possible.

Healthcare providers sometimes use the BE FAST method to determine whether you’re having a stroke. The acronym stands for:

• BALANCE: Watch for a sudden loss of balance.
• EYES: Is there a sudden loss of vision in one or both eyes? Or double vision?
• FACE: Ask the person to smile. Does one side of their face droop?
• ARMS: Ask the person to raise both arms. Does one arm drift downward?
• SPEECH: Ask the person to repeat a simple phrase. Is their speech slurred or strange?
• TIME: If you observe any of these signs, call 911 immediately.

When you get to the hospital, our stroke care specialists will work quickly to restore circulation or reduce blood pressure. Here are some of the most common emergency stroke treatments:

Thrombolytic drugs

These medications help dissolve existing blood clots. They’re a common method for treating ischemic strokes. Healthcare providers can give thrombolytic drugs within the first three hours after your stroke symptoms begin. Getting these medications in your system as soon as possible can reduce your risk of permanent damage.

The most common thrombolytic drug used to dissolve clots is alteplase. Another similar drug, tenecteplase, is used less often and mostly in North America.

Thrombectomy

When thrombolytic drugs aren’t an option, providers may do a thrombectomy. During this procedure, a provider inserts a catheter (thin tube) into a blood vessel. Then, they guide the catheter up to the blood clot to break it up.

It’s important to do a thrombectomy as soon as possible. The best window of time is within 24 hours after stroke symptoms begin.

Blood pressure management

High blood pressure is the most significant risk for all types of strokes. So, it’s important to lower your blood pressure as soon as possible. This helps reduce bleeding and encourages the damaged blood vessel to seal. Healthcare providers use medication to lower your blood pressure.

Clotting support

To help your blood to clot, your provider may give you infusions of medications or blood factors. These infusions can help control bleeding. Providers often give them to people who take blood-thinning medications (anticoagulants). 

Surgery

If less invasive treatments aren’t an option, your provider may recommend one of these surgeries:

• Carotid endarterectomy.
• Carotid stenting.
• Brain aneurysm surgery.
• Craniotomy.
• Intracranial stenting.
• Endovascular aneurysm repair (EVAR).

Stroke care and rehabilitation

Care and rehabilitation after a stroke are important to your recovery. Our Cleveland Clinic stroke care experts may use several different therapies to help you adapt to the changes in your brain. You may have:

• Speech therapy.
• Physical therapy.
• Occupational therapy.
• Cognitive therapy.

Follow-Up Care

A solid follow-up plan is a key part of stroke care. Your healthcare team will talk with you about ways to manage your health and help you recover as quickly as possible. This might include:

• Healthy eating.
• Exercising regularly.
• Not smoking and avoiding other risky lifestyle choices.
• Taking medication.
• Getting therapy and rehabilitation.

Follow-up care is different for everyone, and we’ll base yours around your specific needs. We believe you’re in charge of your own health — and we’re here to help. We’ll make sure our recommendations match your personal goals.

Taking the Next Step

After a stroke, you need skilled, compassionate and experienced healthcare providers on your team. Cleveland Clinic’s stroke care specialists are just that. And we’re here to help. We’ll provide treatment to match your specific needs and goals — from the beginning of your journey and throughout your recovery.