JP Stroke Foundation

What can you do if you suspect that someone is having a stroke?

Heart stroke can be a life-threatening condition, so the time that elapses from the onset of symptoms and diagnosis to treatment is extremely important [1,2]. A patient suspected of having a stroke should be moved to a hospital with a stroke unit or one that provides organized stroke care as soon as possible (calling 911 would be best due to the urgency of care needed) [3]. Stroke treatment involves pharmacotherapy (this means that drugs may be used), but sometimes the patient requires heart surgery. The doctor in charge of care decides on the type of treatment depending on the type of stroke, and other factors involved [3].

Rehabilitation (after medical treatment):

About 40% of stroke patients require active rehabilitation including physiotherapy, speech exercises or a combination of both [2]. Rehabilitation should begin as soon as possible after a stroke survivor is stabilized. The intensity of rehabilitation depends on the condition of the patient and the degree of disability [2]. Brain improvement most likely occurs within the first 3 months following a stroke. However, your doctor may recommend continual active rehabilitation to help your brain, and body improve.

How can you treat a stroke?

Many medical conditions or emergencies can be treated at home. However, in the case of a stroke, it is absolutely impossible to rely on home remedies. If you suspect that someone is having a stroke, they need to go to the hospital to receive rapid medical intervention, stabilize their basic vital functions, and receive a plasminogen activator (alteplase) up to three hours after the first symptoms [4]. If you are at home, call 911, even if the distressing symptoms seem to pass.

The first step in stroke treatment is to give alteplase, a plasminogen activator. Plasminogen is an enzyme in our body that helps break down blood clots [4]. It is important to remember that brain cells die after 3-4 minutes. Therefore, the faster the doctors and nurses can give the drug, the greater the chance of reducing any complications caused by the stroke.

The doctor will also use a computerized tomography (CT) scan to visualize what’s going on inside of a patient’s brain. Only after seeing the CT scan will a doctor be able to diagnose the stroke and proceed with any treatments. Initially, a nurse or doctor will give fluids to rehydrate the patient, oxygen through a mask, or a ventilator if they are having a lot of trouble breathing [5]. If more than a few hours have passed since the onset of symptoms, alteplase will not be given because it won’t help the patient. Usually, if a patient cannot be given alteplase, it could mean that they are suffering from a haemorrhagic stroke. For a haemorrhagic stroke, surgical procedures are often needed. In the case of an ischemic stroke, aspirin and sometimes heparin can be administered [5].

As soon as the patient is stable, conscious, and able to breathe, the primary care team will suggest post-stroke treatment. Rehabilitation, diet changes, and anti-stroke management should be implemented as soon as possible [2]. When a patient is connected to a ventilator, passive movements (for those that are unable to move their legs themselves) are performed to prevent injuries to the skin and activate their muscles. Depending on the patient’s physical condition, a specialist may recommend additional exercises to improve their mobility as much as possible. Physiotherapy treatments or physical exercises, and speech therapy may be necessary for the patient to regain motor and speech skills [2].

After the Hospital: Home Treatments

Depending on the types of physical deficits and their overall condition, the patient will either stay at the hospital or be free to go back home. After the stroke, the most common treatment method is rehabilitation at a specialised stroke unit [6]. Occupational therapy and learning to live independently are part of this type of rehabilitation. Psychotherapy is also necessary, since a stroke can result in mental health issues such as deep depression, often associated with a lack of independence, chronic immobilization, or a complete change in lifestyle [6].

Treating a stroke patient at home is often a huge burden on the family and caregivers. It all depends on the patient’s condition and their level of independence. It is necessary to remove the causes responsible for the stroke, namely hypertension, high cholesterol, or excessive blood clotting [6]. By following a proper diet, engaging in daily physical activity, treating any other chronic diseases, stopping smoking and the use of other types of stimulants, survivors can increase their quality of life post-stroke.

Author: Isha Ballgobin

1. Maleki, M., & Hosseini, Z. (2022). Chapter 19 – Preventive Cardiology. In Practical Cardiology (Second Edition, pp. 341–375). Elsevier Inc. https://doi.org/10.1016/B978-0-323-80915-3.00012-0
2. Cucchiara, B. L., & Kasner, S. E. (2022). 58 – Treatment of “Other” Stroke Etiologies. In Stroke (Seventh Edition, pp. 852–868.e9). Elsevier Inc. https://doi.org/10.1016/B978-0-323-69424-7.00058-2
3. McCarthy, M. M., Fletcher, J., Heffron, S., Szerencsy, A., Mann, D., & Vorderstrasse, A. (2021). Implementing the physical activity vital sign in an academic preventive cardiology clinic. Preventive Medicine Reports, 23, 101435–101435. https://doi.org/10.1016/j.pmedr.2021.101435
4. Bushnell, C., & McCullough, L. (2014). Stroke prevention in women: Synopsis of the 2014 American Heart Association/American Stroke Association guideline. Annals of Internal Medicine, 160(12), 853–857. https://doi.org/10.7326/M14-0762
5. Goldstein, L. B., Bushnell, C. D., Adams, R. J., Appel, L. J., Braun, L. T., Chaturvedi, S., Creager, M. A., Culebras, A., Eckel, R. H., Hart, R. G., Hinchey, J. A., Howard, V. J., Jauch, E. C., Levine, S. R., Meschia, J. F., Moore, W. S., Nixon, J. ., & Pearson, T. A. (2011). Guidelines for the primary prevention of stroke: A Guideline for Healthcare Professionals from the American Heart Association/American Stroke Association. Stroke (1970), 42(2), 517–584. https://doi.org/10.1161/STR.0b013e3181fcb238
6. Del Zoppo, G. J., Saver, J. L., Jauch, E. C., & Adams, H. P. (2009). Expansion of the time window for treatment of acute ischemic stroke with intravenous tissue plasminogen activator: A science advisory from the American heart association/american stroke association. Stroke (1970), 40(8), 2945–2948. https://doi.org/10.1161/STROKEAHA.109.192535