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Treatment for people affected by stroke can be divided up into three
types:

Drug treatment which aims to reduce the amount of brain damage and
therefore increase the likelihood of a good recovery. The sooner this can be given the greater the chances of recovery.

General care which aims to prevent complications such as pneumonia,
dehydration, pressure sores and blood clots in the legs and lungs.

Rehabilitation which aims to maximise recovery from the stroke to allow you to become as independent as possible.

The type of treatment depends on the type and severity of the stroke. Some people recover so quickly or have such mild symptoms that they don’t need to be admitted to hospital at all, although even they may need tests which are only available at the hospital.

Those who have suffered anything other than a very mild stroke should be admitted to a stroke unit, or at least an area of the hospital where a team of doctors, nurses and therapists who specialise in stroke work together. Treatment coordinated by such a specialist team increases the likelihood of a good recovery.

Drugs
At the moment specific drug treatment for stroke is not widely available. Some hospitals use drugs (rt-PA or thrombolysis) to dissolve the clot that is blocking an artery. This can improve recovery if it can be given shortly after the symptoms of stroke have started. Further research is being done to identify who will benefit from this treatment. Other drugs designed to protect the brain tissue from the effects of being starved of blood are also being tested. Whilst in hospital you may be asked whether you would like to take part in testing of one of these drugs (see below for the section on research).

General care
To prevent complications you may:

• be advised to lie or sit in certain positions to reduce the risk of muscle problems and damage to the shoulder joints.
• be asked to wear special stockings or be given injections of heparin (a blood-thinning drug) which reduces the risk of blood clots forming in the legs.
• be got out of bed as soon as possible to reduce the risk of chest infections and blood clots.
• not be allowed to eat or drink if there is a risk of food going down the wrong way into the lungs. In this case you would be given food and fluids by a drip in the arm or by a feeding tube placed through the nose into the stomach. If tube feeding is likely to be needed for a longer period of time, the tube may be inserted directly into the stomach, through the skin, under sedation. This is known as percutaneous endoscopic gastrostomy (PEG) feeding. This is often more comfortable for the person being treated.
• have a tube put into your bladder (a urinary catheter) if you are unable to control your urine.
  

Rehabilitation
Rehabilitation should start as soon as you are medically stable. It may start whilst you are on the admission ward or stroke unit but, depending on your progress, you may be transferred to a rehabilitation unit (in the same or different hospital). The stroke team including the therapists will assess you to decide the best type of treatment. There are several types of therapists who each have different jobs to do, although they work as a team. You may come across:

Physiotherapists who deal mainly with problems due to muscle weakness and stiffness, and loss of co-ordination. They will help you regain your mobility and the use of your arm.

Speech and language therapists who deal with problems with communication (talking, reading and writing) and swallowing.

Occupational therapists who help you regain your independence and adapt to any disability. They can recommend special tools to help you to perform everyday tasks more easily and may also talk to you about adaptations to your house, such as hand rails, bath seats and stair lifts.

Nurses who have an important role in treating people affected by stroke. Not only do they reduce the risk of complications, but in stroke units they are often trained to give the therapy that the therapists prescribe. They help you improve your balance and walking in an effort to help you regain your independence. They are also a very good source of information and can answer many of your questions. The nurses may also follow up your progress after you have been discharged from the unit.

Social workers who can provide help with money and housing problems, and can also organise home helps and other support.

Dieticians who may monitor the amount and type of food you eat whilst in hospital and can provide advice about the healthiest diet for you.

Research
In recent years a lot of research has been carried out to develop new treatments for stroke and to test whether they are safe and effective. Whilst in hospital you may be asked whether you would be willing to take part in a research project or clinical trial. The most common type of research is called a randomised controlled trial where two or more kinds of treatment are given to different people and then compared to find out which is most effective.

If you agree to take part, those running the trial will treat you using a specific drug or treatment and then monitor your progress. Your progress, along with that of all the other people who have received the same treatment, will then be compared with that of people receiving the alternative treatment(s), which could be placebo, or dummy treatment. This will tell the doctors if one treatment is better than another.