from: medicinenet.com

TPA: One of the most important new treatments over the last few years for the immediate treatment of a stroke is a medicine called tPA (which stands for tissue plasminogen activator). TPA is a very powerful "clot–buster" that is infused through the veins. If given within the first three hours after the onset of symptoms, tPA can significantly improve the patient's outcome from the stroke over the long term. The sooner tPA is started, the better the outcome, so time is of the essence.

Early use of Heparin and Aspirin: Drugs to thin the blood (anticoagulation; for example, heparin) are also sometimes used in treating stroke patients in the hopes of improving the patient's recovery. It is unclear, however, whether the use of anticoagulation improves the outcome from the current stroke or simply helps to prevent subsequent strokes (see below). In certain patients, aspirin given after the onset of a stroke does have a small, but measurable effect on recovery. The treating doctor can best determine which of the agents mentioned above is the most appropriate option, based on the results of tests done.

Managing other Medical Problems: Treatment of blood pressure that is too high or too low may be necessary in treating a stroke. Currently, lowering an elevated blood pressure into the normal range is no longer recommended during the first few days following a stroke. Doing so might compromise the blood flow through narrowed or nearly closed arteries, which could make the stroke worse or lessen the chance of recovery. In patients with diabetes, the blood sugar (glucose) level is often quite high after a stroke. Controlling the glucose level in these patients may minimize the size of a stroke. Finally, oxygen may administered to stroke patients when necessary.

Rehabilitation: When a patient is no longer acutely ill after a stroke, the health care staff focuses maximizing the patient's functional abilities. This is most often done in an inpatient rehabilitation hospital or in a special area of a general hospital. Rehabilitation can also take place at a nursing facility. The rehabilitation process can include some or all of the following: (1) speech therapy to relearn talking and swallowing; (2) occupational therapy to regain dexterity in the arms and hands; (3) physical therapy to improve strength and walking; and (4) family education to orient them in caring for their loved one at home and the challenges they will face. The goal is for the patient to resume as many, if not all, of their pre–stroke activities and functions. Since a stroke involves the permanent loss of brain cells, a total return to the patient's pre–stroke status is, unfortunately, not a realistic goal in many cases.

When a stroke patient is ready to go home, a nurse may come to the home for a period of time until the family is familiar with caring for the patient and how to give various medications. Physical therapy may continue at home. Eventually, the patient is usually left at home with one or more caregivers, who now find their lives have changed in major ways. Caring for the stroke patient at home may be easy or very nearly impossible. At times, it becomes apparent that the patient must be placed in a board and care home or a skilled nursing facility because adequate care cannot be given at home despite the good intentions of the family.