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Stroke Care Center at Gates Vascular Institute
Medical Management of Stroke

All patients with strokes are carefully and quickly evaluated by the neuroscience team and the treatment plan determined. Patients are immediately assessed in the emergency department and steps are taken to ensure an open airway, adequate breathing and circulation. A patient’s neurological status and blood pressure are continuously monitored.

Anticoagulation therapy is administered for appropriate patients with ischemic strokes. If the patient meets the criteria for IV thrombolysis, these medications are given. Some patients may require surgical intervention.

Medications used in the treatment and prevention of strokes

Thrombolytics (clot buster drugs)

t-PA - This is the only FDA approved thrombolytic medication (clot busting drug) for the treatment of acute ischemic stroke. t-PA can be safely given within a three-hour window from the onset of stroke symptoms. Patients are carefully evaluated for this treatment due to the risk of bleeding into the brain or anywhere in the body. Not all patients will qualify for this treatment.


These drugs prevent platelets in the blood from sticking to each other and forming clots, thus reducing the risk of stroke.

Examples include:
• Aspirin
• Aspirin/extended release dipridamole (Aggrenox®)
• Clopidogrel (Plavix®)


Anticoagulants prevent blood clots from forming as a result of atrial fibrillation (irregular heart rate) or clotting disorders. Regular blood work will be required by the patient’s healthcare provider.

Examples include:
• Heparin®
• Enoxaparin (Lovenox®)
• Warfarin (Coumadin®)

Warnings - Anticoagulants decrease the blood’s ability to clot. They also prevent more clots from forming. If an individual experiences bruising or bleeding (bleeding gums, blood in urine or stool) the healthcare provider should be contacted immediately.