Before deciding on a suitable course of treatment for someone who has suffered a stroke, a doctor will order tests to determine whether their stroke was ischemic or hemorrhagic. Only then can the appropriate treatment be started. If the scan confirms an ischemic stroke, initial treatment is likely to involve taking anti-clotting drugs to reduce the risk of blood clots forming in any blood vessels to the brain or other parts of the body. Aspirin is the most commonly used anti-clotting drug because it prevents the particles (platelets) that form the core of a clot from sticking together. But two other agents, dipyridamole and clopidogrel, which reduce the risk of clots in slightly different ways, may be used instead of, or in addition to, aspirin.
Warfarin, another anti-clotting agent, is often used to treat people who have a stroke due to a blood clot that formed in their heart and moved to a blood vessel in the brain. Such clots usually arise in the heart as a result of an abnormal heart rhythm (atrial fibrillation). Anyone taking warfarin needs regular blood tests to make sure that their blood does not become too thin.
Clearly, anti-clotting drugs are not suitable for someone whose stroke is due to a hemorrhage in their brain since this could make the bleeding worse. Hence the importance of having a brain scans as soon as possible after a stroke to distinguish between an ischemic and a hemorrhagic stroke. Many people who suffer a stroke have high blood pressure. Once their condition has stabilized, they are likely to be prescribed drugs to reduce their blood pressure. Latest research suggests that even people with relatively normal blood pressure may also benefit from lowering it after a stroke. High cholesterol is another problem linked to strokes, and some people will also be given drugs to reduce their cholesterol levels.