Stroke Treatment

Each year, stroke impacts approximately 750,000 to 800,000 individuals in the United States, taking a tremendous toll on these patients, their families, and society in general. A major cause of disability, many stroke survivors are left with significant speech, motor, and memory difficulties and more than half of them can't return to work.

Stroke occurs when the blood flow to a part of the brain stops, usually due to a blood clot or clogged arteries or because a weak blood vessel ruptures as in an aneurysm or moyamoya disease. In rare cases, a patient may have abnormalities in the veins and arteries called arteriovenous malformations (AVMs), cavernous malformations, or dural arteriovenous fistulas (DAVFs) that rupture. Stroke is a serious condition needing immediate treatment for optimal recovery.

At Brigham and Women's certified Comprehensive Stroke Center, our multidisciplinary team of specialists uses advanced diagnostic capabilities to determine the best treatment approach for the individual patient. The Center's stroke treatment options include medical, endovascular, and surgical therapies, often given in combination.

Medical and endovascular treatments for stroke include intravenous and intra-arterial thrombolysis to break up blood clots. Identification of and medical treatment of underlying causes and risk factors can help reduce further stroke risk.

Neurosurgical procedures, including brain aneurysm surgery, may also be performed as part of stroke treatment. These procedures may include:

• Carotid endarterectomy and other neurosurgical approaches to prevent stroke or recurrence of stroke while minimizing injury to normal brain tissue
• Craniectomy and hemispheric decompression for stroke patients with a large area of brain affected
• Microsurgery to treat aneurysms, AVMs, DAVFs, and cavernous malformations
• Extracranial to intracranial bypass procedures for obstructed vessels and moyamoya disease
• Stereotactic radiosurgery to treat certain AVMs and DAVFs

Neuro-interventional procedures are provided in our state-of-the-art interventional neuroradiology suite at BWH. These procedures include:

• Urgent revascularization of blockages in the brain's arteries
• Carotid and cerebral artery angioplasty
• Minimally invasive procedures such as coil embolization of aneurysms
• Microcatheter embolic injection to fill malformations and decrease the risk of dangerous bleeding in patients with intracranial vascular malformations

For patients with acute neurological conditions, including stroke, the 20-bed Neuroscience Intensive Care Unit provides dedicated care and treatment by neurologists, neurosurgeons, and other specialists. For those patients with serious, life-threatening neurologic and cardiac emergencies, our Emergency Cardiac Neuro Unit (ECNU) provides rapid response care.

Learn more about stroke treatment at BWH's Boston area locations.