In a select group of patients who present with an ischaemic stroke, they may be eligible for thrombolysis (tPA for short) or mechanical thrombectomy where medications are either injected to chemically dissolve the blood clot occluding the blood vessel, or the blood clot is ‘sucked out’ physically by a surgery, provided that they meet the time window from the onset of symptoms.

However, it should be noted that patients would not be eligible for these treatments if they arrive too late at the hospital, as the risks of a poor outcome from tPA or mechanical thrombectomy (most often life-threatening bleeding in the brain), may outweigh any potential treatment benefits. It should also be noted again that for every minute when an acute ischaemic stroke is not treated, 1.9 million neurons in the brain are lost. Hence, it is advised that anyone with sudden onset of symptoms suggestive of a stroke (please refer to the above sessions about stroke symptoms) should visit the Accident and Emergency Department immediately such that appropriate treatment can be given within the effective treatment time window.

In a selected group of patients, normally with severe ischaemic stroke, a neurosurgical operation may also be conducted to relieve the pressure within the brain.

For haemorrhagic stroke, treatment normally depends on the underlying cause leading to the bleeding within the brain. If it is due to an underlying blood clotting problem, then transfusion of blood products are often required. If the stroke is due to an underlying aneurysm or malformation of a blood vessel, then neurosurgical intervention will be required when appropriate. In a small group of patients, a neurosurgical operation may be urgently performed to extract the blood clot within the brain, but this is not normally required in most patients.