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 - Northwestern Memorial Hospital - Chicago

Ischemic Stroke & Treatment

There are two primary types of stroke, ischemic and hemorrhagic, with ischemic being the more common of the two. The ischemic stroke occurs if an artery supplying blood to the brain becomes blocked. Blood clots are often the cause of these blockages that lead to ischemic strokes.

There are two types of ischemic stroke:

  • Thrombotic: a blood clot (or thrombus) forms in an artery that supplies blood to the brain
  • Embolic: a blood clot or fatty plaque (or embolus) travels through the bloodstream to the brain

In both types of ischemic stroke, blockage, whether by a blood clot or a fatty plaque, causes the stroke.

What Causes Ischemic Stroke and TIAs?

Since blockages of arteries cause ischemic strokes and TIAs, any condition that leads to increase of fatty plaques in the blood vessels or the formation of blood clots in the bloodstream can increase the risk of this form of stroke, including:

  • Atherosclerosis: this is fatty buildup (plaque) on the inner walls of arteries, which causes narrowness in the arteries (stenosis) and increases the risk of a plaque breaking off, or causing platelets to form at the site of the lesion caused by atherosclerosis, increasing the risk of a blood clot forming, or a blockage.
  • Carotid artery disease: plaques forming in the carotid arteries are a main culprit in ischemic stroke and TIAs.
  • Atrial fibrillation: this and other heart conditions can create blood clots that may lead to an ischemic stroke or TIA. Atrial fibrillations are a common cause of embolic strokes.

Treatments for Ischemic Stroke and TIAs


If you get treatment within three or four hours of onset of symptoms, your doctor may inject you with a plasminogen activator (tPA) that breaks up blood clots in the arteries of the brain. It should be given as soon as possible, for best results.

If a tPA cannot be administered, you may get antiplatelet medication, which stops platelets from clumping together, reducing risk of dangerous blood clots. Aspirin may be given within 48 hours of stroke for this reason.

Anticoagulants (so-called “blood thinners”) may also be given in order to minimize blood clots and prevent new clots from forming.


In instances where there is blockage in the carotid artery, your doctor may recommend one of two procedures:

  • Carotid endarterectomy: this makes us of an incision in the neck and removal of plaque buildup from the carotid artery.
  • Artery angioplasty: this makes use of a thin tube with a balloon on the end of it which is then inflated, pushing the plaque against the walls of the artery. A stent is usually placed to keep the artery from becoming blocked again.

These procedures, coupled with changes in lifestyle, may greatly lower the risk of stroke in people with carotid artery disease.

Last UpdateApril 30, 2012