Severe stroke will cause permanent nerve damage, and if it is not diagnosed and treated in time in the acute stage, it will cause serious complications and even death. Stroke can be divided into hemorrhagic stroke and ischemic stroke, and there are different treatment methods according to different parts. Specific therapy includes thrombolysis, antiplatelet therapy, early anticoagulation and neuroprotection, while non-specific therapy includes antihypertensive therapy, blood sugar therapy, management of brain edema and intracranial hypertension.

1. drug therapy

Thrombolytic therapy is recognized as the most effective treatment for stroke at present, but it has strict time window requirements (intravenous thrombolysis is limited to 4.5 hours, and arterial thrombolysis can be extended appropriately).

For patients with existing stroke complicated with hypertension, blood pressure control in acute stroke should be carried out according to stroke guidelines, and the goal of blood pressure treatment for chronic or old stroke should generally be achieved.

It is necessary for patients with hypertension, diabetes, hyperlipidemia and other diseases to take the following drugs: aspirin, beta-blockers, angiotensin converting enzyme inhibitors, statins.

2. Surgery

(1) Carotid endarterectomy is suitable for severe stenosis of extracranial internal carotid artery (the stenosis degree is above 70%), and the stenosis degree is below the mandibular angle, which can be achieved by surgery. Surgery can also be considered within 24 hours of complete occlusion of internal carotid artery. If the occlusion lasts for more than 24 ~ 48 hours, if encephalomalacia has occurred, it is not suitable for surgery.

(2) Extracranial-intracranial artery anastomosis is an effective method to prevent TIA. Superficial temporal artery-middle cerebral artery anastomosis, occipital artery-posterior inferior cerebellar artery anastomosis and occipital artery-posterior cerebral artery anastomosis can be selected.