Stroke Diagnosis, Treatment Options, & Recovery

Stroke treatment depends on the type of stroke, the part of the brain affected, and how quickly care begins. This guide explains how doctors diagnose a stroke, which treatments are used, and what recovery and rehabilitation involve.

If you think someone is having a stroke right now, call 150919 immediately (international callers: ( 62) 21 3002 0031). Every minute matters.

Recognize the Warning Signs of a Stroke

The BE FAST checklist can help you spot common stroke symptoms:

• Balance: Sudden loss of balance or coordination
• Eyes: Sudden blurred, double, or lost vision
• Face: One side of the face droops
• Arms: Weakness or numbness in one arm or leg
•  Speech: Slurred or confused speech
• Time: Call emergency services immediately and note when symptoms started

Do not wait to see whether symptoms improve. Some treatments only work within hours of symptom onset.

What Happens During Stroke Diagnosis?

Stroke diagnosis begins with an urgent medical assessment to identify what has happened in the brain and determine the safest treatment. Doctors consider the patient's symptoms, medical history, and the time symptoms started.

Brain Imaging and Medical Tests

Several tests may be used to confirm a stroke, identify its type, and guide treatment.

• CT scan: A non-contrast CT scan of the head is commonly the first imaging test. It helps doctors identify bleeding and distinguish hemorrhagic stroke from suspected ischemic stroke.
• CT angiography (CTA): This scan examines blood vessels in the brain and neck to identify blockages that may require specialized treatment.
• MRI: When appropriate, MRI provides detailed images of brain tissue and helps identify areas affected by a stroke.
• Blood tests and ECG: These tests help identify contributing factors, including diabetes, blood abnormalities, and irregular heart rhythms.
• Neurological examination: Doctors assess speech, vision, strength, coordination, and other brain functions to understand the effects of the stroke.

Because treatment for a blocked blood vessel differs from treatment for bleeding in the brain, accurate diagnosis is essential before treatment begins.

Understanding Stroke Treatment Options

Stroke treatment depends on the stroke type, the time since symptoms started, imaging results, and the patient's overall health. Treatment aims to protect brain function, limit further injury, and prevent complications.

Treatment for Ischemic Stroke

An ischemic stroke occurs when a blood clot blocks blood flow to part of the brain. Treatment may include:

• Intravenous thrombolysis: Clot-dissolving medication may be given to eligible patients, generally within 4.5 hours of symptom onset.
• Mechanical thrombectomy: A specialist procedure that removes a clot from a large blocked artery. It is usually performed within 6 hours of symptom onset, and selected patients may be treated up to 24 hours after onset, depending on clinical assessment and imaging findings.
• Medication and risk-factor management: Depending on the patient's condition, doctors may prescribe antiplatelet medication and manage blood pressure, cholesterol, or diabetes to reduce future stroke risk.

Treatment for Hemorrhagic Stroke

A hemorrhagic stroke occurs when a blood vessel breaks and causes bleeding in or around the brain. Treatment focuses on controlling bleeding, managing blood pressure, and reducing pressure inside the skull.

Some patients need close monitoring and medication, while others may require surgery to address bleeding, an aneurysm, or another blood vessel problem. Doctors assess the potential benefits and risks before recommending medication or a procedure.

What to Expect During Stroke Recovery

Stroke recovery varies from person to person. Some patients regain many of their abilities, while others need ongoing support with movement, communication, or everyday activities.

Progress depends on the severity of the stroke, the affected brain area, and the patient's overall health. Rehabilitation usually begins when the patient is medically stable and the care team confirms that therapy is safe.

Rehabilitation After a Stroke

A personalized rehabilitation program may involve several healthcare professionals working together.

• Physical therapy: Helps improve strength, balance, walking, and mobility.
• Occupational therapy: Helps patients practice everyday activities, including dressing, bathing, and eating.
• Speech-language therapy: Supports communication, speech, swallowing, and related cognitive difficulties.
• Psychological support: Helps patients and families manage emotional changes, anxiety, and depression.
• Follow-up care: Monitors progress, reviews treatment, and addresses ongoing health needs.

Family members can also support recovery by encouraging participation in therapy, helping patients follow medical advice, and attending follow-up appointments when appropriate.

Reducing the Risk of Another Stroke

Recovery also involves preventing another stroke. Depending on the patient's condition, doctors may recommend controlling blood pressure, managing diabetes and cholesterol, stopping smoking, staying physically active when safe, and taking prescribed medication as directed.

Antiplatelet medication or anticoagulants may be appropriate for certain patients, depending on the underlying cause. These medicines are not interchangeable, so patients should follow their doctor's instructions.

Specialist Stroke Care at Bali International Hospital

The Stroke & Brain Center at Bali International Hospital offers:

• Non-contrast CT imaging, available 24/7
• CT angiography (CTA)
• MRI and perfusion imaging
• Intravenous thrombolysis
• Mechanical thrombectomy
• Multidisciplinary rehabilitation

The center aims to begin thrombolysis within 45 minutes of arrival and thrombectomy within 90 minutes of arrival for eligible patients.

If you or a family member needs stroke assessment, treatment, or rehabilitation, explore the Stroke & Brain Center to learn more about the available services and specialist care options.

Contact Bali International Hospital

• Emergency (in Indonesia): 150919
• Call center (in Indonesia): 1500238
• Emergency (international callers): 62 21 3002 0031
• Call center (international callers): 62 21 3113 1923

If stroke symptoms occur suddenly, seek emergency medical attention immediately. Do not wait for a routine appointment or for symptoms to improve.

Frequently Asked Questions

How is a stroke diagnosed?

Doctors assess symptoms, perform a neurological examination, and usually order a CT scan. CTA, MRI, blood tests, and an ECG may also help identify the stroke type, locate blockages, and investigate possible causes.

How quickly does stroke treatment need to start?

As quickly as possible. Clot-dissolving medication is generally given within 4.5 hours of symptom onset, and thrombectomy is usually performed within 6 hours, or up to 24 hours for selected patients.

Call emergency services as soon as symptoms appear.

What treatment may be needed after a stroke?

Treatment depends on whether the stroke is ischemic or hemorrhagic. Options may include clot-dissolving medication, mechanical thrombectomy, bleeding management, surgery when necessary, and medication to reduce the risk of another stroke.

Which doctors are involved in stroke care?

Stroke care may involve neurologists, emergency physicians, radiologists, neurosurgeons when needed, and rehabilitation physicians. Nurses, physical therapists, occupational therapists, speech-language therapists, and psychologists may also support treatment and recovery.

What does stroke rehabilitation involve?

Stroke rehabilitation helps patients improve movement, communication, swallowing, and independence in daily activities. It may include physical, occupational, and speech-language therapy, psychological support, and ongoing management of stroke risk factors.