How Is Stroke Treated

Stroke treatment must begin as quickly as possible.

How Is Stroke Treated?

Stroke is treated differently depending on whether it is caused by a blood clot blocking an artery (ischaemic stroke) or by bleeding in the brain (haemorrhagic stroke). These two types of strokes require completely different approaches.

Ischaemic stroke accounts for approximately 76% of all stroke cases in Malaysia. Treatment focuses on restoring blood flow to the brain as rapidly as possible; while Haemorrhagic stroke treatment focuses on controlling the bleeding and protecting surrounding brain tissue.

blood pressure test

Ischaemic Stroke Treatment

1. Thrombolysis — Clot-Dissolving Medication

Thrombolysis is one of the primary treatments for ischaemic stroke. It involves administering a clot-dissolving medication by breaking down the blood clot that is blocking blood flow to the brain, restoring circulation and limiting the extent of permanent brain damage.

Thrombolysis must be given within 4.5 hours of stroke onset to be effective. The earlier it is administered within that window, the greater the benefit.

2. Mechanical Thrombectomy – Stroke Clot Removal

Mechanical thrombectomy is a minimally invasive endovascular procedure that removes clots from brain vessels.

Based on current international guidelines, mechanical thrombectomy can be performed within 6 hours of symptom onset as standard, and up to 16 to 24 hours after onset

Haemorrhagic Stroke Treatment

Treatment for haemorrhagic stroke focuses on controlling and stabilising the bleed through careful blood pressure management and medication to support clotting.

In cases where the bleed is significant or causing dangerous levels of pressure on the brain, surgical intervention by our neurosurgery team may be required to relieve that pressure or address the source of the bleed directly.

Medical Management During Stroke Treatment

Alongside acute interventions, all stroke patients receive ongoing medical management throughout their admission. Anti-platelet therapy such as aspirin is typically started within 24 to 48 hours of an ischaemic stroke once imaging confirms no bleeding is present. These medications reduce the tendency of blood to clot and lower the risk of a second stroke.

For patients whose stroke was caused by atrial fibrillation, an irregular heart rhythm that allows blood to pool and form clots that travel to the brain, anticoagulant medications are prescribed. Blood pressure, blood sugar, and body temperature are all monitored and managed carefully, as elevated levels of any of these during the acute phase are known to worsen stroke outcomes.

What Happens After Stroke Treatment?

Following acute treatment, stroke patients are admitted to our Intensive Care Unit (ICU) or High Dependency Unit (HDU) for close monitoring during the first 24 to 48 hours. Our stroke unit hospital team carries out continuous neurological checks, vital sign monitoring, swallowing assessment, and active management of any complications that arise including brain swelling, pneumonia, or deep vein thrombosis.

Once the patient is stable, they are transferred to our dedicated stroke unit where the recovery phase begins.

Rehabilitation is started as early as possible, often within the first 24 hours of stabilisation. Our physiotherapists, occupational therapists, and speech language therapists work with each patient based on the specific effects of their stroke and their individual recovery goals.

Stroke Treatment in Penang

At Sunway Medical Centre Penang, our stroke team is available around the clock to assess and begin treatment the moment a patient arrives — because in stroke care, time is brain.

The right treatment depends on the type of stroke, its severity, and how much time has passed since symptoms began. Our team of neurologists, neurosurgeon, and interventional radiologist work together to determine the most appropriate treatment pathway for each patient without delay.

Recognised for Excellence in Stroke Care

Sunway Medical Centre Penang is a recipient of the World Stroke Organization (WSO) Angels Gold Award, an internationally recognised mark of quality in stroke care.

This recognition reflects the performance of our entire multidisciplinary stroke team — from the speed at which eligible patients receive thrombolysis, to the proportion admitted to a dedicated stroke unit, to the appropriateness of medications prescribed at discharge. It reflects a system built to deliver consistently high standards of stroke emergency treatment.

Frequently Asked Questions

Will stroke treatment fully restore the patient to how they were before?

This depends on the severity of the stroke, which part of the brain was affected, and how quickly treatment was received. Some patients recover fully, while others may experience lasting effects such as weakness, speech difficulties, or changes in memory and cognition. Recovery is not always linear — many patients continue to improve for months or even years after the stroke with consistent rehabilitation and support.

How long does stroke treatment take?

Thrombolysis is delivered as a drip over approximately one hour. Mechanical thrombectomy typically takes between one and two hours depending on the complexity of the case. These are followed by a period of close monitoring in the ICU or HDU for 24 to 48 hours, after which the patient is transferred to the stroke unit where rehabilitation begins. The overall hospital stay varies depending on stroke severity and the patient's rate of recovery.

Can a stroke happen again after treatment?

Yes, stroke survivors have a higher risk of experiencing a second stroke compared to the general population. This is why identifying the underlying cause of the first stroke — whether it is high blood pressure, atrial fibrillation, high cholesterol, or diabetes — is a critical part of the treatment process. Appropriate medication, lifestyle changes, and regular follow-up care significantly reduce this risk.

Can stroke treatment be done if the patient is on blood thinners?

Being on blood thinners does not automatically exclude a patient from stroke treatment, but it is one of the factors our stroke team assesses carefully before deciding on the most appropriate approach. Certain blood-thinning medications and their dosages can affect eligibility for thrombolysis. Our team will review the patient's complete medication history alongside imaging results and clinical assessment to determine the safest and most effective treatment option.

Is thrombolysis safe and are there side effects?

Thrombolysis is a well-established treatment that has been used in stroke care for decades and is recommended by international clinical guidelines for eligible patients. Like all medical treatments, it carries a small risk of side effects, the most significant being bleeding, including in rare cases bleeding in the brain. Our stroke team carefully assesses each patient's eligibility before administering thrombolysis to ensure the benefits outweigh the risks for that individual. For eligible patients, the potential benefit of limiting permanent brain damage far outweighs the risk.

What Happens After Your Stroke Is Treated?

At Sunway Medical Centre Penang, stroke treatment does not end when the acute procedure is complete. Recovery involves close monitoring, ongoing medical management, and structured rehabilitation tailored to each patient's specific needs and recovery goals. Our multidisciplinary stroke team supports patients through every stage of that journey, from the Emergency Department through to discharge and beyond.

Speak with our Stroke Specialists to understand which treatment options may be appropriate and what to expect throughout your care.

Learn more about stroke care at our Stroke Centre in Penang