Such treatment has many restrictions, and potentially serious side effects, and therefore is not routinely used. Such treatment comes into consideration only in thrombotic strokes which began less than 3 hours ago. Due to risk of hemorrhage, it does not come into consideration in patients with other recent strokes, recent surgery, bleeding, seizure, those who have severe high blood pressure, or are active users of alcohol or drugs. In case of hemorrhagic strokes, surgical evacuation of the pool of blood in the brain needs to be considered, especially in younger people where the cause is often a ruptured aneurysm in the brain. Short of such aggressive measures, the main appr  oach to stroke treatment is elimination of factors which may impede the recovery, such as the use of sedatives.
True strokes result in permanent damage to some degree.
The damage is often worse at the beginning, and some recovery can follow. The more rapid the improvement in the first several days, the more likely there is to be further recovery. If there is little or no improvement within the first few days, there is little chance of significant improvement later on. However, the rehabilitation team can do only so much to produce results. The attitude, motivation and effort by the patient and family play very important roles in the rehabilitation process.