Hi, If your father is aged 54 then, he would be considered YOUNG in the sense that his strokes may have underlying causes that promote or cause the formation and release of blood clots. This means that it is possible that the medications he s taking are not really the best type for his type of stroke he s experiencing. Your father should undergo what we refer to as a stroke in the young workup which involves a number of blood tests that are a bit specialized and not usually obtained during routine followup visits. I would recommend finding a neurologist who is specialized in stroke and if possible stroke in young patients such as your father so he can be thoroughly and rapidly worked up to discover either a CAUSE for these strokes or to get on a reasonable regimen of either anticoagulant, antiplatelets, or perhaps some type of Antilipid/cholesterol set of medications. Your father would also likely benefit from tests such as electrocardiogram (12 lead) along with a 30-day EVENT MONITOR as well as an echocardiogram study with bubble study and then, in addition, a transesophageal electrocardiogram (TEE) to check for the presence of blood clots in the left atrial chamber of the heart. This is not an uncommon presentation and concern in the face of the number of strokes your father is having despite being on medication. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Dariush Saghafi, Neurologist