About Stroke

There are two types of stroke–ischemic stroke and hemorrhagic stroke.

An ischemic stroke, the most common type of stroke, occurs when a blood vessel becomes blocked, usually by a blood clot. In an ischemic stroke, blood can’t reach the brain, and brain cells suffer from the lack of nutrients and oxygen that they would normally get. This type of stroke can be caused by a blockage anywhere along the arteries feeding into the brain, and these blockages can occur for a variety of reasons. About 80% of all strokes are ischemic strokes.

A hemorrhagic stroke occurs when a blood vessel in the brain ruptures, leaking blood into the brain. Hemorrhagic stroke can often be traced to high blood pressure; however, it may also be caused by an aneurysm (a bubble in the artery wall) that bursts or by a condition called arterial venous malformation, a tangle of abnormal blood vessels in the brain that may bleed due to the fragility of the vessel structure. Hemorrhagic strokes account for about 15% of all strokes.

Symptoms

Most strokes happen suddenly, develop quickly, and can damage the brain within minutes. Some of the most common symptoms of stroke include:

• Loss of (or abnormal) sensations in an arm, leg or one side of the body
• Weakness or paralysis of an arm or leg or one side of the body
• Partial loss of vision or hearing
• Double vision
• Dizziness
• Slurred speech
• Problems thinking of or saying the right word
• Inability to recognize parts of the body
• Imbalance and falling

Causes/Risk Factors

Although both types of stroke occur differently, the risk factors and outcomes are often the same. Smoking, obesity, and poor diet, along with health conditions such as heart disease, diabetes, high blood pressure, and high cholesterol, all contribute to your overall risk of stroke.

Diagnosis

Stroke is diagnosed with the help of a computed axial tomography (CAT) scan of the brain to determine if you are in fact suffering a stroke, and whether it is ischemic or hemorrhagic in nature.  If the scan reveals an ischemic stroke (result of a clot), special CAT scans may be performed to enable physicians to view the arteries and determine the site of the blockage.

These scans will also reveal the way blood flows to the brain, information that is used to assess the presence of brain damage or if there is at-risk brain tissue that could potentially be saved. Rapid and accurate diagnosis of the kind of stroke and the exact location of its damage is critical to successful treatment.

Treatment Options

Treatment for stroke depends on whether you’re having an ischemic stroke or a hemorrhagic stroke. To treat an ischemic stroke, doctors must quickly restore blood flow to your brain with medication and/or invasive procedures. Therapy with clot-busting drugs (thrombolytics) must start within 4.5 hours if they are given into the vein — and the sooner, the better. Quick treatment not only improves the patient’s chances of survival but may also reduce stroke complications. Aspirin is an immediate treatment used to reduce the likelihood of having another stroke. Other blood-thinning drugs may also be given.

Doctors sometimes treat ischemic strokes with invasive procedures that must be performed as soon as possible. They may either insert a long, thin tube (catheter) through an artery in the groin and thread it to the brain, which then releases clot-busting drugs directly into the area where the stroke is occurring. Or, doctors may use a catheter to maneuver a tiny device into the brain to physically grab and remove the clot.

Treatment of hemorrhagic stroke focuses on controlling the bleeding and reducing the pressure in the brain. Surgery also may be used to help reduce future risk.

If a patient is taking any medications to reduce blood clots, they may be given drugs or transfusions of blood products to counteract the effects of these drugs. Patient’s may also be given drugs to lower pressure in the brain, lower blood pressure, or prevent seizures. People having a hemorrhagic stroke can’t be given clot-busting drugs because these drugs may worsen bleeding. Once the bleeding stops, treatment usually involves bed rest and supportive medical care while the body absorbs the blood. Healing is similar to what happens while a bad bruise goes away. If the area of bleeding is large, surgery may be used in certain cases to remove the blood and relieve pressure on the brain.

Following emergency stroke treatment, stroke after care often focuses on helping patient’s regain their strength, recover as much function as possible, and return to independent living. The impact of the stroke depends on the area of the brain involved and the amount of tissue damaged.

Your doctor will consider your medical situation, and possible risks, to determine the most appropriate course of treatment.