What is a stroke?
A stroke occurs when a blood vessel in the brain is blocked or bursts. Without blood and the oxygen it carries, part of the brain starts to die. The part of the body controlled by the damaged area of the brain can’t work properly.
Brain damage can begin within minutes. That’s why it’s so important to know the symptoms of stroke and to act fast. Quick treatment can help limit damage to the brain and increase the chance of a full recovery.
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What are the symptoms?
The symptoms for stroke can come on suddenly and include:
- Numbness or weakness on one side of the body.
- Confusion or difficulty speaking or understanding speech.
- Difficulty seeing with one or both eyes.
- Difficulty walking, dizziness or lack of coordination.
- Severe headache with no known cause.
Because strokes require rapid assessment and medical intervention, time is critical to prevent permanent brain damage, long-term disability and even death. Recognizing signs and taking action when someone is experiencing a stroke can be remembered through F.A.S.T. The acronym stands for:
- F ace drooping (one side of the person’s face droops or is numb)
- A rm weakness (one arm of the person is weak, numb or doesn’t move at all)
- S peech difficulty (the person slurs or can’t form words)
- T ime is critical – call 911 (if the person shows any of these symptoms)
See your doctor if you have symptoms that seem like a stroke, even if they go away quickly. You may have had a transient ischemic attack (TIA), sometimes called a mini-stroke. A TIA is a warning that a stroke may happen soon. Getting early treatment for a TIA can help prevent a stroke.
What causes a stroke?
There are two major types of stroke:
- Ischemic stroke occurs when a blood vessel that supplies blood to the brain is blocked by a blood clot. A clot may form in an artery that is already very narrow this is called a thrombotic stroke. A clot may break off from another place in the blood vessels of the brain, or from some other part of the body, and travel up to the brain. This is called cerebral embolism, or an embolic stroke.
- A hemorrhagic stroke develops when an artery in the brain leaks or bursts. This causes bleeding inside the brain or near the surface of the brain. Hemorrhagic strokes are less common but more deadly than ischemic strokes. Hemorrhagic strokes may also occur when someone is taking blood thinners, such as warfarin (Coumadin). Very high blood pressure may cause blood vessels to burst, leading to hemorrhagic stroke.
High blood pressure is the main risk factor for strokes. Other major risk factors are:
- Irregular heartbeat, called atrial fibrillation
- Family history of stroke
- High cholesterol
- Increasing age, especially after age 55
- Ethnicity (African Americans are more likely to die of a stroke)
Stroke risk is also higher in:
- People who have heart disease or poor blood flow in their legs caused by narrowed arteries
- People who have unhealthy lifestyle habits such as smoking, a high-fat diet, and lack of exercise
- Women who take birth control pills (especially those who smoke and are older than 35)
- Women who are pregnant have an increased risk while pregnant
- Women who take hormone replacement therapy
How is a stroke diagnosed?
The doctor will do a physical exam to:
- Check for problems with vision, movement, feeling, reflexes, understanding, and speaking. Your doctor and nurses will repeat this exam over time to see if your stroke is getting worse or improving.
- Listen to the carotid arteries in the neck with a stethoscope for an abnormal sound, called a bruit, which is caused by abnormal blood flow.
- Check for high blood pressure.
You may have the following tests to help find the type, location, and cause of the stroke and rule out other problems:
- Angiogram of the head to look for a blood vessel that is blocked or bleeding
- Carotid duplex (ultrasound) to see if the carotid arteries in your neck have narrowed
- Echocardiogram to see if the stroke could have been caused by a blood clot from the heart
- Magnetic resonance angiography (MRA) or CT angiography to check for abnormal blood vessels in the brain
Other tests include:
- Blood tests
- Electrocardiogram (ECG) and heart rhythm monitoring
For an ischemic stroke, treatment focuses on restoring blood flow to the brain. If you get to the hospital right away after symptoms begin, doctors may use a medicine that dissolves blood clots. Research shows that this medicine can improve recovery from a stroke, especially if given within 90 minutes of the first symptoms. Other medicines may be given to prevent blood clots and control symptoms.
A hemorrhagic stroke can be hard to treat. Doctors may do surgery or other treatments to stop bleeding or reduce pressure on the brain. Medicines may be used to control blood pressure, brain swelling, and other problems.
After either kind of stroke and after your condition is stable, treatment shifts to preventing other problems and future strokes. You may need to take a number of medicines to control conditions that put you at risk for stroke, such as high blood pressure or atrial fibrillation. Some people need to have a surgery to remove plaque buildup from the blood vessels that supply the brain (carotid arteries).
The best way to get better after a stroke is to start stroke rehabilitation (rehab). The goal of stroke rehab is to help you regain skills you lost or to make the most of your remaining abilities. Stroke rehab can also help you take steps to prevent future strokes. You have the greatest chance of regaining abilities during the first few months after a stroke. So it is important to start rehab soon after a stroke and do a little every day.
How can you prevent stroke?
Reducing your stroke risk factors lessens your chance of a having stroke.