Stroke
Stroke Overview
A stroke occurs when there is a sudden loss of blood flow to the brain due to a blood vessel blockage or rupture. The loss of blood deprives brain cells of oxygen, and they begin to die. When brain cells die, the bodily functions they control are impaired or lost. Broadly speaking, there are two types of stroke: ischemic stroke and hemorrhagic stroke.
- Ischemic stroke occurs when fatty deposits build up inside a blood vessel that supplies blood to the brain and cause a blockage, or when a blood clot travels to the brain and causes a blockage.
- Hemorrhagic stroke occurs when a blood vessel leaks or ruptures, and the leaked blood compresses and damages brain cells.
- Subarachnoid hemorrhage occurs when a brain aneurysm ruptures.
- Transient ischemic attack (TIA, or “mini stroke”) occurs when blood flow to the brain is blocked for a short period of time, usually no more than five minutes. While there is usually no permanent injury to the brain following a TIA, it is a warning sign that a major stroke may occur.
Video: How tPA is Used to Treat Ischemic Stroke
Stroke Symptoms
Stroke symptoms are usually sudden and can vary depending on the part of the brain that is affected. Common symptoms include:
- Sudden, severe headache, sometimes referred to as a “thunderclap headache” or “the worst headache of my life”
- Paralysis or weakness on one side of the body
- Numbness or tingling
- Difficulty speaking or understanding
- Vision problems
- Dizziness or vertigo
- Loss of balance
Call 9-1-1 immediately if you think you are having a stroke or TIA.
Recognizing a stroke quickly and calling 9-1-1 leads to faster diagnosis and treatment and better recovery. People should “BE FAST” when it comes to stroke.
Here’s how to BE FAST:
- B – BALANCE: Ask the person to walk. Do they have trouble keeping their balance or walking normally?
- E – EYES: Ask the person about their eyesight. Have they lost vision or experienced vision changes in one or both eyes?
- F – FACE: Ask the person to smile. Does one side of the face droop?
- A – ARMS: Ask the person to raise both arms. Does one arm drift downward?
- S – SPEECH: Ask the person to repeat a simple phrase. Is their speech slurred or strange?
- T – TIME: If you observe any of these signs, call 9-1-1 immediately.
Stroke Treatment
If appropriate medical care is received within the first four hours and 30 minutes of the onset of symptoms, the impact of the stroke can be minimized.
Treatment for Ischemic Stroke
- Thrombolytic therapy during the first 4.5 hours after a stroke, a “clot-busting” medication called tissue plasminogen activator (tPA) is administered through an IV to dissolve the blood clot and restore blood flow to the brain.
- Thrombectomy therapy, a type of endovascular neurosurgery, may be used when a stroke is caused by the blockage of a large artery. In this procedure, an endovascular neurosurgeon inserts a wire through the artery to remove the blockage. This treatment has to be done within 24 hours of the onset of stroke symptoms.
Treatment for Hemorrhagic Stroke
- Surgery may be needed to remove blood from the brain and to place a temporary drainage catheter to reduce pressure within the brain.
- If the bleeding is caused by a ruptured aneurysm, it can be treated by filling the aneurysm with platinum coils or by placing a clip across the base of the aneurysm to prevent it from bleeding again.
- Endovascular procedures are less invasive than surgical treatments. They involve inserting a tube through a major artery in the leg or arm and guiding it to the weak spot or break in a blood vessel. The tube is then used to install a device to repair the damage and prevent further bleeding.
Neuro-Rehabilitation for Stroke
Neuro-rehabilitation programs can help you regain some of the abilities you had before a stroke.
At Barrow Neurological Institute, our team of stroke rehabilitation specialists includes:
- Rehabilitation physicians
- Neuropsychologists
- Nurses
- Physical, occupational, speech and language, and recreational therapists
Additional Information on Stroke
Are strokes preventable?
Strokes are preventable. Around 80% of strokes could be prevented by lifestyle and behavior modification and control of healthcare conditions like diabetes, obesity, and high cholesterol. If you have any of the following risk factors, speak to your doctor about it. They will work with you to help get them under control and reduce your risk of stroke.
- Smoking
- High blood pressure: systolic blood pressure greater than 140 mm/Hg; diastolic blood pressure greater than 85 mm/HG
- Diabetes: hemoglobin A1c, an index on how blood sugar is controlled, should be less than 5.7%
- Hypercholesterolemia: your “bad cholesterol”, LDL, should be around 70 mg/dL
- Physical inactivity and obesity
- Excessive alcohol consumption
How common are strokes?
Stroke is the leading cause of serious long-term disability and the fifth leading cause of death in the United States. More than 795,000 Americans suffer a stroke each year, and of that number nearly 130,000 people do not survive. On average, one American dies from a stroke every four minutes.
Ischemic strokes account for about 87 percent of all stroke cases.
Who gets strokes?
The risk of having a stroke increases with age, but anyone can have a stroke at any age.
While men are more likely to have a stroke than women, women are more likely to suffer a fatal stroke. Pregnancy and the use of birth control pills pose special stroke risks for women.
The risk of having a first stroke is nearly twice as high for blacks than for whites.
Other risk factors include a previous stroke or TIA, high blood pressure, high cholesterol, heart disease, diabetes, and sickle cell disease.
How are strokes diagnosed?
If you have symptoms of a stroke or TIA, your doctor may do the following to reach a diagnosis:
- Review of your medical history
- Conduct a physical and neurological examination
- Have blood tests done
- Have imaging tests done
Our team at the Petznick Stroke Center is equipped to perform a full range of diagnostic tests to determine the exact cause of a stroke 24 hours a day, seven days a week. Common diagnostic tests include:
- Carotid ultrasound
- Transcranial doppler (TCD) ultrasonography transesophageal echocardiography
- Computed tomography (CT)
- Magnetic resonance imaging (MRI)
- Magnetic resonance angiography (MRA)
- Cerebral angiography
- Electroencephalogram (EEG)
- Cerebrovascular Testing
