Stroke

A stroke occurs when the blood supply to part of your brain is interrupted or severely reduced, depriving brain tissue of oxygen and nutrients. Within minutes, brain cells begin to die.

A stroke is a medical emergency. Prompt treatment is crucial. Early action can minimize brain damage and potential complications.

The good news is that strokes can be treated and prevented, and many fewer Americans die of stroke now than even 15 years ago.

Symptoms

Watch for these signs and symptoms if you think you or someone else may be having a stroke. Note when your signs and symptoms begin, because the length of time they have been present may guide your treatment decisions:

  • Trouble with speaking and understanding. You may experience confusion. You may slur your words or have difficulty understanding speech.
  • Paralysis or numbness of the face, arm or leg. You may develop sudden numbness, weakness or paralysis in your face, arm or leg, especially on one side of your body. Try to raise both your arms over your head at the same time. If one arm begins to fall, you may be having a stroke. Similarly, one side of your mouth may droop when you try to smile.
  • Trouble with seeing in one or both eyes. You may suddenly have blurred or blackened vision in one or both eyes, or you may see double.
  • Headache. A sudden, severe headache, which may be accompanied by vomiting, dizziness or altered consciousness, may indicate you’re having a stroke.
  • Trouble with walking. You may stumble or experience sudden dizziness, loss of balance or loss of coordination.

IF YOU OR SOMEONE YOU KNOW IS CONCERNED ABOUT HAVING RISK FACTORS FOR POTENTIAL STROKE, PLEASE INQUIRE AT THE FRONT WINDOW ABOUT SCHEDULING A NEUROLOGICAL EVALUATION.

Seek immediate medical attention if you notice any signs or symptoms of a stroke, even if they seem to fluctuate or disappear.

Think “FAST” and do the following:

  • Face. Ask the person to smile. Does one side of the face droop?
  • Arms. Ask the person to raise both arms. Does one arm drift downward? Or is one arm unable to raise up?
  • Speech. Ask the person to repeat a simple phrase. Is his or her speech slurred or strange?
  • Time. If you observe any of these signs, call 911 immediately.

Call 911 or your local emergency number right away. Don’t wait to see if symptoms go away. Every minute counts. The longer a stroke goes untreated, the greater the potential for brain damage and disability.

If you’re with someone you suspect is having a stroke, watch the person carefully while waiting for emergency assistance.

Types of Strokes

Ischemic stroke

About 85 percent of strokes are ischemic strokes. Ischemic strokes occur when the arteries to your brain become narrowed or blocked, causing severely reduced blood flow (ischemia). The most common ischemic strokes include:

  • Thrombotic stroke. A thrombotic stroke occurs when a blood clot (thrombus) forms in one of the arteries that supply blood to your brain. A clot may be caused by fatty deposits (plaque) that build up in arteries and cause reduced blood flow (atherosclerosis) or other artery conditions.
  • Embolic stroke. An embolic stroke occurs when a blood clot or other debris forms away from your brain — commonly in your heart — and is swept through your bloodstream to lodge in narrower brain arteries. This type of blood clot is called an embolus.

Hemorrhagic stroke

Hemorrhagic stroke occurs when a blood vessel in your brain leaks or ruptures. Brain hemorrhages can result from many conditions that affect your blood vessels, including uncontrolled high blood pressure (hypertension), overtreatment with anticoagulants and weak spots in your blood vessel walls (aneurysms).

A less common cause of hemorrhage is the rupture of an abnormal tangle of thin-walled blood vessels (arteriovenous malformation) present at birth. Types of hemorrhagic stroke include:

  • Intracerebral hemorrhage. In an intracerebral hemorrhage, a blood vessel in the brain bursts and spills into the surrounding brain tissue, damaging brain cells. Brain cells beyond the leak are deprived of blood and also damaged.

High blood pressure, trauma, vascular malformations, use of blood-thinning medications and other conditions may cause an intracerebral hemorrhage.

  • Subarachnoid hemorrhage. In a subarachnoid hemorrhage, an artery on or near the surface of your brain bursts and spills into the space between the surface of your brain and your skull. This bleeding is often signaled by a sudden, severe headache.

A subarachnoid hemorrhage is commonly caused by the bursting of a small sack-shaped or berry-shaped outpouching on an artery known as an aneurysm. After the hemorrhage, the blood vessels in your brain may widen and narrow erratically (vasospasm), causing brain cell damage by further limiting blood flow.

Transient ischemic attack (TIA)

A transient ischemic attack (TIA) — also known as a ministroke — is a brief period of symptoms similar to those you’d have in a stroke. A temporary decrease in blood supply to part of your brain causes TIAs, which often last less than five minutes.

Like an ischemic stroke, a TIA occurs when a clot or debris blocks blood flow to part of your brain. A TIA doesn’t leave lasting symptoms because the blockage is temporary.

Seek emergency care even if your symptoms seem to clear up. Having a TIA puts you at greater risk of having a full-blown stroke, causing permanent damage later. If you’ve had a TIA, it means there’s likely a partially blocked or narrowed artery leading to your brain or a clot source in the heart.

It’s not possible to tell if you’re having a stroke or a TIA based only on your symptoms. Up to half of people whose symptoms appear to go away actually have had a stroke causing brain damage.

Risk factors

Many factors can increase your risk of a stroke. Some factors can also increase your chances of having a heart attack. Potentially treatable stroke risk factors include:

Lifestyle risk factors

  • Being overweight or obese
  • Physical inactivity
  • Heavy or binge drinking
  • Use of illicit drugs such as cocaine and methamphetamines

Medical risk factors

  • High blood pressure — the risk of stroke begins to increase at blood pressure readings higher than 120/80 millimeters of mercury (mm Hg). Your doctor will help you decide on a target blood pressure based on your age, whether you have diabetes and other factors.
  • Cigarette smoking or exposure to secondhand smoke.
  • High cholesterol.
  • Diabetes.
  • Obstructive sleep apnea — a sleep disorder in which the oxygen level intermittently drops during the night.
  • Cardiovascular disease, including heart failure, heart defects, heart infection or abnormal heart rhythm.

Other factors associated with a higher risk of stroke include:

  • Personal or family history of stroke, heart attack or transient ischemic attack.
  • Being age 55 or older.
  • Race — African-Americans have a higher risk of stroke than do people of other races.
  • Gender — Men have a higher risk of stroke than women. Women are usually older when they have strokes, and they’re more likely to die of strokes than are men. Also, they may have some risk from some birth control pills or hormone therapies that include estrogen, as well as from pregnancy and childbirth.

 


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