Stroke

Article
2021-02-01

Also known as cerebrovascular accident, ischemic stroke, hemorrhagic stroke, transient ischemic attack

Stroke happens when blood flow to the brain is blocked. This prevents the brain from getting oxygen and nutrients from the blood. Without oxygen and nutrients, brain cells begin to die within minutes. Sudden bleeding in the brain can also cause a stroke if it damages brain cells.

Stroke is a medical emergency. A stroke can cause permanent brain damage, long-term disability, or even death. Signs of a stroke can range from mild weakness to paralysis or numbness on one side of the face or body. Other signs include sudden and severe headache, sudden weakness, trouble seeing, and trouble speaking or understanding speech.

If you think you or someone else is having a stroke, call 9-1-1 right away. Do not drive to the hospital or let anyone else drive you. Call an ambulance so medical personnel can begin life-saving treatment on their way to the emergency room. During a stroke , every minute counts.

At the hospital, a stroke team will assess your condition and treat your stroke with medication, surgery, or another procedure. Your recovery will depend on how severe your stroke was and how quickly you were treated. A rehabilitation plan can help you do the same things you used to do for your stroke.

Symptoms

The signs and symptoms of a stroke often develop quickly. However, they can develop over hours or even days, such as when a transient ischemic attack (TIA) turns into a stroke.

The type of symptoms depend on the type of stroke and the area of the brain that is affected.

Signs and symptoms of a TIA or stroke can include:

Sudden numbness or weakness, especially on one side of the body
Sudden confusion or difficulty speaking or understanding speech
Sudden trouble seeing in one or both eyes
Sudden trouble walking, dizziness, or loss of balance or coordination
Sudden severe headache with no known cause

The FAST test can help you remember what to do if you think someone is having a stroke:

F - Face: Ask the person to smile. Is one side of the face hanging down?

A - Arms: ask the person to raise both arms. Is an arm floating down?

S - Speech: Ask the person to repeat a simple sentence. Is their speech slurred or strange?

T - Time: If you notice any of these signs, call 9-1-1 immediately. Early treatment is essential.

If you think you or someone else has a TIA or stroke, don't drive to the hospital or let someone else drive you. Call an ambulance so medical personnel can begin life-saving treatment on their way to the emergency room. During a stroke , every minute counts.

Complications

A stroke can cause permanent brain damage, long-term disability, or even death. If you have a stroke, your doctor can assess how severe it is. A more severe stroke means that more brain tissue has been damaged. If significant damage has occurred, your doctor may call it a major stroke. This can lead to more serious complications.

After a stroke, you can have complications such as:

Dangerous blood clots. If you are unable to move for a long time, your risk of blood clots in the deep veins of the legs may increase. In some cases, blood clots can break loose and travel to the lungs. Your stroke care team can try to prevent these complications with drugs or a device that puts pressure on your calves to get your blood flowing.
Difficulty speaking. If a stroke affects the muscles you use to speak, you may have trouble communicating as easily as before.
Loss of bladder or bowel control. Some strokes affect the muscles used to urinate and have bowel movements. It could be dWhen you need a urinary catheter (a tube that is placed in the bladder) until you can pass urine yourself. Using these catheters can lead to urinary tract infections. You can also lose control of your bowels or become constipated.
Loss of bone density or strength. This usually happens on one side of the body. Physical activity as part of rehabilitation can help prevent this loss. Your health care team can also assess you for osteoporosis.
Loss of vision, hearing, or touch. Your ability to feel pain or temperature may be affected after a stroke, or you may have trouble seeing or hearing as before. Some of these changes can affect your ability to cook, read, change your clothes, or perform other tasks.
Muscle weakness or inability to move. A stroke can make your muscles weak and stiff or cause spasms. This can be painful or make it difficult to stand or walk alone. You may also have problems with your balance or control your muscles. This puts you at risk of falling.
Problems swallowing and pneumonia . If a stroke affects the swallowing muscles, it can be difficult to eat or drink. You may also be at risk of breathing food or drink into your lungs. If this happens, you could get pneumonia.
Problems with language, thinking or memory. A stroke can affect your ability to focus on a task or make decisions quickly. It also increases the risk of dementia.
Epileptic attacks. This is more common in the weeks after a stroke and less likely with time. If you have seizures, your stroke team can give you medicine.
Swelling in the brain. After a stroke, fluid can build up between the brain and skull or in the cavities of the brain, causing swelling. Doctors can drain fluid from the brain or cut out part of the skull to relieve pressure on your brain.

Therapy

Stroke requires emergency care. You will likely be treated in a specialized stroke unit at the hospital. A team of specialists supervises your care. Treatment depends on whether the stroke was ischemic or hemorrhagic, how much time has passed since symptoms started, and whether you have other medical conditions.

Treating an ischemic stroke

Treatment for an ischemic stroke or transient ischemic (TIA) can consist of medications and medical procedures.

Medicines

The main treatment for ischemic stroke is a drug called tissue plasminogen activator (tPA). It breaks up the blood clots that block blood flow to your brain. A doctor will inject tPA into a vein in your arm. This type of medicine should be given within 3 hours of the start of your symptoms. In some cases it is given for up to 4.5 hours. The sooner the treatment starts, the better your chances of recovery.

If you can't get tPA, your doctor can give you an anticoagulant or blood-thinning medication, such as aspirin or clopidrogrel. This helps prevent blood clots from forming or getting bigger. The main side effect of these drugs is bleeding.

Medical procedures

You may need a procedure to open blocked arteries and restore blood flow to the brain. This can be done in several ways.

A thrombectomy removes the clot from the blood vessel. A surgeon will insert a long, flexible tube called a catheter into your groin (upper leg) and route it to the blocked artery in your neck or brain. They will then use angioplasty and stenting or a device called a stent retriever to open the blocked artery.

Angioplasty and stenting procedures use a thin tube to deliver a balloon or small-mesh tube into the artery. Inflating the balloon or expanding the mesh tube frees up space so that blood can flow more easily to the brain.
The stent retriever is a wire mesh in the catheter that traps the clot. The stent retractor and blood clot are then continued

Was this article helpful?

Did you not find what you were looking for? Search further in the

symptomchecker