Types of Strokes

Stroke, TIA and Warning Signs

Stroke occurs when a blood vessel bringing blood and oxygen to the brain gets blocked or ruptures. When this happens, brain cells don’t get the blood that they need. Deprived of oxygen, nerve cells stop working and die within minutes. Then, the part of the body they control can’t function either. The effects of stroke may be permanent depending on how many cells are lost, where they are in the brain, and other factors.

Stroke is the No. 5 cause of death and a leading cause of serious, long-term disability in America.

TIA, or transient ischemic attack, is a “minor stroke” that occurs when a blood clot blocks an artery for a short time. The symptoms of a TIA are the same as those of a stroke, but they usually last only a few minutes. About 15 percent of major strokes are preceded by TIAs, so don’t ignore a TIA. Call 9-1-1 or seek emergency medical attention immediately!

Stroke is largely preventable.

You can reduce your stroke risk by living a healthy lifestyle — controlling high blood pressure; not smoking; eating a low-fat, low cholesterol diet; being physically active; maintaining a healthy body weight; managing diabetes; drinking moderately or not at all.

Also, much is being done to fight the effects of stroke. For example, the FDA approved use of the clot-dissolving drug tissue plasminogen activator (tPA) to treat stroke. This is an advantage because tPA can stop a stroke in progress and reduce disability. But to be eligible for tPA, you must seek emergency treatment right away, because it must be given within 4.5 hours after symptoms start, and have a stroke caused by a clot.

The warning signs of stroke should be recognizable by you and your family members. You may have some or all of these signs. Note the time when symptoms start and call 9-1-1 or the emergency medical number in your area. Stroke is a medical emergency!

Don’t ignore these warning signs, even if they go away. Timing is important. There are treatments that can be considered within 4 ½ to 8 hours of the onset of symptoms

Stroke Warning Signs

 

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

 

Before you need to take emergency action, find out where the emergency entrance is to your nearest hospital. Also, keep a list of emergency phone numbers next to your phone and with you at all times, just in case. Take these steps NOW

Hemorrhagic Stroke

There are two kinds of hemorrhagic stroke. In both, a blood vessel ruptures, disrupting blood flow to part of the brain.

Intracerebral hemorrhages (most common type of hemorrhagic stroke):

  • Occur when a blood vessel bleeds or ruptures into the tissue deep within the brain.
  • Are most often caused by chronically high blood pressure or aging blood vessels.
  • Are sometimes caused by an arteriovenous malformation (AVM). An AVM is a cluster of abnormally formed blood vessels. Any one of these vessels can rupture, also causing bleeding into the brain.

Subarachnoid hemorrhages:

  • Occur when an aneurysm (a blood-filled pouch that balloons out from an artery) on or near the surface of the brain ruptures and bleeds into the space between the brain and the skull.
  • Are often caused by high blood pressure.
  • In addition to high blood pressure, factors that increase the risk of hemorrhagic strokes include:
    • cigarette smoking
    • use of oral contraceptives (particularly those with high estrogen content)
    • excessive alcohol intake
    • use of illegal drugs

Diagnosis

When someone has shown symptoms of a stroke or a TIA (transient ischemic attack), a doctor will gather information and make a diagnosis. He or she will review the events that have occurred and will:

  • get a medical history
  • do a physical and neurological examination
  • have certain laboratory (blood) tests done
  • get a CT or MRI scan
  • study the results of other diagnostic tests that might be needed

Diagnostic tests examine how the brain looks, works and gets its blood supply. They can outline the injured brain area. Diagnostic tests fall into three categories.

  • Imaging tests give a picture of the brain similar to X-rays.
  • Electrical tests record the electrical impulses of the brain.
  • Blood flow tests show any problem that may cause changes in blood flow to the brain.

Treatment

Because hemorrhages may be life-threatening, hospital care is required. Medication is used to control high blood pressure. Other medicine may be given to reduce the brain swelling that follows a stroke.

Surgery may be needed depending on the cause of the hemorrhage. Surgery is often recommended to either place a metal clip at the base of an aneurysm or to remove the abnormal vessels that make up an AVM.

Some procedures are less invasive and use of a catheter that goes in through a major artery in the leg or arm. The catheter is guided to the aneurysm or AVM where it places a device, such as a coil, to prevent rupture.