What is a stroke?

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A stroke is a medical event that occurs when blood flow to the brain is disrupted. In most cases, this occurs as a result of a blood clot or plaque, which can block vital blood vessels. This blockage or rupture deprives the brain of oxygen, which can cause brain cells and tissues to suffer damage and die. There are several types of stroke, each with its own cause, outcome, and prognosis.

Strokes are the fifth leading cause of death in the United States, and without medical attention, they can cause major disabilities in adults. However, most strokes are preventable with regular doctor visits and lifestyle changes. Plus, strokes can be treatable if the individual receives help quickly. If you are at risk of having a stroke, see a cardiologist regularly. If you believe you or someone near you is having a stroke, call 9-1-1 immediately.

What are common stroke causes?

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Different types of strokes have different causes. Some strokes are caused by the blockage of a blood vessel. This is usually the result of plaque build-up or a blood clot. When this causes a stroke, it is called an ischemic stroke. By contrast, some strokes are caused by a sudden bleeding in the brain. These are called hemorrhagic strokes, and the exact cause is not always known.

As with many cardiovascular events, many strokes are preventable, but some people are genetically predisposed. If you are at risk for experiencing a stroke, see a cardiologist regularly. Working with a medical professional can reduce your risk and improve your prognosis in the event of a stroke.

What do stroke symptoms look like?

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Stroke symptoms are different between individuals, but some are widely experienced. Stroke symptoms usually appear in body parts controlled by the area of the brain that is damaged. In many cases, a person experiencing a stroke can exhibit any of the following conditions:

  • Paralysis
  • Confusion
  • Slurred speech
  • Numbness, especially in the arm, leg, and face, especially on one side of the body
  • Loss of balance
  • Dizziness
  • Sudden and severe head pain
  • Drooping on one side of the face

As with heart attacks, stroke symptoms in women are slightly different. People with female bodies are more likely to experience nausea, hallucination, pain, shortness of breath, seizures, and/or loss of consciousness than people with male bodies. Additionally, women are more likely to die than men from a stroke, likely because their symptoms are more generalized and harder to diagnose. If you are experiencing any of these symptoms, contact an emergency service immediately.

What are common stroke risk factors?

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Many lifestyle and genetic factors can increase the risk of a person experiencing a stroke. The most common lifestyle risk factors are the same for many other cardiovascular impairments: binge drinking, a lack of physical activity, a history of obesity, and the use of some illegal drugs, like methamphetamine and cocaine. Medical risk factors, some of which are genetic, can also increase a person’s risk of having a stroke:

  • Diabetes
  • High cholesterol
  • High blood pressure
  • Cigarette smoking
  • Cardiovascular disease
  • Obstructive sleep apnea
  • Personal or family history of stroke

The best way to remember common signs of a stroke is the FAST test. If you think someone may be having a stroke, use this acronym to assess their state:

F – Face: Ask the individual to smile. Observe whether one side of the face droops.

A – Arms: Ask the individual to raise both arms. If one arm cannot move, or if it drifts downward, they may be having a stroke.

S – Speech: Ask the individual to repeat a simple phrase, like their home address. Check for slurred speech.

T – Time: If you notice any of these signs, call 9-1-1 as soon as possible. Stroke outcomes improve significantly with fast treatment.

Remember that certain life-stage factors can increase risk of stroke. People aged 55 and over are at a higher risk, as are those with male bodies and people who are prescribed hormonal treatments, such as birth control pills and some hormone therapies.

While many stroke risk factors are genetic, lifestyle choices can significantly reduce your likelihood of experiencing a stroke. If you have a family history of this condition, talk to your cardiologist or general physician about which lifestyle changes can help most.

Are there different types of strokes?

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 Strokes typically fall into three major categories: ischemic, transient ischemic attack (TIA), and hemorrhagic. We have explained each type of stroke in further detail below.

  • Ischemic Stroke – An ischemic stroke is caused by artery blockage, either by a blood clot or plaque buildup. The two most common types of ischemic strokes are thrombotic and embolic. Embolic strokes happen when blood clots or other debris form in one part of the body and travel to the brain. Thrombotic strokes occur when clots form in an artery that supplies blood to the brain. These are the most common types of stroke; according to the CDC, around 87 percent of strokes are ischemic.
  • Transient Ischemic Attack (TIA) – Also called a “mini stroke,” transient ischemic attacks occur when blood flow to the brain is temporarily blocked. While symptoms are similar to those of a full stroke, the often disappear within minutes or hours. While people are not likely to die of a TIA, these mini strokes are often a precursor to larger stroke events. If you believe you have had a TIA, contact your cardiologist immediately.
  • Hemorrhagic Stroke – This type of stroke happens when the brain experiences a hemorrhage, when the brain leaks blood. The hemorrhage is often the result of an artery burst, which can happen because of an aneurysm o high blood pressure. This blood leak causes excess pressure, which leads to swelling and damage. Only around 13 percent of strokes are hemorrhagic, but they are among the most dangerous.

How is a stroke diagnosed?

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If your doctor believes you are having a stroke, they will review your medical history to understand your individual risk factors. They will also check your blood pressure, listen to your heart, and ask what medications you use. The doctor will also check your coordination, balance, and vision and check for signs of weakness, numbness, and confusion. From there, your doctor will likely administer treatment.

After stroke treatment, the doctor will likely conduct additional tests to confirm the diagnosis and rule out other potential causes. This can include a range of blood tests to check platelet levels and blood sugar. In most cases, the doctor will use an imaging test, such as an MRI or CT, to check for brain tissue damage.

Is there a stroke treatment available?

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The stroke treatment you receive will depend on the type of stroke you have experienced. Ischemic strokes and TIAs, which are caused by blood clots and blockage, are often treated with antiplatelet, anticoagulant, and clot-breaking drugs. Some may require a procedure, such as a mechanical thrombectomy. During this surgery, the doctor will insert a catheter into a large blood vessel inside the head, then manually extract the clot. A stent or other surgery may also be used to mitigate stroke causes.

Hemorrhagic strokes require different treatment strategies. During these strokes, the goal of treatment is to make blood clot, thus stopping the bleeding. As a result, you will likely receive drugs to reduce blood pressure and counteract any blood thinners you have taken. In some cases, a doctor may perform a coiling procedure. This involves using a long tube to support the weakened artery wall, which reduces bleeding. Your stroke may also require a clamping procedure, during which a doctor will place a small clamp at the base of the aneurysm, cutting off blood supply and preventing the blood vessel from bursting.

If you have experienced a TIA or an ischemic stroke, your cardiologist may put you on a medication to reduce future risk. Most often, this will include an anti-platelet drug or anticoagulants, both of which can reduce your risk for developing a blood clot.

What can I do to prevent strokes?

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Many strokes are the result of certain lifestyles and activities. While individual risk factors will vary by person, there are some strategies folks can use to reduce their risk of cardiovascular events. This includes controlling high blood pressure, lowering the amount of “bad” cholesterol and saturated fat in your diet, managing diabetes, quitting cigarette smoking, and regularly exercising. Talk to your doctor about how to manage your risk factors in a healthy and sustainable way.

Remember that it can take months, even years, to recover from a stroke. While some folks recover completely, others are left with lasting complications. Around 10 percent of stroke survivors will make an almost-complete recovery, while 25 percent will recover with minor impairments. Some stroke survivors will require speech or cognitive therapy, physical therapy, and/or therapy to help relearn certain sensory skills.

However, the best stroke treatment is stroke prevention. Work with your cardiologist to find a prevention strategy or stroke treatment that works for you.