A stroke is a medical condition in which poor blood flow to the brain causes cell death. There are two main types of stroke: ischemic, due to lack of blood flow, and hemorrhagic, due to bleeding.[5] Both cause parts of the brain to stop functioning properly.
Signs and symptoms of a stroke may include an inability to move or feel on one side of the body, problems understanding or speaking, dizziness, or loss of vision to one side. Signs and symptoms often appear soon after the stroke has occurred. If symptoms last less than one or two hours, the stroke is a transient ischemic attack (TIA), also called a mini-stroke. A hemorrhagic stroke may also be associated with a severe headache.The symptoms of a stroke can be permanent.Long-term complications may include pneumonia and loss of bladder control.
The main risk factor for stroke is high blood pressure. Other risk factors include high blood cholesterol, tobacco smoking, obesity, diabetes mellitus, a previous TIA, end-stage kidney disease, and atrial fibrillation. An ischemic stroke is typically caused by blockage of a blood vessel, though there are also less common causes.A hemorrhagic stroke is caused by either bleeding directly into the brain or into the space between the brain's membranes. Bleeding may occur due to a ruptured brain aneurysm. Diagnosis is typically based on a physical exam and supported by medical imaging such as a CT scan or MRI scan.A CT scan can rule out bleeding, but may not necessarily rule out ischemia, which early on typically does not show up on a CT scan. Other tests such as an electrocardiogram (ECG) and blood tests are done to determine risk factors and rule out other possible causes.Low blood sugar may cause similar symptoms.
Prevention includes decreasing risk factors, surgery to open up the arteries to the brain in those with problematic carotid narrowing, and warfarin in people with atrial fibrillation. Aspirin or statins may be recommended by physicians for prevention. A stroke or TIA often requires emergency care. An ischemic stroke, if detected within three to four and half hours, may be treatable with a medication that can break down the clot. Some hemorrhagic strokes benefit from surgery. Treatment to attempt recovery of lost function is called stroke rehabilitation, and ideally takes place in a stroke unit; however, these are not available in much of the world.
In 2013, approximately 6.9 million people had an ischemic stroke and 3.4 million people had a hemorrhagic stroke.[16] In 2015, there were about 42.4 million people who had previously had a stroke and were still alive.[10] Between 1990 and 2010 the number of strokes which occurred each year decreased by approximately 10% in the developed world and increased by 10% in the developing world.In 2015, stroke was the second most frequent cause of death after coronary artery disease, accounting for 6.3 million deaths (11% of the total). About 3.0 million deaths resulted from ischemic stroke while 3.3 million deaths resulted from hemorrhagic stroke.[11] About half of people who have had a stroke live less than one year. Overall, two thirds of strokes occurred in those over 65 years old.
A stroke is a medical emergency. It happens when a blood vessel in the brain bursts or, more commonly, when a blockage happens. Without treatment, cells in the brain quickly begin to die. This can cause serious disability or death. If a loved one is having stroke symptoms, call 911 right away.
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Call 911 right away about signs of a stroke, which may include sudden:
Every second counts. Without oxygen, brain cells begin dying within minutes. Once brain tissue has died, the body parts controlled by that area won’t work right. This makes stroke a top cause of long-term disability. There are clot-busting drugs that can curb brain damage, and they must be given in a short time -- usually within 3 hours of when symptoms start.
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Tests may start when you’re still in the ambulance. Once you get to the ER, you’ll get imaging tests such as a CT scan, MRI, or ultrasound. You may get other types of tests, such as an EKG (checks your heart’s electrical activity) and an EEG (checks your brain’s electrical activity).
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This is the most common type of stroke: Nearly nine out of 10 fall into this category. An ischemic stroke happens when a blood clot blocks the supply of blood to or in the brain. The clot may start in that spot or travel through the blood from elsewhere in the body. Clogged arteries are a top cause.
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Hemorrhagic strokes happen when a weakened blood vessel in the brain bursts. The result is bleeding inside the brain that can be hard to stop. The most common cause is high blood pressure. Other causes include aneurysms and AVMs (arteriovenous malformations), which weaken blood vessels in the brain.
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Transient ischemic attacks, often called "mini-strokes," are also an emergency. When they happen, blood flow is temporarily hampered in part of the brain, causing stroke-like symptoms. When the blood flows again, the symptoms stop. You can’t tell at the time if it’s a stroke or TIA. So call 911. Having a TIA is also a warning sign, so see your doctor if you think you've had one.
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Ischemic strokes: The goal is to restore blood flow. A clot-busting medication called tPA is very good at dissolving clots and cutting the chance of long-term damage, but it must be given in time -- usually within 3 hours. Hemorrhagic strokes: These are harder to manage. Treatment usually involves trying to control high blood pressure, bleeding, and brain swelling.
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Ischemic strokes: Clogged arteries are a top cause. Plaque made of fat, cholesterol, and other things builds up in the arteries, leaving less space for blood to flow. A blood clot may lodge in this narrowed space and cause an ischemic stroke. All that plaque makes it easier for a clot to form and can also rupture, blocking blood flow.
Hemorrhagic strokes: These can happen if uncontrolled high blood pressure bursts a weakened artery.
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Eating too much fat and cholesterol can cause plaque to narrow arteries. Too much salt may lead to high blood pressure. Eating plenty of fruits, vegetables, whole grains, and fish may help lower your stroke risk.
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