1 what is a stroke?
A stroke is also a Cerebra Vascular Accident (CVA) or “brain attack.” It occurs when a blood vessel in the brain becomes blocked or bursts. It is a life-threatening medical emergency because blood carries oxygen, and brain cells begin to die within a few minutes once the blood supply is cut off. Although many strokes are treatable, some can lead to lasting brain damage, long-term disability, or even death. 【1】
The Centers for Disease Control and Prevention (CDC) pointed out that stroke is the No. 5 cause of death and a leading cause of disability in the United States.【2】If you think that you or someone else is having a stroke, please call 9-1-1. Because immediate treatment may save someone’s life and increase the chances for successful rehabilitation and recovery.【3】
2 What are the types of stroke?
There are two types of stroke: Ischemic stroke and Hemorrhagic stroke.
- Ischemic stroke
An ischemic stroke happens when a blood vessel supplying blood to your brain gets blocked by a blood clot. It is accountable for 80% of all strokes.【4】Treatment for ischemic strokes depends on how quickly after the symptoms start the stroke victim arrives at the hospital.
- Hemorrhagic stroke
A hemorrhagic stroke happens when a weakened blood vessel in the brain ruptures. It is the most serious kind of stroke. About 13% of all strokes are hemorrhagic. There are two types of hemorrhagic strokes: intracerebral and subarachnoid.【5】
Another condition that’s similar to a stroke is a transient ischemic attack (TIA), which call a “mini-stroke” as well. It is different from the major types of stroke because blood flow to the brain is blocked for only a short time—usually no more than 5 minutes. 【6】 The damage to the brain cells isn’t permanent, but if you have had a TIA, you are at a much higher risk of having a stroke. 【7】
3 What causes a stroke?
As mentioned above, there will be a stroke when blood flow to your brain is stopped or disrupted. Like all organs, the brain needs the oxygen and nutrients provided by blood to function properly. If there is no full supply of blood, as a result, brain cells begin to die. This can lead to serious problems, such as brain injury, disability, and possibly death.
Ischemic strokes are caused by blood clots. A fatty substance called plaque collects in your arteries and narrows them. In that case, this process is called atherosclerosis, and it slows the flow of blood. Then, as it pools, blood can clump and form clots — and your artery gets blocked. There are two main types of ischemic stroke:【8】
- Thrombotic strokes. It’s because of a blood clot that forms in an artery that supplies blood to your brain.
- Embolic strokes. They happen when a clot forms somewhere else in your body and travels through the blood vessels to your brain. It gets stuck there and stops the flow of your blood.
Hemorrhagic strokes are caused by bleeding in or around the brain. With a hemorrhagic stroke, pressure builds up in the nearby brain tissue. This causes even more damage and irritation. The most common causes of common causes are:【9】
- High blood pressure
- Injury
- Bleeding disorders
- Cocaine use
- Abnormal blood vessels (AVMs)
- Aneurysm (a weak area in a blood vessel that breaks open)
There are two types of hemorrhagic stroke as well. One is subarachnoid hemorrhage, which means it happened in the area between your brain and skull. The other is intracerebral hemorrhage, which means bleeding inside the brain.
4 Who is at risk?
Anyone can have a stroke at any age. but certain risk factors make you more susceptible to stroke. Some of them can be changed or managed, while others can’t.【10】
- High blood pressure
- Diabetes
- Heart and blood vessel diseases: Conditions that can cause blood clots or other blockages include coronary heart disease, atrial fibrillation, heart valve disease, and carotid artery disease.
- Smoking
- Birth control pills (oral contraceptives)
- History of TIAs (transient ischemic attacks)
- High red blood cell count
- High blood cholesterol and lipids
- Abnormal heart rhythm
- Cardiac structural abnormalities
- Anxiety, depression, and high stress levels
- Lack of exercise
- Obesity
- Living or working in areas with air pollution
- Excessive alcohol use
- Illegal drugs
- Sleep apnea
- COVID-19
Risk factors for stroke that can’t be changed:【11】
- Older age
- Race. In the United States, stroke occurs more often in African American, Alaska Native, American Indian, and Hispanic adults than in white adults.
- Gender. Stroke occurs more often in men, but more women than men die from stroke.
- History of prior stroke. You are at higher risk for having a second stroke after you have already had a stroke.
- Family history and genetics
5 What are the signs and symptoms of a stroke?
Since a stroke is an emergency situation, it’s important to know the signs of a stroke and get help quickly. If you or someone have a stroke, following symptoms may occur, and you need to call 911 immediately:
- Sudden weakness or numbness on one side of your face or in one arm or leg.
- Problems with vision, such as dimness or loss of vision in one or both eyes.
- Fainting (loss of consciousness) or seizure.
- Sudden loss of balance, sometimes along with vomiting, nausea, fever, hiccups, or trouble swallowing.
- Dizziness or sudden falls with no clear cause.
- Having trouble speaking or understanding.
- Severe headaches with no known cause, especially if they happen suddenly.
- Brief loss or change of consciousness, such as fainting, confusion, seizures, or coma.
Some people may also experience:
- bladder or bowel control problems
- depression
- paralysis or weakness on one or both sides of the body
- difficulty controlling or expressing their emotions
Experts use the acronym FAST to help people remember the signs and symptoms of a stroke.【12】
- F – Face dropping. Can’t smile naturally because the face may have dropped on 1 side.
- A – Arm weakness. Unable to lift both arms and keep them there because of weakness or numbness in 1 arm.
- S – Speech difficulty. Hardly to speak a whole sentence. The patient’s speech may become slurred or garbled; they may also have problems understanding what you’re saying to them.
- T – Time to call 911. It’s time to dial 911 immediately if you see any of these signs or symptoms.
6 How is a stroke diagnosed?
Your doctor will diagnose a stroke based on your symptoms, your medical history, a physical exam, and test results. The result of exams and tests will help to find out the type of stroke you’ve had and the condition of your illness.
A physical exam may include a check of:
- mental alertness
- coordination and balance
- Any numbness or weakness in the face, arms, and legs
- Any trouble speaking and seeing clearly
The following tests may also use as well:
- Blood tests: It aims to check how quickly your blood clots.
- CT scan: A brain CT scan uses X-rays to create images of your brain.
- MRI scan: These use radio waves and magnets to create an image of the brain.
- Carotid ultrasound: This can check blood flow in the carotid arteries and see if there is any narrowing or plaque present.
- Cerebral angiogram: It provides a detailed view of the blood vessels in the brain and neck.
- Echocardiogram: This test uses sound waves to create images of your heart, and may detect the source of blood clots that have traveled from your heart to your brain.
7 What are the complications of having a stroke?
The complications after stroke can vary. A stroke can sometimes cause temporary or permanent disabilities, depending on how long the brain lacks blood flow and which part is affected. Some of these complications include: 【13】
- Loss of muscle movement
- Difficulty talking or swallowing
- Seizures
- Memory loss or thinking difficulties
- Emotional problems
- Changes in behavior
- Pain
- Bed sores
These complications can be managed by methods such as:
- Medication
- Physical therapy
- Counseling
8 What are the treatments for stroke?
Treatment depends on the type of stroke you have, including which part of the brain was affected and what caused it. Different types of stroke will need different therapy and curing.【14】
Treating an ischemic stroke
- Medicines: Tissue plasminogen activator (tPA). It breaks up the blood clots that flow to your brain. It must be injected in your arm within 3 hours after your symptoms start.
- Surgery: The main surgery need to take is thrombectomy. It removes the clot from the blood vessel.
Treating a hemorrhagic stroke
- Medicines: You may be given blood pressure medicine to lower the pressure and strain on blood vessels in the brain. You will also be taken off any anticoagulant or blood-thinning medicines that may have led to bleeding.
- Surgery:
- Aneurysm clipping: This surgery helps stop bleeding from an aneurysm and prevent the aneurysm from bursting again.
- Coil embolization: It will block blood flow to or seal an aneurysm.
- Blood transfusion:
- Draining excess fluid
- Remove or shrink an arteriovenous malformation (AVM)
- Remove pooled blood
9 Is recovery after a stroke possible?
Stroke remains a major killer in the United States and worldwide. In the U.S., 20% of stroke patients will die within a year. However, 10% of stroke survivors make an almost complete recovery, while another 25% recover with only minor issues.【15】
You need a professional care team to help you recover. Your care team may recommend medicines to manage pain, muscle spasms, or other problems as you recover. Your rehabilitation may include working with speech, physical, and occupational therapists, and your recovery mainly includes:
- Speech therapy. You may have trouble communicating after a stroke. In other words, You may not be able to put complete sentences together, or put words together in a way that makes sense. A speech and language therapist will work with you to relearn how to speak.
- Cognitive therapy. Many people may have changes to their thinking and reasoning skills after a stroke. But an occupational therapist can help you regain your former patterns of thinking and behavior.
- Relearning sensory skills. Some people may find that they feel things well, such as temperature, pressure, or pain. An occupational therapist can help you learn to adjust to this lack of sensation.
- Physical therapy. A stroke may affect only one side of the body or part of one side. Thus, it can cause muscle weakness or paralysis, which can put you at risk of falling. A physical therapist will work with you to regain your strength and balance, and find ways to adjust to any limitations.
10 Can strokes are prevented?
80% of strokes are preventable.【16】 Many stroke risk factors can be changed, treated, or medically modified. First thing to remember is you need to live a healthy lifestyle:
- Make healthy food choices.
- Aiming for a healthy weight
- No smoking
- Limit alcohol use
- Getting regular physical activity
- Managing stress
- Get enough good-quality sleep
- Managing your blood pressure and cholesterol levels
If these changes are not enough, your doctor may recommend certain medications to reduce your stroke risk:【17】
- Blood-thinning medicines
- Antiplatelets (such as aspirin)
- Blood-pressure medicines
- Cholesterol-lowering drugs
- Heart medicines
- Diabetes medicines
