A stroke occurs when the blood supply to part of your brain is interrupted or reduced, preventing brain tissue from getting oxygen and nutrients. Brain cells begin to die in minutes.
A stroke is a medical emergency, and prompt treatment is crucial. Early action can reduce brain damage and other complications.
The good news is that many fewer Americans die of stroke now than in the past. Effective treatments can also help prevent disability from stroke.
The information on this page is sourced from The Mayo Clinic.
Source: GARD Last updated on 05-01-20
If you or someone you're with may be having a stroke, pay particular attention to the time the symptoms began. Some treatment options are most effective when given soon after a stroke begins.
Signs and symptoms of stroke include:
Seek immediate medical attention if you notice any signs or symptoms of a stroke, even if they seem to come and go or they disappear completely. Think "FAST" and do the following:
Call 911 or your local emergency number right away. Don't wait to see if symptoms stop. Every minute counts. The longer a stroke goes untreated, the greater the potential for brain damage and disability.
If you're with someone you suspect is having a stroke, watch the person carefully while waiting for emergency assistance.
Last updated on 05-01-20
There are two main causes of stroke: a blocked artery (ischemic stroke) or leaking or bursting of a blood vessel (hemorrhagic stroke). Some people may have only a temporary disruption of blood flow to the brain, known as a transient ischemic attack (TIA), that doesn't cause lasting symptoms.
This is the most common type of stroke. It happens when the brain's blood vessels become narrowed or blocked, causing severely reduced blood flow (ischemia). Blocked or narrowed blood vessels are caused by fatty deposits that build up in blood vessels or by blood clots or other debris that travel through your bloodstream and lodge in the blood vessels in your brain.
Hemorrhagic stroke occurs when a blood vessel in your brain leaks or ruptures. Brain hemorrhages can result from many conditions that affect your blood vessels. Factors related to hemorrhagic stroke include:
A less common cause of bleeding in the brain is the rupture of an abnormal tangle of thin-walled blood vessels (arteriovenous malformation).
A transient ischemic attack (TIA) — sometimes known as a ministroke — is a temporary period of symptoms similar to those you'd have in a stroke. A TIA doesn't cause permanent damage. They're caused by a temporary decrease in blood supply to part of your brain, which may last as little as five minutes.
Like an ischemic stroke, a TIA occurs when a clot or debris reduces or blocks blood flow to part of your nervous system.
Seek emergency care even if you think you've had a TIA because your symptoms got better. It's not possible to tell if you're having a stroke or TIA based only on your symptoms. If you've had a TIA, it means you may have a partially blocked or narrowed artery leading to your brain. Having a TIA increases your risk of having a full-blown stroke later.
Many factors can increase your stroke risk. Potentially treatable stroke risk factors include:
Other factors associated with a higher risk of stroke include:
A stroke can sometimes cause temporary or permanent disabilities, depending on how long the brain lacks blood flow and which part was affected. Complications may include:
Knowing your stroke risk factors, following your doctor's recommendations and adopting a healthy lifestyle are the best steps you can take to prevent a stroke. If you've had a stroke or a transient ischemic attack (TIA), these measures might help prevent another stroke. The follow-up care you receive in the hospital and afterward also may play a role.
Many stroke prevention strategies are the same as strategies to prevent heart disease. In general, healthy lifestyle recommendations include:
If you've had an ischemic stroke or TIA, your doctor may recommend medications to help reduce your risk of having another stroke. These include:
Anti-platelet drugs. Platelets are cells in your blood that form clots. Anti-platelet drugs make these cells less sticky and less likely to clot. The most commonly used anti-platelet medication is aspirin. Your doctor can help you determine the right dose of aspirin for you.
Your doctor might also consider prescribing Aggrenox, a combination of low-dose aspirin and the anti-platelet drug dipyridamole to reduce the risk of blood clotting. After a TIA or minor stroke, your doctor may give you aspirin and an anti-platelet drug such as clopidogrel (Plavix) for a period of time to reduce the risk of another stroke. If you can't take aspirin, your doctor may prescribe clopidogrel alone.
Anticoagulants. These drugs reduce blood clotting. Heparin is fast acting and may be used short-term in the hospital.
Slower-acting warfarin (Coumadin, Jantoven) may be used over a longer term. Warfarin is a powerful blood-thinning drug, so you'll need to take it exactly as directed and watch for side effects. You'll also need to have regular blood tests to monitor warfarin's effects.
Several newer blood-thinning medications (anticoagulants) are available for preventing strokes in people who have a high risk. These medications include dabigatran (Pradaxa), rivaroxaban (Xarelto), apixaban (Eliquis) and edoxaban (Savaysa). They're shorter acting than warfarin and usually don't require regular blood tests or monitoring by your doctor. These drugs are also associated with a lower risk of bleeding complications.
Last updated on 05-01-20
Things will move quickly once you get to the hospital, as your emergency team tries to determine what type of stroke you're having. That means you'll have a CT scan or other imaging test soon after arrival. Doctors also need to rule out other possible causes of your symptoms, such as a brain tumor or a drug reaction.
Some of the tests you may have include:
Last updated on 05-01-20
Emergency treatment for stroke depends on whether you're having an ischemic stroke or a stroke that involves bleeding into the brain (hemorrhagic).
To treat an ischemic stroke, doctors must quickly restore blood flow to your brain. This may be done with:
Emergency IV medication. Therapy with drugs that can break up a clot has to be given within 4.5 hours from when symptoms first started if given intravenously. The sooner these drugs are given, the better. Quick treatment not only improves your chances of survival but also may reduce complications.
An IV injection of recombinant tissue plasminogen activator (tPA) — also called alteplase (Activase) — is the gold standard treatment for ischemic stroke. An injection of tPA is usually given through a vein in the arm with the first three hours. Sometimes, tPA can be given up to 4.5 hours after stroke symptoms started.
This drug restores blood flow by dissolving the blood clot causing your stroke. By quickly removing the cause of the stroke, it may help people recover more fully from a stroke. Your doctor will consider certain risks, such as potential bleeding in the brain, to determine if tPA is appropriate for you.
The time window when these procedures can be considered has been expanding due to newer imaging technology. Doctors may order perfusion imaging tests (done with CT or MRI) to help determine how likely it is that someone can benefit from endovascular therapy.
To decrease your risk of having another stroke or transient ischemic attack, your doctor may recommend a procedure to open up an artery that's narrowed by plaque. Options vary depending on your situation, but include:
Emergency treatment of hemorrhagic stroke focuses on controlling the bleeding and reducing pressure in your brain caused by the excess fluid. Treatment options include:
After emergency treatment, you'll be closely monitored for at least a day. After that, stroke care focuses on helping you recover as much function as possible and return to independent living. The impact of your stroke depends on the area of the brain involved and the amount of tissue damaged.
If your stroke affected the right side of your brain, your movement and sensation on the left side of your body may be affected. If your stroke damaged the brain tissue on the left side of your brain, your movement and sensation on the right side of your body may be affected. Brain damage to the left side of your brain may cause speech and language disorders.
Most stroke survivors go to a rehabilitation program. Your doctor will recommend the most rigorous therapy program you can handle based on your age, overall health and degree of disability from your stroke. Your doctor will take into consideration your lifestyle, interests and priorities, and the availability of family members or other caregivers.
Rehabilitation may begin before you leave the hospital. After discharge, you might continue your program in a rehabilitation unit of the same hospital, another rehabilitation unit or skilled nursing facility, as an outpatient, or at home.
Every person's stroke recovery is different. Depending on your condition, your treatment team may include:
A stroke is a life-changing event that can affect your emotional well-being as much as your physical function. You may sometimes feel helpless, frustrated, depressed and apathetic. You may also have mood changes and a lower sex drive.
Maintaining your self-esteem, connections to others and interest in the world are essential parts of your recovery. Several strategies may help you and your caregivers, including:
Problems with your speech and language can be especially frustrating. Here are some tips to help you and your caregivers cope with communication challenges:
Last updated on 05-01-20
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