What is a stroke?
A stroke is a sudden brain problem that happens when a blood vessel in your brain either gets blocked or breaks open and bleeds.
Part of your brain stops getting blood. Brain tissue that doesn't get blood stops working and dies. If a lot of brain tissue is affected, your symptoms will be more severe.
If a blocked blood vessel opens up quickly on its own, your symptoms may go away completely. This is called a transient ischemic attack (TIA), which is a warning sign that you could soon have a stroke.
Stroke symptoms come on suddenly
You get different symptoms depending on what part and how much of your brain was affected
You may have face numbness or drooping, a weak arm or leg, difficulty seeing, trouble speaking, or a very bad headache
Symptoms often involve only one side of your body
Even though brain tissue that dies never comes back, sometimes other parts of your brain learn to take over the job of the damaged part
If you have any symptom that makes you think you're having a stroke, you should go to an emergency department
Treatment with medicines may help limit brain damage and prevent a future stroke
What causes a stroke?
Strokes are caused by a lack of blood flow to part of your brain from:
A blocked blood vessel in your brain
A bleeding blood vessel in your brain
A blocked blood vessel can be caused by:
A blood clot that forms in a blood vessel in your brain
A blood clot that forms in your heart or a blood vessel near your heart that breaks loose, moves through your bloodstream, and gets stuck in a blood vessel in your brain
A fat deposit (plaque) that breaks off the lining of a blood vessel, travels to your brain, and gets stuck in a blood vessel there
Fat deposits in your blood vessels are called atherosclerosis (hardening of the arteries). Atherosclerosis in the two big blood vessels in your neck (the carotid arteries) can cause a stroke or transient ischemic attack (TIA) because these blood vessels are the main blood supply to the brain.
A bleeding blood vessel in your brain can be caused by:
An aneurysm that bursts open
An aneurysm is a bulge in the wall of a blood vessel. If you have a stroke from an aneurysm, it's likely you were born with that aneurysm. Other aneurysms develop later from having high blood pressure for many years.
Clogs and Clots: Causes of Ischemic Stroke
When an artery that carries blood to the brain becomes clogged or blocked, an ischemic stroke can occur. Arteries may be blocked by fatty deposits (atheromas, or plaques) due to atherosclerosis. Arteries in the neck, particularly the internal carotid arteries, are a common site for atheromas. Arteries may also be blocked by a blood clot (thrombus). Blood clots may form on an atheroma in an artery. Clots may also form in the heart of people with a heart disorder. Part of a clot may break off and travel through the bloodstream (becoming an embolus). It may then block an artery that supplies blood to the brain, such as one of the cerebral arteries. |
What are the risk factors for having a stroke?
The major risk factors for stroke are:
Atherosclerosis (narrowing or blockage of blood vessels by fatty deposits)
Other risk factors include:
Having relatives who have had a stroke
Drinking too much alcohol
Using illicit drugs like cocaine
Having an abnormal heart rhythm such as atrial fibrillation
Having a blood clotting disorder
What are the symptoms of a stroke?
Symptoms start quickly, usually within a few minutes. A severe stroke may kill you right away.
Many different symptoms can occur, depending on which part of your brain isn't getting enough blood:
Feeling weak or numb on one side of your face or body
Difficulty talking
Difficulty swallowing
Trouble understanding what people say
Confusion
Loss of coordination
Blind spots in your vision
Brain swelling (edema) can result from a severe stroke. It causes symptoms several hours to a day or two later. You may become confused or go into a coma. Brain swelling is one of the main reasons people die from a stroke.
What are the long-term problems after a stroke?
After a stroke, you may:
Lose weight or choke on food and drink (aspiration) because you can't swallow food properly
Get bedsores (pressure sores) because you can't change position on your own
Develop blood clots in your legs because you aren't moving around
Have seizures because brain cells near the area of your stroke are damaged
Feel depressed because of all the problems from your stroke
How will my doctor know if I had a stroke?
Doctors will do an imaging test, such as a CT (computed tomography) scan or MRI (magnetic resonance imaging), to get detailed pictures of your brain. The CT or MRI will tell your doctor whether your stroke was caused by a blood clot or a bleeding vessel.
Doctors will also do tests to find out what caused your stroke:
ECG (electrocardiography) and echocardiography to look for problems in your heart
Imaging tests to see if blood vessels in your neck are blocked or narrowed
Blood tests to check for risk factors like high cholesterol, diabetes, or excessive blood clotting
How do doctors treat a stroke?
First, you'll be admitted to the hospital.
In the hospital
Doctors can't repair brain tissue damaged by a stroke. However, your doctor may give treatments to:
Give medications to break up the blood clot
Remove a blood clot or close a bleeding vessel
Keep brain damage from getting worse by getting your heart rate, blood pressure, and body temperature back to normal
If you had a blood clot, prevent another one by giving you blood thinners
Help you function as best you can (with rehabilitation)
If your stroke was caused by a blood clot, doctors can sometimes break up the clot with medicine (clot-busting drugs). If the clot is broken up quickly enough, your symptoms may go away completely. However, the drugs must be given within the first few hours. Also, some people have a high risk of complications from these drugs and can't use them safely. Sometimes a blood clot is removed using a catheter.
If your stroke was caused by narrowing of the blood vessels in your neck, doctors may do surgery to open them. Or they might put a small tube (stent) in the blood vessel to keep it open.
If your stroke was caused by a bleeding blood vessel, doctors can sometimes close the leak. Doctors put a small metal coil in the leaking vessel or do surgery to close it.
Rehabilitation (rehab) helps you function better after a stroke. Rehab:
Starts in the hospital, usually within 1 or 2 days after your stroke
Includes exercises to teach healthy areas of your brain to do the jobs injured areas used to do
Continues after you leave the hospital
After you leave the hospital
Where you go depends on how severe your symptoms are and how much help you need. You may go:
Home
To a rehabilitation facility
To a nursing home
Wherever you go, you may need treatment for months or years. Doctors will also try to prevent another stroke and help you adjust to challenges in your daily life. Usually they'll have you:
Take medicines to treat the cause of your stroke, such as high blood pressure or blood clots
Continue rehab to help improve your ability to function
Get counseling or medicines to help you deal with depression or other mood changes that may happen after your stroke
Can you recover after a stroke?
Yes. In the United States, about 795,000 people have a stroke and about 130,000 die of stroke each year.
The sooner a stroke is treated, the less severe brain damage is likely to be and the better the chances for recovery.
Usually, the more you improve during the first few days, the more you'll continue to improve. You generally can expect to continue to improve for 6 months after the stroke.
