The main treatments for ischemic stroke involve breaking up or removing blood clots that block oxygen flow to the brain. Medications also help lower your blood pressure and treat health conditions that increase your risk of stroke.
Examples of these conditions include high blood pressure, atherosclerosis (fatty buildup, called plaque), and irregular heart rhythms such as atrial fibrillation.
Signs of Stroke
The most common type of stroke is caused by a blood clot that cuts off oxygen to part of the brain. Usually the blockage occurs in an artery that leads to the brain. It can also occur when an irregular heartbeat — called atrial fibrillation — causes a clot to dislodge from the heart, travel through the blood vessels and reach the brain. These clots are called emboli.
Symptoms of an ischemic stroke vary depending on what area of the brain is affected and can include numbness or weakness in one side of the body, trouble seeing (often on only one side), and difficulty speaking. Ask the person to smile and see if one side of their mouth droops. Try to raise both arms. Does one drift downward or does it slouch? Is the person able to speak normally, or does their speech sound slurred and difficult to understand? It’s important to note the time when the symptoms begin, because the sooner treatment starts, the more likely it is that the brain damage will be limited.
If the signs of a stroke are present, call 911 immediately. Remember, every minute counts, so it’s important to act fast. A medical emergency team can administer a medication called tissue plasminogen activator (tPA) to break up the clot and restore blood flow to the brain.
Strokes can affect anyone, but certain factors increase the risk. Men are more likely to have a stroke than women. This is because they are more likely to have a genetic condition that increases the risk, such as Marfan syndrome, a type of hereditary cardiovascular disease. They are more likely to have a high cholesterol level, which is another risk factor. People of African descent have a higher risk than people from other races.
Other factors that can contribute to a stroke include age, a family history of a stroke, high blood pressure, and a history of diabetes or high cholesterol. In addition, smoking increases the risk of a stroke. The most effective way to prevent a stroke is to control your blood pressure, cholesterol and other risk factors.
Symptoms of Ischemic Stroke
A clot or fatty buildup in an artery can block blood flow to the brain and cause brain cells to die. This is called an ischemic stroke. It is the most common type of stroke and makes up around 85% of all strokes in the UK.
If you think you have a TIA, call 999 right away and ask for an ambulance. A TIA is a temporary event and the symptoms usually go away, but it is a very serious warning sign that you may have a full-blown stroke soon.
Ischemic strokes can be caused by things such as heart problems (including atrial fibrillation, a condition that causes irregular heartbeat) or a blood clot in the neck, which can then travel to the brain and get stuck. It can also happen if part of a clot breaks free and moves up to the brain from another part of the body, such as a leg.
Hemorrhagic strokes can be caused by a burst blood vessel (a haemorrhage) or by a weakness in the wall of a blood vessel inside the skull (an aneurysm). They are less common than ischemic strokes and make up around 15% of all strokes.
Symptoms of a hemorrhagic stroke include sudden and severe headache, vomiting, dilated pupils, changes in level of consciousness, and sudden sensitivity to touch on one side of the face or body. It is important to note the time when the symptoms first start, as this will help doctors decide what treatment is needed.
The main goal of treating a TIA or ischemic stroke is to open the blocked blood vessel so that fresh blood can get through. To do this, they may use drugs to break down or dissolve blood clots. Other treatments can include stents to open narrowed arteries and drugs to lower blood pressure. They can also prescribe long-term medicines to prevent more clots from forming, such as aspirin and anticoagulants. They can also give you medications to control health conditions that increase your risk of having a stroke, such as high blood pressure and atherosclerosis.
Symptoms of Cerebral Embolism
Cerebral embolism is a type of ischemic stroke caused by a blood clot that travels from another part of the body to block the blood flow in an artery in the brain. This clot is called an embolus and can be a blood clot, fatty material or another particle. It is more common in people with a blood-clotting disorder, such as atrial fibrillation or a history of rheumatic heart disease.
This clot typically breaks off from plaque in the large arteries in the heart or chest and neck and moves through the blood to the brain. It can also come from a blood clot within the brain (intracerebral hemorrhage or subarachnoid hemorrhage). These clots reduce the amount of oxygen and nutrients getting to the brain, which causes damage.
The symptoms of an embolic stroke depend on which part of the brain is affected and vary from person to person. They can be as mild as a slight headache or as severe as paralysis. The symptoms can occur suddenly, so it’s important to watch for these signs and act quickly.
If a stroke is due to a cerebral embolism, doctors can usually treat it by administering drugs that break up or dissolve the clot. They may also give patients medications to make their blood less likely to clot. At some specialized centers, doctors may use instruments threaded through a catheter to physically remove the clot from an artery (mechanical thrombectomy) or to widen a narrowed artery (angioplasty). A tube made of wire mesh called a stent can be placed in the artery to help keep it open.
During the initial assessment of your stroke symptoms, your doctor will perform a physical exam and order imaging tests, such as a CT scan or MRI and an ultrasound of the carotid arteries in the neck and head (carotid duplex and transcranial Doppler). These diagnostic tools can help confirm the cause of your ischemic stroke.
The sooner you see a doctor after you experience these symptoms, the more quickly your brain can be treated to prevent further damage. This is especially important if you have a condition that increases your risk of a stroke, such as atrial fibrillation, a history of rheumatic or valvular heart disease, high blood pressure or diabetes.
Symptoms of Subarachnoid Hemorrhage
A subarachnoid hemorrhage is bleeding that occurs underneath one of the outer coverings (arachnoid) of your brain. This happens when a weak spot in an interconnected network of blood vessels (aneurysm) ruptures. This condition is very dangerous and can be fatal if not treated immediately.
Your doctor can tell if you have a subarachnoid hemorrhage by asking questions about your symptoms. You will also have a head CT scan to find the source of the bleeding, which is usually an aneurysm. A lumbar puncture, or spinal tap, may be done to test cerebrospinal fluid for blood. If the aneurysm is located, surgery can be done to repair it. If there is no aneurysm, your doctor will drain the blood from the area to prevent more bleeding.
Some of the signs of a subarachnoid hemorrhage include a headache, nausea and vomiting, blurred vision, difficulty walking, balance problems, and a weakness on one side of your body. Other symptoms depend on the location of the bleed. A subarachnoid hemorrhage in the cerebellum, for example, can cause slurred speech, difficulty swallowing, and seizures.
You may be at higher risk for subarachnoid hemorrhage if you have a tangle of abnormal blood vessels in your brain (arteriovenous malformation), head trauma, high blood pressure, or other health problems. You are also more likely to have a subarachnoid hemorrhage when you’re younger and have a family history of this type of stroke.
To reduce your risk, you should avoid activities that put you at risk of head injury. Use a helmet when you ride a bike or motorcycle, wear seatbelts in cars and buses, don’t drink too much alcohol, and don’t take cocaine or other stimulants. You should also work with a physical or occupational therapist to learn how to balance your activities and improve your ability to move around safely. Addressing any other health concerns that can increase your risk of having a stroke, such as smoking and getting better control of blood-pressure or diabetes, is also important.
