Ischemic strokes happen when a blood clot blocks oxygen-rich blood from reaching brain cells. They account for about 85% of all strokes.
They often start suddenly and cause weakness or numbness on one side of the body, trouble seeing, and slurred speech.
Emergency treatment focuses on lowering your blood pressure to limit bleeding and relieve pressure in the brain. It also includes giving you clot-busting medicine.
The most common type of stroke, an ischemic stroke results from a blood clot in one of the arteries that supply blood to the brain. It is a medical emergency and getting treatment within 3 hours of the first symptoms can significantly improve outcomes. The most common early symptoms are a drooping (edema) on one side of the face, slurred or confused speech and difficulty walking. Symptoms vary depending on which part of the brain is affected.
An embolus — a fragment of a blood clot that forms somewhere else in the body, breaks free and travels through your blood vessels until it gets stuck in an artery that supplies blood to the brain (thrombosis). An arterial hemorrhage — a ruptured blood vessel in or around the brain (hemorrhagic stroke).
Other symptoms may include sudden vision problems in one or both eyes (double vision, blackout or blurred vision), trouble with balance and coordination, and numbness or tingling on the sides of the body. In some cases, a stroke causes changes in emotions or personality and an inability to control your bladder (urinary incontinence). People who’ve had a stroke also often feel sad or depressed. Some have trouble caring for themselves and need help with daily tasks, such as dressing or eating.
Some medications and diseases can increase your risk for a stroke. These include high blood pressure, high cholesterol and triglyceride levels, smoking, and some types of medication, including birth control pills, aspirin, heart medicines and antidepressants.
Hemorrhagic strokes account for 13% of all strokes and are usually caused by a ruptured blood vessel in or near the brain. They often have more dramatic symptoms than ischemic strokes because of the sudden release of blood under pressure. Symptoms include severe, sudden headache, vomiting, seizures, and rapid deterioration in neurological function or consciousness (hemorrhagic stroke).
The sooner you get treatment for an ischemic stroke, the more likely it is that your brain will recover. Treatment can include removing the clot or breaking it up (thrombolytic therapy). It may also include giving you medicine to prevent another clot from forming (anticoagulants) or surgery to remove blockages in your arteries (carotid endarterectomy). You should always call 911 when you have an ischemic stroke or suspect someone else is having one.
As soon as someone has symptoms of a stroke, they should be seen by a doctor. It is a medical emergency: the longer people wait to get care, the more brain damage they may have and the higher the risk of permanent disability or death.
Doctors will examine the person and ask about their past health and symptoms. They will do a physical exam and do lab (blood) tests to check for problems that can cause strokes. These include an irregular heart rhythm, blood-clotting problems, hardening of the arteries and inflammation of the blood vessels that carry oxygen to the brain.
They will do a CT or MRI brain scan to see if the artery that supplies blood to the part of the brain that is affected by a stroke is blocked. The imaging test also helps doctors identify the type of stroke — ischemic or hemorrhagic.
If it isn’t clear whether a stroke was caused by a blood clot or by bleeding in the brain, doctors may do a lumbar puncture (also called a spinal tap). This involves inserting a needle into the lower spine to collect fluid that surrounds the brain. The fluid is then tested for signs of damage from a hemorrhagic stroke.
Blood clots are the most common cause of an ischemic stroke. But they can be caused by other things, too. These include an abnormal heartbeat (arrhythmia), heart valve disease, infections, hardening of the arteries and poor circulation, inflammation of the blood vessels that supply the brain, high blood pressure and certain blood disorders that make it harder for the body to form healthy blood clots.
Some ischemic strokes have no obvious cause and are called cryptogenic strokes. This means they are due to some other condition, but doctors don’t know what it is. This is more common with TIAs, which can be mistaken for a regular stroke and aren’t treated as urgently as a full-blown one.
A healthy brain relies on an uninterrupted flow of blood to deliver oxygen and nutrients to all its cells. When a blood clot or piece of plaque clogs an artery, brain cells are starved of vital nourishment and function is impaired. Ischemic stroke symptoms depend on the part of the brain affected and can range from difficulty speaking or walking to memory problems and other cognitive difficulties. Treatment must begin quickly to unblock blood flow and limit damage.
Doctors use a variety of medications and procedures to treat ischemic stroke. The first is to remove any clots causing the blockage, usually with drugs like tissue plasminogen activator (tPA), which breaks apart and disperses clots that are clogging an artery. This drug can be administered through a vein in the arm or leg (or intravenously) and is typically given within six hours of when stroke symptoms begin.
If tPA isn’t available, doctors can try to remove the clot mechanically using a procedure called mechanical thrombectomy. In this technique, a catheter is threaded through an artery in the arm or leg under guidance from continuous x-ray imaging (fluoroscopy) and into the blood vessel blocking the brain. A clot-retrieving device (usually a mesh-wire basket or suction cup) is then used to pull the clot out of the artery. Mechanical thrombectomy can be done up to 24 hours after symptoms start, and it can improve outcomes for some people.
Another surgery that can help reopen a blocked artery is carotid endarterectomy, which involves surgically removing the thickened wall of a diseased carotid artery. This can be performed along with a procedure called stenting, which involves inserting a small mesh-wire tube-shaped stent to prop open an artery. Both clot-removing surgeries require a specialist trained in the endovascular procedures that involve the blood vessels of the head and neck.
In some cases, doctors can also prevent future ischemic strokes by treating conditions that can lead to them, such as high blood pressure, high cholesterol and atherosclerosis. A healthcare professional may prescribe medications to control these disorders, including blood thinners to keep the arteries clear and statins to lower cholesterol levels.
In a healthy person, blood flows freely to different parts of the body, including the brain. But when a clot or piece of plaque blocks the flow of blood, part of the brain can’t get enough oxygen and function is impaired. This can cause symptoms such as trouble with speech or facial muscles, or difficulty walking and balance. The severity of these symptoms depends on the area of the brain affected. It’s important that ischemic stroke is diagnosed and treated quickly to unblock the blood flow and prevent further damage.
TIAs (also called mini-strokes) usually happen in one small area of the brain and last for a short period before the blockage clears. They’re not considered a true stroke but it’s still important to seek emergency care because they can be a warning sign of a full-blown stroke. In fact, about 20% of people who have a TIA will experience a full-blown ischemic stroke within 24 hours, so they should be treated as an urgent medical emergency.
To avoid a TIA, get regular exercise, eat a balanced diet and limit your salt intake, and don’t smoke or drink too much alcohol. Managing health conditions, such as high blood pressure, diabetes and cholesterol, can also help prevent a stroke. See your healthcare provider regularly for checkups and wellness visits, and make sure you take any medications — especially blood thinners — as prescribed by your doctor.
The most common treatment for ischemic stroke is mechanical thrombectomy, which removes the clot from the blood vessel that’s blocking the flow of blood. This procedure can save lives and reduce disability in many people who suffer a stroke. It’s typically done within six hours of when symptoms begin. But it’s starting to be used earlier, even up to 24 hours after the start of symptoms. This is because it’s now possible to use imaging tests to look at the brain and see if undamaged tissue remains, so doctors can be more accurate about when to perform the procedure.
About 90% of strokes are preventable. That’s because most are caused by modifiable risk factors, such as high blood pressure, unhealthy eating habits, smoking and physical inactivity. For the best results, a harmonious, integrated approach to primary and secondary prevention is needed, with education about the dangers of stroke, simple screening and management of individuals for a history of modifiable risk factors, and improving social and environmental conditions.
Ischemic stroke occurs when a blood clot blocks the flow of oxygen-rich blood to part of the brain. It’s important to recognize the symptoms and get to the hospital quickly, because the longer a person goes without treatment, the more damage can occur.
The best treatments are available if you can be treated within three hours of when the first symptoms appear. Remember the FAST test
Numbness or tingling in one side of the body is usually a sign that the brain isn’t getting enough oxygen. This is because a blood clot or a piece of plaque has blocked or plugged a blood vessel in the brain, and that’s stopping the flow of blood. As a result, brain cells begin to die. This type of stroke is called ischemic, and it’s the most common type.
The first symptoms of a stroke can appear suddenly, and you should call 911 right away. That way, you can get immediate medical care to prevent further damage and reduce your risk of permanent disabilities or death.
Ischemic strokes usually happen when a blood clot blocks a blood vessel that supplies oxygen to part of the brain. It can also occur when a fatty buildup — called plaque — in the arteries blocks the flow of blood. These clots or plaque often form in the deep veins of the legs or groin (deep vein thrombosis). But they can also break free and travel through the bloodstream to the lungs, where they block an artery there (a condition called pulmonary embolism).
People who have had an ischemic stroke often have problems with balance and coordination. They may also have difficulty speaking or swallowing. They may lose their ability to think clearly and make decisions. They can also have trouble remembering things. They might also have emotional problems, such as depression.
Symptoms of an ischemic stroke usually develop quickly, over minutes to hours. They can get worse over the next few days, because of swelling in the brain (edema). The more time passes before you receive treatment, the greater the chances that the brain will have permanent damage. The most important thing is to restore blood flow as soon as possible, so you can preserve brain tissue and recover more of your old abilities.
You may find it difficult to talk or you might slur your words. This is called dysarthria. It is caused by a stroke or problems with your brain or nerves. You might also have trouble swallowing (dysphagia). Swallowing relies on specific muscles to push food, liquid, medication and other things down your throat. Dysarthria can make it hard to eat or drink and can cause pain or pressure in your throat or stomach.
This is usually a sign of a stroke, but it can also be a sign of other conditions. For example, it can be related to a seizure or caused by a condition that makes it difficult for you to control your muscles, such as Parkinson’s disease.
Your doctor can diagnose a stroke by asking about your medical history and performing a physical exam. They will also do an imaging test, such as an MRI or CT scan, and run blood tests. Getting treatment right away is important because it will reduce the chance that your symptoms will become permanent.
Symptoms of an ischemic stroke are sudden and they can affect one or both sides of your body. Look for a drooping face or mouth, slurred speech and difficulty moving your arms and legs. You should call 911 for help if you or someone you know is having these symptoms.
Most ischemic strokes happen when an artery that supplies blood to the brain is blocked, often by a clot or fatty deposit from atherosclerosis. If you have a stroke, getting medical care within three hours of your first symptoms can improve your chances of survival and recovery.
In a healthy person, blood flows freely throughout the body, bringing oxygen to different parts. When an ischemic stroke occurs, part of the brain can’t get enough blood and becomes dysfunctional. This can cause many symptoms, depending on what part of the brain is affected. It also depends on what functions are controlled by that area of the brain.
When a person experiences these symptoms, it’s important to call emergency medical services right away. The sooner treatment is started, the better the chances for a good recovery and less damage to the brain and body.
Ischemic strokes are most common, and usually happen because of a clot in a narrowed blood vessel (artery). These types of clots or pieces of plaque break off from inside the artery walls, causing a lack of blood flow to brain tissue.
A blood clot can block one of the small blood vessels that carry blood to the brain, and in just minutes, the brain cells start to die from a lack of oxygen. Other ischemic stroke symptoms may include trouble swallowing (difficulty or pain), dizziness, or a loss of balance.
Some ischemic strokes are preceded by “ministrokes” called transient ischemic attacks or TIAs. These are temporary and don’t involve brain damage, but they can be a warning sign that you’re at risk of a major stroke.
Some medications that can break up clots and restore blood flow must be started within 4.5 hours of when the first symptoms occurred, so the faster you get care, the better your chances are for a full recovery. Your doctor can tell you what to watch for and how to recognize a possible stroke.
If you are experiencing blurry vision suddenly, this can be a sign of a health emergency. It may indicate that a blood vessel has burst, or there is a blood clot in your brain. This is a life-threatening situation and requires immediate medical attention to prevent permanent damage.
This type of stroke happens when an artery that supplies oxygen to the brain gets blocked by a clot or narrowing. This is known as an ischemic stroke and accounts for about 87% of all strokes. It can also be caused by a build-up of fatty deposits in the arteries that supply blood to the brain (atherosclerosis).
It’s important to note that some factors for ischemic stroke aren’t under your control, such as smoking and other risky lifestyle choices. However, it is possible to reduce your risk of a stroke by making healthy changes to your lifestyle and avoiding habits that increase your risk.
Blurry vision in one eye can also be a symptom of certain health conditions and diseases, such as diabetes, retinal disease or even a detached retina. It can also be a side-effect of some medications.
If you are pregnant, blurry vision may be a symptom of preeclampsia, a dangerous condition in which you have high blood pressure and protein in your urine. It’s best to see your GP if you have symptoms of preeclampsia, as it is a serious condition that can lead to complications for both you and your baby. Blurry vision can also be a symptom of Parkinson’s disease, in which case your doctor will recommend medication to help control your symptoms.
Seizures occur when a part of your brain misfires and sends out uncontrolled electrical signals. These signals are how different parts of your brain communicate with each other, allowing you to solve problems, store memories and move around. When something goes wrong, it can lead to a domino effect: More neurons start firing and more signals go haywire until the seizure occurs.
There are two main types of seizures: focal and generalized. Health care professionals determine the type of seizure based on how and where the brain activity that causes the seizures begins. If they don’t know where it starts, they may classify the seizures as unknown onset.
If you see someone having a seizure, make sure they’re safe and can’t fall or hurt themselves. Help them get to a comfortable position and call 911 if they can’t answer your questions or follow simple commands. Once the seizure is over, they may be confused and tired and have a headache or muscle aches.
Some people have warning signs before a seizure, called an aura. These may include a feeling in the stomach or emotions like fear or a sense that you’ve experienced this moment before (deja vu). You may also experience changes to vision, such as seeing things that aren’t there.
If you have a stroke with the symptoms described above, it’s important to get to the hospital right away. The earlier you get treatment, the better your chances of preventing brain damage and improving outcomes. Doctors can usually diagnose a clot-related ischemic stroke based on your history of symptoms and the results of a physical exam. They’ll use a series of tests to assess your level of consciousness, ability to understand and obey simple commands, arm and leg movements and your eyesight. A CT scan or an MRI is the next step.
The faster you get medical treatment for a stroke, the better your chances of minimizing brain damage and preventing long-term complications. Treatments focus on removing blood vessel blockages, lowering your risk of future strokes and helping you regain as many abilities as possible through rehabilitation.
The most common type of stroke is an ischemic stroke. It’s caused by a blood clot that forms in your heart or large arteries, then breaks loose and travels to your brain.
Stroke drugs can help restore blood flow to the brain and stop or prevent long-term damage. The type of drug your doctor prescribes will depend on the type of stroke and its cause.
Anticoagulants (clot-dissolving medicines) are used to prevent clots from forming or stopping existing ones from getting bigger. These include warfarin (Coumadin, Jantoven), heparins, and a blood thinner called dabigatran. Antiplatelet medicines, such as aspirin, a combination of aspirin and dipyridamole, or clopidogrel, stop platelets from sticking together and forming blood clots that can cause strokes. Your doctor may also recommend a medicine to treat high blood pressure, which is called hypertension.
Some medications can be taken orally (by mouth) and others are given through a tube in the nose, throat, or stomach. Your doctor will tell you how to take your medication, and may suggest a beverage to help you swallow the pill or suppository.
If you’ve had a TIA or an ischemic stroke, doctors will try to get treatment started right away. They will test your symptoms and medical history to find out what kind of stroke you had and when it happened. If the symptoms are serious, you’ll probably be taken to a hospital emergency room or stroke unit.
A medical team of specialists will give you treatment during and after your hospital stay. They will check your condition and answer any questions you have about recovery. They’ll look at your medical records and scans of your head to diagnose what kind of stroke you had. They’ll also ask you about your lifestyle and any health problems you have.
If it’s a TIA or an ischemic thrombotic stroke, the first treatment is usually IV tPA/Alteplase. This medicine can break up a clot and restore blood flow to the brain. It’s important to start this treatment within three hours of your symptoms starting.
In some cases, clot-busting medications aren’t successful, and a mechanical thrombectomy may be needed to remove the clot and restore blood flow. Nuvance Health is among the first in Southeastern Wisconsin to offer this innovative procedure, which can improve your chances of a good long-term outcome and keep you close to home for care.
Your doctor will order imaging exams, such as X-rays, arteriograms, venograms, or CT scans to locate the location and size of your clot. You will receive fluids through an IV and possibly sedation through another vein in your arm to help you stay relaxed during the surgery. The surgery lasts an hour or more, depending on the location and size of the blood clot.
A doctor will insert a long, flexible tube called a catheter into your blood vessel. It may go to the blocked artery in your neck or brain, or it may reach the clot in your lung (pulmonary embolism). A catheter with a balloon-like device or a mesh tube can be inflated gently to open up the clot and allow more blood to pass through.
Other devices, such as a retriever or stent, can be used to physically remove the clot and return blood flow. These devices are often made of a metal alloy called nitinol, which has unique properties that make it very useful in medical procedures.
Once the clot is removed, your doctor will close and repair your blood vessel. He or she will also use a stent to help keep the blood vessel open and prevent future clots from forming. After surgery, you will be taken to a recovery room to be monitored. You will likely need to stay in the hospital overnight or longer, depending on where your clot is located.
After you recover from a clot removal, you will need to take blood-thinning medication and other medications that help prevent clots from forming again. Your doctor will also talk to you about lifestyle changes and other ways to lower your risk of clots in the future.
Angioplasty can be used to open narrowed blood vessels in the heart. It’s often done after a heart attack or to treat blockages that cause a stroke.
This procedure uses a catheter — a thin tube with a balloon on the end. The provider puts the catheter into a blood vessel in your wrist or groin. They use medicine to keep you from feeling the tube go into your body. Then they move the catheter through your blood vessels to your heart, using X-rays to help find their way. They release dye through the catheter to highlight your blood vessels on X-rays. Then they put a wire into the coronary artery that’s blocked or narrowed and then a second tube with a balloon on the end (a balloon catheter). They inflate the balloon, which expands the wall of the blood vessel and helps blood flow better.
A small wire mesh tube called a stent may be placed in the blood vessel to keep it open. This is usually done if the clot caused a hemorrhagic stroke, which is when blood breaks loose from a blood vessel and travels to other places in the body or into the brain.
If your doctor has a good reason to think you’ll benefit from angioplasty, they’ll ask you to come to the hospital for the procedure. You’ll wear a hospital gown and sit in a special chair or bed. A nurse or a radiology technologist will clean the area where the sheath goes into your blood vessel (usually in the groin). Then the interventional radiologist injects local anesthesia into that spot. It feels like a sting for a few seconds.
Surgical techniques are used to treat ischemic stroke in people who’ve had severe problems with blood flow to the brain. These surgeries improve a person’s chance of surviving and having fewer disabilities. Surgery can also help reduce the risk of having another stroke or heart disease.
Doctors try to remove blood clots that are blocking oxygen to the brain as soon as possible after a stroke occurs. This treatment is called thrombolysis or mechanical thrombectomy. The best results come from this treatment if it’s given within three to six hours of the first signs of a stroke.
The most common way to get clots out of the bloodstream is with a medication called alteplase (also known as tissue plasminogen activator, or tPA) that’s injected into a vein. This medication dissolves a blood clot and helps restore blood flow to the brain. Doctors usually try to give this medication within two and a half hours of when a person had a stroke.
Another surgery for ischemic stroke is called carotid endarterectomy. This involves removing plaques and clots from the major blood vessels in the neck that lead to the brain. This is an option for people who’ve had a clot in the left internal carotid artery or right external carotid artery. It’s not as effective with other types of ischemic stroke.
If a person has a hemorrhagic stroke, doctors must control bleeding and relieve pressure in the brain caused by excess fluid quickly. They may give you medicine to prevent blood clots or put in a tube in your throat — called a shunt — to drain fluid from the brain and body.
After a stroke, people often need physical and occupational therapy to help them recover the skills they lost. This can help them learn to walk again, move their arms and legs, and speak. Doctors can also prescribe medicines to manage high blood pressure and cholesterol, lower blood sugar, and keep blood clots from forming. They might also recommend exercise and a healthier diet to help you lose weight. This helps to prevent heart disease, which is a leading cause of stroke.
