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Stroke

Stroke Overview

According to the Centers for Disease Control and Prevention (CDC), stroke is the fourth-leading cause of death in the United States. Brain tissue loses oxygen and food when a blood vessel in the brain ruptures and bleeds or if the blood supply to the brain is blocked. Brain cells and tissue begin to die within minutes, which causes a stroke.

What Are Symptoms of Stroke?

Stroke symptoms happen in body parts that the brain controls. Symptoms include:

  • paralysis
  • numbness or weakness in the arms, face, or leg, especially on one side of the body
  • difficulty speaking or understanding speech
  • confusion
  • slurring speech
  • trouble seeing in one or both eyes, with vision blackened or blurred or double vision
  • trouble walking
  • loss of balance or coordination
  • dizziness
  • severe, sudden headache with an unknown cause

Call 911 if you think someone is having a stroke. Fast treatment is key to preventing brain damage, long-term disability, and death from a stroke.

Causes and Types of Strokes

A stroke caused by a blocked artery is called an ischemic stroke. A stroke caused by a burst or leaking blood vessel is known as a hemorrhagic stroke. Another type of stroke is a transient ischemic attack (TIA or mini-stroke).

According to the CDC, most strokes are ischemic strokes. In this type of stroke, the arteries supplying blood to the brain narrow or get blocked. These blockages are often caused by blood clots or blood flow that’s severely reduced. The two most common types of ischemic strokes are thrombotic and embolic. A thrombotic stroke happens when a blood clot forms in one of the arteries supplying blood to the brain. Embolic stroke is when a blood clot or other debris forms in another part of the body — often the heart — and goes through the blood and gets stuck in brain arteries, also causing a blood clot.

A hemorrhagic stroke happens when an artery in the brain suddenly breaks open or leaks blood. That leaking blood puts excess pressure in the skull and swells the brain, damaging brain cells and tissues. This stroke is often caused by high blood pressure and aneurysms. The two types of hemorrhagic strokes are subarachnoid and intracerebral. Intracerebral is the most common type of hemorrhagic stroke. It happens when the tissues surrounding the brain fill with blood after an artery bursts. Less common is the subarachnoid hemorrhage, which is bleeding in the area between the brain and tissues that cover it.

Known as a TIA or a mini-stroke, a transient ischemic attack is when blood flow to the brain is blocked for under five minutes. Symptoms may be temporary and disappear after a few minutes. A TIA is often caused by a blood clot and is a warning of a future stroke. Don’t ignore a TIA. Seek the same treatment you would for a major stroke.

Risk Factors for Stroke

Certain risk factors make you more susceptible to stroke. The more risk factors you have, the more likely you are to have a stroke. One risk factor is an unhealthy diet. This means your diet is high in salt, saturated fats, trans fat and cholesterol. All of these are linked to stroke.

Inactivity can also raise your risk for stroke. The CDC recommends that adults get 2.5 hours of aerobic exercise every week. That can mean a brisk walk a few times a week.

The risk for stroke also increases if you drink too much alcohol. According to the Mayo Clinic, alcohol consumption should be in moderation. This means no more than one drink per day for women and no more than two for men. More than that may raise blood pressure levels and triglyceride levels, which can harden your arteries. Using tobacco also raises your risk since it can damage your blood vessels and heart. The same goes for smoking because your blood pressure rises when you use nicotine.

Certain risk factors for stroke you can’t control. Stroke risk can be linked to your:

  • family history
  • sex
  • age
  • race
  • ethnicity

Stroke risk is higher in some families because health issues like high blood pressure can be based on genetic issues. According to the CDC, both women and men can have strokes, but it’s more common in men than in women for most age groups. Age is also a risk factor. You’re more likely to have a stroke the older you are. Asians and non-Hispanic whites are less likely to have a stroke than African-Americans, Hispanics, Alaska natives, and American Indians.

As mentioned above, certain medical conditions are linked to a stroke risk. These include:

  • having already had a stroke or a TIA
  • high blood pressure
  • high cholesterol
  • heart disorders such as coronary artery disease
  • heart valve defects
  • enlarged heart chambers and irregular heartbeats
  • sickle cell disease
  • diabetes

Diagnosis of Stroke

Several tests can help determine:

  • if you had a stroke
  • what may have caused it
  • what part of the brain is impacted
  • if you have bleeding in the brain

These tests can also determine if your symptoms are being caused by something else.

You’ll get a physical exam. The doctor will check your balance and coordination, weakness or numbness in your arms, face, and legs, signs of confusion, and vision.

The doctor will ask you or a family member about your symptoms and what you were doing when they happened. They’ll take your medical history to find out your stroke risk factors. The doctor will ask what medications you take, check your blood pressure, and listen to your heart.

Tests for Stroke

You may go through various tests to further help determine if you’ve had a stroke. Your doctor might call for blood tests. That can determine:

  • your blood sugar levels
  • if you have an infection
  • your platelet levels
  • how fast your blood clots

You may undergo magnetic resonance imaging (MRI) and a computerized tomography (CT) scan. The MRI will help see if there is any changed brain tissue or damaged brain cells. A CT scan will provide a detailed and clear picture of your brain and show any bleeding or damage in the brain. It may also show other brain conditions that may be causing your symptoms.

You may get an electrocardiogram (EKG). This simple test records the electrical activity in the heart, measuring its rhythm and recording how fast it beats. It can help find out if you have any heart conditions that may have led to stroke, such as a prior heart attack.

Other tests may include a cerebral angiogram. This offers a detailed look at the arteries in your neck and brain. You may get a carotid ultrasound, which can show fatty deposits (plaque) and whether your carotid arteries have been narrowed or blocked. You also may receive an echocardiogram, which can find sources of clots in your heart that may have traveled to your brain and caused a stroke.

Prevention

You can take measures to prevent stroke by living a healthy lifestyle. That means not smoking and limiting how much alcohol you drink. If you smoke, quitting will lower your risk for stroke. Alcohol consumption can raise your blood pressure, so try to reduce your intake.

Keep your weight at a healthy level. Being obese or overweight increases your stroke risk. Eat a diet that’s healthy and full of fruits and vegetables. Eat foods low in cholesterol, trans fat, and saturated fats. Stay physically active to maintain a healthy weight and help decrease your blood pressure and cholesterol levels.

Be on top of your health. Get your cholesterol and blood pressure checked. Talk to your doctor about modifying your lifestyle and discuss your medication options. Address any heart problems. If you have diabetes, take steps to manage it. Taking all these measures will help put you in optimal shape to prevent stroke.

Content licensed from:

Written by: the Healthline Editorial Team
Published on Oct 30, 2014
Medically reviewed on Oct 30, 2014 by Brenda B. Spriggs, MD, MPH, MBA

This feature is for informational purposes only and should not be used to replace the care and information received from your health care provider. Please consult a health care professional with any health concerns you may have.
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