Stroke: Causes, symptoms, diagnosis, and treatment (2023)

Stroke occurs due to a decrease or blockage in the brain’s blood supply. A person experiencing a stroke needs immediate emergency treatment.

Stroke is the fifth leading cause of death in the United States. In fact, nearly 800,000 people have a stroke each year. That equates to around one person every 40 seconds.

There are three main types of stroke:

  • Ischemic stroke: This is the most common type of stroke, making up 87% of all cases. A blood clot prevents blood and oxygen from reaching an area of the brain.
  • Hemorrhagic stroke: This occurs when a blood vessel ruptures. These are usually the result of aneurysms or arteriovenous malformations (AVMs).
  • Transient ischemic attack (TIA): This occurs when blood flow to a part of the brain is inadequate for a brief period of time. Normal blood flow resumes after a short amount of time, and the symptoms resolve without treatment. Some people call this a ministroke.

Stroke can be fatal. According to the American Heart Association (AHA), the age-adjusted mortality rate for 2017 was 37.6 in every 100,000 stroke diagnoses. Doctors have made a great deal of progress in managing strokes, meaning that this mortality rate is 13.6% lower than it was in 2007.

This article explains why strokes occur and how to treat them. It also explores the different types of stroke, as well as the steps a person can take to prevent them.

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A stroke occurs when a blockage or bleed of the blood vessels either interrupts or reduces the supply of blood to the brain. When this happens, the brain does not receive enough oxygen or nutrients, and brain cells start to die.

Stroke is a cerebrovascular disease. This means that it affects the blood vessels that feed the brain oxygen. If the brain does not receive enough oxygen, damage may start to occur.

This is a medical emergency. Although many strokes are treatable, some can lead to disability or death.

Treatment

(Video) Ischemic Stroke - causes, symptoms, diagnosis, treatment, pathology

Because ischemic and hemorrhagic strokes have different causes and effects on the body, both require different treatments.

Rapid diagnosis is important for reducing brain damage and enabling the doctor to treat the stroke using a suitable method for the type.

The sections below cover the treatment options for ischemic stroke and hemorrhagic stroke, as well as some general rehabilitation tips for both types.

Ischemic stroke

Ischemic stroke occurs due to blocked or narrowed arteries. Treatment tends to focus on restoring an adequate flow of blood to the brain.

Treatment starts with taking drugs that break down clots and prevent others from forming. A doctor may administer blood thinners such as aspirin or an injection of tissue plasminogen activator (TPA).

TPA is very effective at dissolving clots. However, the injection needs to take place within 4.5 hours of the stroke symptoms starting.

Emergency procedures include administering TPA directly into an artery in the brain or using a catheter to physically remove the clot. Research is ongoing as to the benefits of these procedures.

There are other procedures that surgeons can perform to reduce the risk of strokes or TIAs. A carotid endarterectomy, for example, involves opening the carotid artery and removing plaque that could break and travel to the brain.

Another option is angioplasty. This involves a surgeon inflating a small balloon inside a narrowed artery using a catheter. Afterward, they will insert a mesh tube, or a stent, into the opening. This prevents the artery from narrowing again.

Hemorrhagic stroke

Blood leaking into the brain can cause a hemorrhagic stroke. Treatment focuses on controlling the bleeding and reducing the pressure on the brain.

Treatment often begins with taking drugs that reduce pressure in the brain and control overall blood pressure, as well as preventing seizures and any sudden constrictions of blood vessels.

If a person is taking blood-thinning anticoagulants or antiplatelet medication, such as warfarin or clopidogrel, they can receive medications to counter the effects of the blood thinners.

Surgeons can repair some of the problems with blood vessels that have led or could lead to hemorrhagic strokes.

When an aneurysm — or a bulge in a blood vessel that may burst — causes a hemorrhagic stroke, a surgeon can place small clamps at the base of the aneurysm or fill it with detachable coils to stop the blood flow and shrink the aneurysm.

If the hemorrhage occurs due to an AVM, a surgeon can remove it. AVMs are connections between arteries and veins that can be at risk of bleeding.

(Video) Stroke - Causes, Symptoms and Treatment Options

Rehabilitation

Stroke is a potentially life changing event that can have lasting physical and emotional effects.

Successful recovery from a stroke will often involve specific therapies and support systems, including:

  • Speech therapy: This helps with problems producing or understanding speech. Practice, relaxation, and changing communication style can all make communicating easier.
  • Physical therapy: This can help a person relearn movement and coordination. It is important to stay active, even though this may be difficult at first.
  • Occupational therapy: This can help a person improve their ability to carry out daily activities, such as bathing, cooking, dressing, eating, reading, and writing.
  • Support groups: Joining a support group can help a person cope with common mental health issues that can occur after a stroke, such as depression. Many find it useful to share common experiences and exchange information.
  • Support from friends and family: Close friends and relatives should try to offer practical support and comfort after a stroke. Letting friends and family know what they can do to help is very important.

Rehabilitation is an important and ongoing part of stroke treatment. With the right assistance and the support of loved ones, regaining a normal quality of life is usually possible, depending on the severity of the stroke.

The best way to prevent a stroke is to address the underlying causes. People can achieve this by making lifestyle changes such as:

  • eating a healthful diet
  • maintaining a moderate weight
  • exercising regularly
  • not smoking tobacco
  • avoiding alcohol, or only drinking moderately

Eating a nutritious diet means including plenty of:

  • fruits
  • vegetables
  • whole grains
  • nuts
  • seeds
  • legumes

Be sure to limit the amount of red and processed meat in the diet, as well as cholesterol and saturated fats. Also, moderate salt intake to support healthy blood pressure levels.

Other measures a person can take to help reduce the risk of stroke include:

  • controlling their blood pressure levels
  • managing diabetes
  • getting treatment for heart disease

As well as making these lifestyle changes, taking anticoagulant or antiplatelet medications can also reduce the risk of experiencing another stroke.

Undergoing cardiac artery, carotid artery, or brain aneurysm surgery can also lower the risk of additional strokes, as can some other surgical options still under investigation.

Causes and risk factors

(Video) Stroke Diagnosis and Treatment - Acute and Long Term Treatment of Ischemic and Hemorrhagic Stroke

Each type of stroke has a different set of potential causes. Generally, however, stroke is more likely to affect a person if they:

  • have overweight or obesity
  • are 55 years of age or older
  • have a personal or family history of stroke
  • have high blood pressure
  • have diabetes
  • have high cholesterol
  • have heart disease, carotid artery disease, or another vascular disease
  • are sedentary
  • consume alcohol excessively
  • smoke
  • use illicit drugs

Some studies have found that males have a higher risk of death from stroke than females. However, one 2016 review of studies suggests that these differences do not take into account adjustments for race, age, the severity of the stroke, and other risk factors.

The review explains that the risk of stroke mortality often increases due to age and demographic, rather than the biological differences between males and females.

According to a 2016 analysis, African American people have a significantly higher risk of experiencing a first-time stroke. They are also around 60% more likely to experience another stroke within 2 years.

The following sections describe the specific causes of each type of stroke.

Ischemic stroke

This type of stroke occurs due to blockages or narrowing in the arteries that provide blood to the brain. This causes ischemia, or a severely reduced blood flow, which damages brain cells.

Blood clots often cause ischemic stroke. Clots can form in the brain arteries and other blood vessels in the body. The bloodstream carries these into narrower arteries in the brain.

Fatty plaque deposits within the arteries can also cause clots that result in ischemia.

Hemorrhagic stroke

Leaky or burst arteries in the brain can give rise to hemorrhagic strokes.

Leaked blood puts pressure on brain cells and damages them. It also reduces the blood supply that can reach the brain tissue after the hemorrhage.

Blood vessels can burst and spill blood into the brain or near the surface of the brain. This may also send blood into the space between the brain and the skull.

Having hypertension, experiencing physical trauma, taking blood-thinning medications, and having an aneurysm can all make a blood vessel leak or burst.

Intracerebral hemorrhage is the most common type of hemorrhagic stroke. This occurs when brain tissue floods with blood after an artery bursts.

Subarachnoid hemorrhage is another type of hemorrhagic stroke. These are less common. In a subarachnoid hemorrhage, bleeding occurs in the area between the brain and the thin tissues that cover it.

TIAs

TIAs only briefly interrupt the flow of blood to the brain. They are similar to ischemic strokes, in that they occur due to clots.

(Video) Stroke: Definition, Classification, Causes, Symptoms, Diagnosis, and Treatment

People should treat them as medical emergencies, even if the symptoms are temporary. They serve as warning signs for future strokes and indicate a partially blocked artery or clot source in the heart.

According to the Centers for Disease Control and Prevention (CDC), over a third of people who experience a TIA have a major stroke within a year if they do not receive any treatment. Around 10–15% of people will have a major stroke within 3 months of experiencing a TIA.

The symptoms of a stroke often appear without warning. Some of the main symptoms include:

  • confusion, including difficulty speaking and understanding speech
  • a headache, possibly with altered consciousness or vomiting
  • numbness or an inability to move parts of the face, arm, or leg, particularly on one side of the body
  • vision problems in one or both eyes
  • difficulty walking, including dizziness and a lack of coordination

Stroke can lead to long-term health problems. Depending on the speed of the diagnosis and treatment, a person can experience temporary or permanent disabilities after a stroke.

Some people may also experience:

  • bladder or bowel control problems
  • depression
  • paralysis or weakness on one or both sides of the body
  • difficulty controlling or expressing their emotions

Symptoms vary and may range in severity.

Learning the acronym “FAST” is a good way to remember the symptoms of stroke. This can help a person seek prompt treatment. FAST stands for:

  • Face drooping: If the person tries to smile, does one side of their face droop?
  • Arm weakness: If the person tries to raise both their arms, does one arm drift downward?
  • Speech difficulty: If the person tries to repeat a simple phrase, is their speech slurred or unusual?
  • Time to act: If any of these symptoms are occurring, contact the emergency services immediately.

The outcome depends on how quickly someone receives treatment. Prompt care also means that they would be less likely to experience permanent brain damage or death.

Stroke begins rapidly. For the best outcome, a person should receive treatment at a hospital within 3 hours of their symptoms first appearing.

(Video) Brain Stroke, Types of, Causes, Pathology, Symptoms, Treatment and Prevention, Animation.

There are several different diagnostic tests a doctor can use to determine the type of stroke. These include:

  • Physical examination: A doctor will ask about the person’s symptoms and medical history. They will check muscle strength, reflexes, sensation, vision, and coordination. They may also check blood pressure, listen to the carotid arteries in the neck, and examine the blood vessels at the back of the eyes.
  • Blood tests: A doctor may perform blood tests to determine if there is a high risk of bleeding or blood clots, measuring levels of particular substances in the blood, including clotting factors, and checking whether or not an infection is present.
  • CT scan: A series of X-rays can show hemorrhages, strokes, tumors, and other conditions within the brain.
  • MRI scan: These use radio waves and magnets to create an image of the brain, which a doctor can use to detect damaged brain tissue.
  • Carotid ultrasound: A doctor may carry out an ultrasound scan to check blood flow in the carotid arteries and to see if there is any narrowing or plaque present.
  • Cerebral angiogram: A doctor may inject a dye into the brain’s blood vessels to make them visible under X-ray or MRI. This provides a detailed view of the blood vessels in the brain and neck.
  • Echocardiogram: This creates a detailed image of the heart, which doctors can use to check for any sources of clots that could have traveled to the brain.

It is only possible to confirm the type of stroke using a brain scan in a hospital environment.

FAQs

What is stroke causes symptoms and treatment? ›

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.

What are the main causes of stroke? ›

Some of the most important treatable risk factors for stroke are:
  • High blood pressure, or hypertension. Hypertension is by far the most potent risk factor for stroke. ...
  • Cigarette smoking. ...
  • Heart disease. ...
  • Warning signs or history of TIA or stroke. ...
  • Diabetes. ...
  • Cholesterol imbalance. ...
  • Physical inactivity and obesity.
26 Sept 2022

What is stroke and its treatment? ›

Ischemic stroke. To treat an ischemic stroke, doctors must quickly restore blood flow to the 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.

What is the medical diagnosis for stroke? ›

If a stroke is suspected, a CT scan is usually able to show whether you have had an ischaemic stroke or a haemorrhagic stroke. It's generally quicker than an MRI scan and can mean you're able to receive appropriate treatment sooner.

What is definition of stroke? ›

(stroke) In medicine, a loss of blood flow to part of the brain, which damages brain tissue. Strokes are caused by blood clots and broken blood vessels in the brain. Symptoms include dizziness, numbness, weakness on one side of the body, and problems with talking, writing, or understanding language.

What are the 7 signs of a stroke? ›

Symptoms include:
  • Vertigo, like the room, is spinning.
  • Imbalance.
  • One-sided arm or leg weakness.
  • Slurred speech or dysarthria.
  • Double vision or other vision problems.
  • A headache.
  • Nausea and or vomiting.
10 Jun 2021

What is the biggest risk for stroke? ›

High blood pressure is the leading cause of stroke and is the main cause for increased risk of stroke among people with diabetes. Talk to your doctor about ways to keep diabetes under control.

Who is at risk of stroke? ›

Older age. For each decade of life after age 55, your chance of having a stroke more than doubles. Race. African Americans have a much higher risk for death and disability from a stroke than whites.

What are 6 foods that prevent stroke? ›

Here are some of the best foods that help prevent stroke:
  • Oatmeal (for whole grains) ...
  • Yogurt (for probiotics) ...
  • Dry Beans (for fiber) ...
  • Onions (for antioxidants) ...
  • Flaxseeds (for fatty acids) ...
  • Red wine (for antioxidants) ...
  • Salmon (for vitamin D)
18 Aug 2020

What are 3 treatments for a stroke? ›

Treating ischaemic strokes
  • Thrombolysis – "clot buster" medicine. ...
  • Thrombectomy. ...
  • Aspirin and other antiplatelets. ...
  • Anticoagulants. ...
  • Blood pressure medicines. ...
  • Statins. ...
  • Carotid endarterectomy.

Which tablet is best for stroke? ›

Anticoagulants help keep the blood from clotting. They make clots harder to form or slow them from growing. Warfarin and heparin are common examples. There are also medicines called direct oral anticoagulant and these include: Apixaban (Eliquis), dabigatran (Pradaxa), edoxaban (Lixiana, Savaysa), rivaroxaban (Xarelto).

What is the best recovery for a stroke? ›

Learn how you can help your ageing loved one recover from a stroke quickly.
  • Don't Overdo Physical Activity. Exercise is crucial because it increases the flow of blood and oxygen throughout the brain. ...
  • Follow a Healthy Diet. Creating more neurons is the key to quick stroke recovery. ...
  • Get Plenty of Rest. ...
  • Use Respite Care.
17 Jul 2019

What is the treatment for a mild stroke? ›

If you get to the hospital within 3 hours of the first symptoms of an ischemic stroke, you may get a type of medicine called a thrombolytic (a “clot-busting” drug) to break up blood clots. Tissue plasminogen activator (tPA) is a thrombolytic. tPA improves the chances of recovering from a stroke.

How can I prevent strokes? ›

Prevent Stroke: What You Can Do
  1. Choose healthy foods and drinks. Choosing healthy meal and snack options can help you prevent stroke. ...
  2. Keep a healthy weight. ...
  3. Get regular physical activity. ...
  4. Don't smoke. ...
  5. Limit alcohol. ...
  6. Check cholesterol. ...
  7. Control blood pressure. ...
  8. Control diabetes.
5 Apr 2022

Is stroke can be cured? ›

The short answer is yes, stroke can be cured — but it occurs in two stages. First, doctors administer specific treatment to restore normal blood flow in the brain. Then, the patient participates in rehabilitation to cure the secondary effects.

How long can a stroke last? ›

It can last a few minutes or persist up to 24 hours.

What is the full name of stroke? ›

Stroke | CVA | Cerebrovascular Accident | MedlinePlus.

Can stress cause a stroke? ›

Stress can cause the heart to work harder, increase blood pressure, and increase sugar and fat levels in the blood. These things, in turn, can increase the risk of clots forming and travelling to the heart or brain, causing a heart attack or stroke.

What are the 4 silent signs of a stroke? ›

Silent Stroke Symptoms
  • Sudden lack of balance.
  • Temporary loss of basic muscle movement (bladder included)
  • Slight memory loss.
  • Sudden changes in mood or personality.
  • Issues with cognitive skills and ability.

How do you test for stroke at home? ›

Something doesn't add up about strokes.
  1. They are common. ...
  2. They are preventable. ...
  3. F = Face — Ask the person to smile. ...
  4. A = Arms — Ask the person to raise both arms. ...
  5. S = Speech — Ask the person to repeat a simple phrase. ...
  6. T = Time — If the person failed any part of the test, note the time and get help.
14 Dec 2020

What age strokes occur? ›

What is the average age for stroke? The majority of strokes occur in people who are 65 or older. As many as 10% of people in the U.S. who experience a stroke are younger than 45.

What is the most common age for strokes? ›

Most strokes do affect people who are at least 65 years old. But did you know that stroke affects many people who are younger than 65, and that women are at higher risk than men? Among the various explanations for this increased risk among women and young adults is the tendency to overlook the warning signs of stroke.

What is stroke level blood pressure? ›

Call 911 or emergency medical services if your blood pressure is 180/120 mm Hg or greater and you have chest pain, shortness of breath, or symptoms of stroke. Stroke symptoms include numbness or tingling, trouble speaking, or changes in vision.

What age is risk for stroke? ›

Aging is the most robust non-modifiable risk factor for incident stroke, which doubles every 10 years after age 55 years. Approximately three-quarters of all strokes occur in persons aged ≥65 years.

How do doctors test for stroke risk? ›

A CT scan of the head is usually one of the first tests used for a stroke. A CT scan can show bleeding in the brain or damage to brain cells. The CT scan also can find other problems that can cause stroke symptoms.

Can banana prevent stroke? ›

1. Fruits and vegetables

Foods high in potassium, such as sweet and white potatoes, bananas, tomatoes, prunes, melon and soybeans, can help you maintain a healthy blood pressure — the leading risk factor of stroke. Magnesium-rich foods, such as spinach, are also linked to a lower risk of stroke.

What vitamins help prevent stroke? ›

Folic acid, vitamin B6 (pyridoxine), and vitamin B12 (cyanocobalamin) may lower blood levels of homocysteine and reduce the risk of having another stroke or a heart attack.

Is banana good for stroke patient? ›

(10) Get enough potassium

Potassium is abundant in fruit, vegetables, and milk products. Therefore, if you consume recommended amounts of these food groups, you should achieve an adequate intake of potassium. Good fruit choices include bananas, apricots, oranges, cantaloupe, and apples.

What drug can prevent stroke? ›

Anticoagulants are used for preventing ischemic stroke (the most common type of stroke) and ministroke. The anticoagulant warfarin (Coumadin, Jantoven) is used to prevent blood clots from forming or to prevent existing clots from getting larger.

Is aspirin good for stroke? ›

Stroke is a medical emergency. If you experience stroke warning signs, call 911 immediately. Taking aspirin isn't advised during a stroke, because not all strokes are caused by blood clots. Some strokes are caused by ruptured blood vessels and taking aspirin could make these bleeding strokes more severe.

Is sleep good for stroke recovery? ›

Sleep is critical, but sleep problems may follow after a stroke. Poor sleep can slow your recovery and lead to depression, memory problems and night-time falls. The good news is there are ways to improve your sleep.

Does brain heal after stroke? ›

The short answer is yes; the brain can heal after acute trauma from a stroke or brain injury, although the degree of recovery will vary. The reason the brain can recover at all is through neuroplasticity, sometimes referred to as brain plasticity.

How long are you in hospital after a stroke? ›

The typical length of a hospital stay after a stroke is five to seven days. During this time, the stroke care team will evaluate the effects of the stroke, which will determine the rehabilitation plan.

What is a Level 2 stroke? ›

A Level 2 stroke alert is a patient LKN 8-24 hours prior. These patients proceed directly on the EMS stretcher and to CTA imaging, at which time the ED contacts Vascular Neurology to review the CTA remotely and determine if intervention is necessary.

Can you feel a stroke coming? ›

Sudden numbness or weakness in the face, arm, or leg, especially on one side of the body. Sudden confusion, trouble speaking, or difficulty understanding speech. Sudden trouble seeing in one or both eyes. Sudden trouble walking, dizziness, loss of balance, or lack of coordination.

Can drinking water help prevent a stroke? ›

Drink a lot of water: You should drink at least five glasses of water per day, and this will reduce your risk of stroke by 53%, according to a recent study by Loma Linda University.

Is Egg good for stroke patient? ›

No significant inverse association between egg intake and stroke risk was observed (RR = 0.92, 95% CI: 0.84–1.01).

Can a person with stroke go back to normal? ›

The injury to the brain caused by a stroke can lead to widespread and long-lasting problems. Although some people may recover quickly, many people who have a stroke need long-term support to help them regain as much independence as possible. This process of rehabilitation depends on the symptoms and their severity.

Can stroke lead to death? ›

A stroke, sometimes called a brain attack, occurs when something blocks blood supply to part of the brain or when a blood vessel in the brain bursts. In either case, parts of the brain become damaged or die. A stroke can cause lasting brain damage, long-term disability, or even death.

Is there life after stroke? ›

Stroke is one of the leading causes of death, taking 140,000 U.S. lives each year. But it is also one of the leading causes of disability because more than 80% of people who have a stroke survive.

What are the 4 types of strokes? ›

Ischemic Stroke. Hemorrhagic Stroke. Transient Ischemic Attack (Mini-Stroke) Brain Stem Stroke.

What are the 3 types of strokes? ›

There are three different types of stroke: Ischaemic stroke. Haemorrhagic stroke. Transient ischaemic attack or TIA.

What are 5 warnings of a stroke? ›

Call 9-1-1 immediately if any of these signs of stroke appear: Numbness or weakness in the face, arm, or leg; Confusion or trouble speaking or understanding speech; Trouble seeing in one or both eyes; Trouble walking, dizziness, or problems with balance; severe headache with no known cause.

How does a stroke cause death? ›

5 cause of death and a leading cause of disability in the United States. A stroke occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot or bursts (or ruptures). When that happens, part of the brain cannot get the blood (and oxygen) it needs, so it and brain cells die.

What is the most serious type of stroke? ›

Hemorrhagic strokes are extremely dangerous because the blood in the brain can sometimes lead to further complications such as hydrocephalus, increased intracranial pressure, and blood vessel spasms. If not treated aggressively, these conditions can lead to severe brain damage and even death.

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