A stroke, or cerebrovascular accident, occurs when the blood supply to the brain is reduced or cut off. Without oxygen and nutrients, brain cells begin to die within minutes. Strokes can cause permanent disability, brain damage, and in some cases death. Strokes are emergencies and should be treated immediately for the best chance at survival. If you think yourself or someone around you is having a stroke, call emergency medical services immediately. There are three main types of strokes: ischemic strokes, hemorrhagic strokes, and transient ischemic attacks. Ischemic strokes (87% of strokes) occur when blood flow is cut off or reduced to the brain by some factor such as a blood clot. Hemorrhagic strokes occur when there is bleeding on the brain that causes neurological damage. Transient ischemic attacks, or “mini strokes,” involve only temporary loss of blood flow to the brain but may be a warning sign of a future stroke.
Strokes are caused by either a blocked artery or leakage from a blood vessel in the brain. Risk factors for strokes include high blood pressure, obesity, smoking, hyperlipidemia, illegal drug use (such as cocaine and methamphetamine), sedentary lifestyle, heavy alcohol consumption, diabetes, cardiovascular disease (especially atrial fibrillation), history or family history of prior stroke, transient ischemic attack, or heart attack, and COVID-19. Individuals age 55 and older, African American and Hispanic individuals, men, individuals on birth control and/or hormone therapy, who eat an unhealthy diet, who have high red blood cell counts, and who are under a significant amount of stress are also at greater risk for stroke.
Symptoms of stroke include:
Difficulty speaking and understanding speech
Paralysis/numbness on one or both sides of the face, arms, or legs
Facial droop on one or both sides with smiling
Difficulty walking/loss of balance
Nausea and vomiting
Fainting or seizures
The type of treatment given for stroke depends on the type of stroke an individual is undergoing. In ischemic strokes, medication called tPA, or tissue plasminogen activator, may be given. Additionally, emergency endovascular procedures may be performed to break up a clot or prevent further blood clotting. In hemorrhagic strokes, medication may be given, but surgery is often required to reduce intracranial pressure or to clip an aneurysm in the brain. Depending on the case, other surgeries may be required for treatment or preventative measures. After a stroke, patients are often sent to stroke rehabilitation with different specialists to relearn basic skills and to help them recover in the best way possible.
To prevent stroke, it is important to control all underlying conditions such as hypertension, diabetes, obstructive sleep apnea, and heart disease and to eat a heart healthy diet high in fruits and vegetables and low in trans-fat, saturated fats, cholesterol, salt, and sugar. It is also important to maintain a healthy weight, avoid or quit tobacco use, avoid illegal drug use, limit alcohol consumption, get regular exercise, take all prescribed medications consistently, and see a doctor regularly. Certain surgical procedures may be required, such as a carotid endarterectomy or a carotid angioplasty and stent placement. Your doctor may also prescribe you certain anticoagulants (blood thinners) or anti-platelet medication.
American Association of Neurological Surgeons. (n.d.). Stroke. https://www.aans.org/en/Patients/Neurosurgical-Conditions-and-Treatments/Stroke.
American Diabetes Association. (n.d.). Stroke. https://www.diabetes.org/diabetes/complications/stroke.
Centers for Disease Control and Prevention. (2021, May 25). Types of stroke. https://www.cdc.gov/stroke/types_of_stroke.htm.
John Hopkins Medicine. (n.d.). Stroke. https://www.hopkinsmedicine.org/health/conditions-and-diseases/stroke.
Mayo Clinic Staff. (2021, February 9). Stroke. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/stroke/symptoms-causes/syc-20350113.
National Health Service. (2019, August 15). Stroke. https://www.nhs.uk/conditions/stroke/.
U.S. National Library of Medicine. (2021, May 20). Stroke. MedlinePlus. https://medlineplus.gov/stroke.html.