A stroke occurs when a clot or rupture prevents blood flow to the brain. Without proper blood flow, the brain does not receive key nutrients and oxygen, causing cells to die. Depending on the area of the brain affected and the amount of damage, a stroke can have a number of different impacts on the patient. Many patients experience lifelong disabilities.
Strokes are the fifth most common cause of death in the U.S. They can affect people of any age, but are most common in those over the age of 60.
In the U.S. alone, someone suffers a stroke every 40 seconds, with almost 800,000 people affected every year. As the fifth leading cause of death in the U.S., strokes kill nearly 130,000 people each year. One in every twenty Americans will die of a stroke.
Statistically, women are more likely to have strokes than men because they typically have a longer life span. African-Americans suffer from strokes more than any other racial group, with a death rate twice as high as that of Caucasians.
Strokes do not discriminate by age. Although most stroke patients are over the age of 60, recent research has shown that younger adults are also at risk. It is also possible for strokes to occur during childhood, but this is less common. There are approximately 6.4 strokes per 100,000 children.
What Causes a Stroke?
Strokes are caused by an interrupted flow of blood to the brain. This interruption can happen through either a clot within a blood vessel or a rupture of the blood vessel itself. Each cause leads to a different type of stroke.
Types of Stroke
|Ischemic Stroke||Hemorrhagic Stroke|
|A brain clot blocks the blood flow to the brain causing an ischemic stroke. This type of stroke accounts for 87 percent of all cases, making it the most common stroke type.||A weakened blood vessel in the brain ruptures to cause a hemorrhagic stroke. The most common cause of a hemorrhagic stroke is high blood pressure. Fewer than 15 percent of strokes are hemorrhagic strokes.|
Some patients also experience a transient ischemic attack (TIA), which is a temporary clot to the brain that does not cause long-term damage. Although some people consider TIAs to be “mini-strokes,” they should still be treated as seriously as an ischemic or hemorrhagic stroke to ensure the patient has the greatest chance of recovery.
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Strokes have many causes, but most can be prevented. In fact, the American Stroke Association says that 80 percent of strokes are preventable. Healthy lifestyles can reduce your risk of stroke.
Specifically, doctors advise taking care of high blood pressure and cholesterol, as these can lead to hemorrhagic strokes. Adjusting your diet and increasing exercise can also prevent strokes and lead to healthier cardiovascular lifestyles. Smokers are more likely to experience strokes, as nicotine has negative impacts on cardiovascular health, so doctors advise quitting. Overall, making heart-healthy decisions can dramatically decrease your risk of stroke.
In some cases, strokes can occur as a side effect of drugs. For example, testosterone therapy has been linked to increased risk of stroke, especially ischemic stroke. As with all drugs and therapies, make sure you are aware of the risks and speak to your doctor about potential side effects before beginning a treatment.
Stroke Symptoms and Effects
There are three leading symptoms that indicate stroke: face drooping, arm weakness, and speech difficulty. Symptoms appear rapidly and often unexpectedly.
Other common symptoms include:
- Sudden difficulty with vision
- Sudden numbness or weakness on one side of the body
- Sudden confusion or difficulty with speech
- Sudden headaches
- Sudden dizziness or difficulty with balance
If experiencing any of the above symptoms, or witnessing them in someone else, remember to act FAST. This acronym will help you to remember the key indicators of a stroke, as follows:
The effects of strokes after the initial attack can vary. Many patients experience lasting effects that remain with them for the rest of their lives. Long-term effects are difficult to predict when a stroke is happening, but include both cognitive and physical disabilities.
Long-Term Effects of a Stroke
|Cognitive Effects||Physical Effects|
|Since strokes are brain injuries, many lasting effects are cognitive, having to do with continuing issues in the brain. Things that were second nature, like speaking or thinking, may become difficult. Some of the most common cognitive effects are:||Lack of blood and nutrients to the brain can have lasting effects throughout the body. Most commonly, patients experience numbness, weakness, and stiffness. There are a wide range of long-term physical effects that a patient may experience after a stroke, including:|
Stroke patients can experience any number of these side effects, typically in the side of the body corresponding with the side of the brain that was affected. Physical therapy and medications can help with many of the issues.
The symptoms of stroke are very specific and are key indicators of the “brain attack.” Diagnosing a stroke quickly is critical to administering treatment, so it’s important to seek medical attention immediately after experiencing any symptoms or spotting them in others. The faster a stroke patient receives help, the better their chances of recovery will be.
To diagnose a stroke, doctors will consider the full medical history of the patient and then order diagnostic tests and procedures to determine the stroke’s cause and identify damage done to the brain.
Brain computed tomography (CT) scan: With a CT scan, the doctor will take a picture of the brain that can show bleeding or damage to brain cells.
Magnetic resonance imaging (MRI) scan: An MRI uses magnetic waves to generate images of the brain in order to detect damage or changes to brain tissue.
Electroencephalogram (EEG): This test entails putting discs on the side of the head to pick up brain waves and figure out if something is wrong.
Carotid ultrasound: A carotid ultrasound helps doctors see whether there are blockages to the carotid artery, which supplies blood to the brain.
The treatment for a stroke will differ depending on how long it’s been since the stroke occurred, as well as what type of stroke took place.
The initial goal of stroke treatment is to resume blood flow to the brain as quickly as possible. Given that blockages in the brain’s blood vessels can have different causes, the treatment approach will depend on the type of stroke that took place.
Ischemic Stroke Treatment
Treatment of ischemic strokes centers around removing or “busting” (breaking up or dissolving) the blood clot. There are two ways this is done.
Tissue plasminogen activator (alteplase): Alteplase is a protein that breaks down blood clots. Delivered intravenously, this treatment is often the first step in treating ischemic strokes. When administered quickly (within 3 hours), alteplase can increase the likelihood of a full recovery with few or no long-term effects. Unfortunately, the protein can only be used within three hours of having a stroke, meaning many patients miss the window.
Endovascular thrombectomy: This procedure uses a catheter and is a more invasive way to remove a clot. Doctors use a stent reliever to go into an artery and trap the clot in the spiral wire of the device to allow for a clean removal.
After strokes, doctors may prescribe blood thinners (anticoagulants) like warfarin, Xarelto or Pradaxa to patients to help prevent the formation of future blood clots. However, these drugs can lead to severe bleeding side effects that patients should be aware of. In the case of Xarelto, there is no antidote available to reverse the effects of the drug, and patients are at risk of deadly internal bleeding. A lack of warning information combined with these health risks lead to a $650 million Pradaxa lawsuit settlement, and thousands of Xarelto lawsuits.
Other prescription medications may help to control underlying conditions that caused the blood clot in the first place, or symptoms and aftereffects of the stroke.