Stroke

Stroke Overview

What Are the Symptoms of a Stroke?

You should consider these symptoms warning signs and consult your health care provider:

  • Sudden weakness or numbness in the face, arm, or leg on one side of the body
  • Abrupt loss of vision, strength, coordination, sensation, speech, or the ability to understand speech. These symptoms may become worse over time
  • Sudden dimness of vision, especially in one eye
  • Sudden loss of balance, possibly accompanied by vomiting, nausea, fever, hiccups, or trouble with swallowing
  • Sudden and severe headache with no other cause followed rapidly by loss of consciousness — indications of a stroke due to bleeding
  • Brief loss of consciousness
  • Unexplained dizziness or sudden falls

Call 911 If:

If you or someone with you exhibits any of the signs of stroke, do not delay because timely treatment is critical to survival and recovery.

Call for emergency services.

If the symptoms pass quickly, this may indicate a transient ischemic attack(TIA), a brief blockage of blood flow to the brain that is often a forerunner of stroke. Do not ignore this warning sign.

You must get to the hospital immediately. Some treatments must begin within the first few hours of symptoms; early treatment can often help prevent a fatal or disabling stroke from occurring.

Have you learned that someone you care about had a stroke? Don’t jump to conclusions about how it will affect him. Not all strokes are created equal. There are three major kinds, with different warning signs and symptoms.

All types have one thing in common: a loss of blood to part of your brain. That causes big problems.

Your brain cells need the oxygen that’s carried by your blood. So when a stroke cuts the supply, some of the cells start to die. And that sets off trouble like memory loss, confusion, and numbness on one side your body.

There are two main types of stroke:

  • Ischemic
  • Hemorrhagic

If you have signs of any of them, call 911 right away. The sooner you get treated, the less likely you are to have long-term effects.

Ischemic Stroke

Most strokes are this type. You get them when a fatty substance called plaque collects in your arteries and narrows them. This is called atherosclerosis, and it slows the flow of blood. As it pools, blood can clump and form clots — and your artery gets blocked.

Besides atherosclerosis, some other things that can raise your chances of getting an ischemic stroke are:

  • Irregular heartbeat
  • Heart attack
  • Problem with your heart’s valves
  • Injury to blood vessels in your neck
  • Blood clotting problem

There are two main types of ischemic stroke:

Thrombotic strokes​:​ They’re caused by a blood clot that forms in an artery that supplies blood to your brain.

Embolic strokes​:​ They happen when a clot forms somewhere else in your body and travels through the blood vessels to your brain. It gets stuck there and stops the flow of your blood.

The symptoms of an ischemic stroke depend on which parts of your brain are affected. They can include things like:

  • Sudden numbness or weakness of your face, arm, or leg, often on one side of the body
  • Confusion
  • Problems speaking or understanding others
  • Dizziness, loss of balance or coordination, or trouble walking
  • Vision loss or double vision

You’re more likely to have an ischemic stroke if you:

Are over age 60
Have high blood pressure, heart disease, high cholesterol, or diabetes
Have an irregular heartbeat
Smoke
Have a family history of strokes

Sometimes you can get complications. A stroke damages your brain cells. The more damage that’s done, the more problems you can have. That’s why it’s important to get medical help as soon as possible. If you don’t get treatment, you can have trouble like:

  • Fluid buildup, swelling, and bleeding in your brain
  • Seizures
  • Problems with memory and understanding

Ischemic strokes also include something called a “mini stroke” or a TIA (transient ischemic attack). This is a temporary blockage in blood flow to your brain. The symptoms usually last for just a few minutes or may go away in 24 hours.

TIAs can happen because the vessels that bring blood to your brain narrow. They also might occur because of a clot.

The symptoms may be similar to an ischemic stroke. You might have:

  • Numbness on one side of your body
  • Confusion
  • Dizziness or loss of balance
  • Trouble talking or understanding
  • Problems with your vision
  • Severe headache

Things that can raise your chances of getting a TIA are the same as those for other strokes, including:

  • Age
  • High blood pressure, high cholesterol, diabetes, and heart disease
  • Obesity
  • Smoking
  • Family history of strokes

A TIA can sometimes be a warning sign that you’ll have an ischemic stroke soon.

Don’t take any chances if you or someone you know has any symptoms that seem like a stroke. Get medical help in a hurry.

Hemorrhagic Stroke

These happen when there is bleeding in your brain that damages nearby cells. The most common causes are:

  • High blood pressure
  • Injury
  • Bleeding disorders
  • Cocaine use
  • Abnormal blood vessels (AVMs)
  • Aneurysm (a weak area in a blood vessel that breaks open)

Your doctor may tell you about two types of hemorrhagic stroke that are based on where the bleeding happens. If he says you had a “subarachnoid hemorrhage,” it means it happened in the area between your brain and skull. But if he says it was an “intracerebral hemorrhage,” your bleeding was inside the brain.

Hemorrhagic stroke symptoms usually increase gradually over minutes or a few hours, although a subarachnoid hemorrhage may come on suddenly. Some things that can happen:

  • Intense headache that some people describe as “the worst headache they’ve ever had”
  • Confusion
  • Nausea or throwing up
  • Sensitivity to light
  • Problems with vision
  • Passing out

You’re more likely to have this type of stroke if you:

  • Are over age 65
  • Have high cholesterol, high blood pressure, or diabetes that’s not under control
  • Are obese
  • Had a stroke in the past
  • Have a family history of strokes
  • Smoke
  • Eat unhealthy foods
  • Don’t exercise

A hemorrhagic stroke can cause complications like:

  • Seizures
  • Memory and thinking problems
  • Heart problems
  • Swallowing problems and trouble eating and drinking

Some people have strokes without realizing it. They’re called silent strokes, and they either have no easy-to-recognize symptoms, or you don’t remember them. But they do cause permanent damage in your brain.

If you’ve had more than one silent stroke, you may have thinking and memory problems. They can also lead to more severe strokes.

Detecting a Silent Stroke

If you have a silent stroke, you probably won’t know it unless you happen to have a brain scan and the damage shows up. You may have slight memory problems or a little difficulty getting around. A doctor may be able to see signs of silent strokes without testing.

Silent Strokes More Common Than You’d Expect

A study of middle-aged people with no apparent signs of stroke found that about 10% had brain damage from one.

The damage that happens is permanent, but therapy might help stimulate other parts of the brain so you regain abilities that may have weakened.

Prevent Strokes With Good Habits

Your chances of getting a stroke go up if you have high blood pressure or irregular heartbeat.

Changes to the way you live can help lower your odds of stroke and heart disease. Make a plan to adopt these healthy habits:

  • Keep tabs on your blood pressure, and get it under control if it’s too high
  • Check your cholesterol
  • Keep your blood sugar at the right levels
  • If you smoke, quit
  • Eat a healthy diet that includes plenty of fresh fruits, veggies, and whole grains. Cut back on saturated fats (found in red meat, for example), salt, and sugar
  • Get regular exercise
  • Keep to a healthy weight

If you have a stroke, it means something has cut off your brain’s blood supply. It’s an emergency, because without oxygen and nutrients from the blood, the part of your brain that’s affected quickly starts to die. So you, or someone who’s with you, needs to call 911 right away. Symptoms include:

  • Sudden numbness or weakness on one side of the body
  • Not able to talk
  • Double or blurred vision in one eye
  • Sudden dizziness or falling

Sometimes called “brain attacks,” strokes happen in one of two main ways:

  • A clot blocks the blood flow to your brain. These are “ischemic” strokes
  • A blood vessel bursts or leaks in your brain. Doctors call this a “hemorrhagic” stroke

With either type of stroke, brain cells can’t live more than a few minutes without oxygen.

Strokes Caused by Blood Clots

These are when a clot stops the blood traveling through a vessel in the brain or neck. Most strokes — 80%-90% — are this type. Doctors call these “ischemic” strokes.”

Some clots form inside a blood vessel and stay put, blocking blood flow in the brain. Doctors call this a “cerebral thrombosis.” The causes usually are high cholesterol and narrowed or hardened arteries that pump blood throughout the body.

A stroke can also happen if a clot forms in another part of your body — usually in the heart or upper chest and neck — and travels up through your bloodstream until it blocks the blood flow to your brain. This is a “cerebral embolism.”

Sometimes, a clot dissolves or dislodges on its own. This is a transient ischemic attack, or TIA. Although TIAs don’t injure the brain permanently, you can’t tell whether it’s a TIA while it’s happening, so you must call 911 at the first symptoms. Never wait to see if they pass, or it may be too late for treatments to help.

TIAs can also mean that you’re at risk for having a full-blown stroke later.

Strokes Caused by Bleeding

This happens because of bleeding in the brain. These “hemorrhagic” strokes are less common than the ischemic kind, but they can be more severe and deadlier.

Most often, it happens after an aneurysm — a thinned or weakened spot on an artery that has ballooned from pressure — bursts. Other times, the artery wall grows brittle over time from fatty plaque and then breaks open.

How to Lower Your Risk

Strokes can happen at any age, even to babies in the womb. Still, the odds of a stroke climb quickly after middle age.

To cut your odds of having a stroke:

Keep your blood pressure healthy​:​ If you have high blood pressure(consistently over 130/80), this is the single biggest thing you can do to lower your odds of a stroke.

Avoid tobacco​:​ Smoking cigarettes and chewing tobacco — even secondhand smoke — cause physical changes in your body. They can thicken your blood and make it more likely to clot and cause fatty buildup in your arteries.

Control your cholesterol levels​:​ High levels of LDL, or “bad” cholesterol, make it more likely that plaque will build up in your arteries, putting you at greater risk of a clot that causes a heart attack or stroke.

Manage diabetes, if you have it​:​ If it’s not under control, it can lead to a stroke by damaging your blood vessels.

Check your weight and waist​:​ Your doctor can let you know if these numbers are in a healthy range. if you have a belly that’s bigger than 40 inches around for men or more than 35 inches for women, that may be especially risky.

When you have a stroke, your brain isn’t getting the blood it needs. You need treatment right away to lower your chances of brain damage, disability, or even death.

Use the FAST test to check for the most common symptoms of a stroke in yourself or someone else.

Face: Smile and see if one side of the face droops.

Arms: Raise both arms. Does one arm drop down?

Speech: Say a short phrase and check for slurred or strange speech.

Time: If the answer to any of these is yes, call 911 right away and write down the time when symptoms started.

Minutes matter in treating stroke. Calling a doctor or driving to the hospital yourself wastes time. Ambulance workers can judge your situation sooner, and that boosts your chance of getting the treatment you need as soon as possible.

Depending on the type of stroke, doctors may give you aspirin or powerful clot-busting drugs. The treatment works best when you get this medication within 3 hours of when your symptoms started. If your stroke was caused by a burst blood vessel, doctors will try to stop the bleeding as soon as possible.

Warning Signs

Sometimes a stroke happens gradually, but you’re likely to have one or more sudden symptoms like these:

  • Numbness or weakness in your face, arm, or leg, especially on one side
  • Confusion or trouble understanding other people
  • Difficulty speaking
  • Trouble seeing with one or both eyes
  • Problems walking or staying balanced or coordinated
  • Dizziness
  • Severe headache that comes on for no reason

If you have these symptoms, call 911 even if you’re not sure you’re having a stroke.

Be Prepared

Each year, some 800,000 people in the U.S. have a stroke. They can happen to anyone at any time. Planning for an emergency can make a big difference.

Learn the warning signs of a stroke and let your family and friends know, too.
If you have any medical conditions, wear a medical bracelet or other identification that lists them, your allergies, and any medication you take.
Teach your children the FAST test, plus how to call 911, give your address, and describe what’s happening.​

For more information, please visit our LEARN section.

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