A stroke occurs when the blood supply to part of your brain is interrupted or reduced, depriving brain tissue of oxygen and nutrients. Within minutes, brain cells begin to die.
A stroke is a medical emergency. Prompt treatment is crucial. Early action can minimize the brain damage. The good news is that strokes can be treated and prevented, and many fewer Americans die of stroke now than in the past.
Symptoms: Watch for these signs and symptoms if you think you or someone else may be having a stroke. Pay attention to when the signs and symptoms begin. The length of time they have been present can affect your treatment options:
Trouble with speaking and understanding. You may experience confusion. You may slur your words or have difficulty understanding speech. Paralysis or numbness of the face, arm or leg. You may develop sudden numbness, weakness or paralysis in your face, arm or leg. This often happens just on one side of your body. Try to raise both your arms over your head at the same time. If one arm begins to fall, you may be having a stroke. Also, one side of your mouth may droop when you try to smile.
Trouble with seeing in one or both eyes. You may suddenly have blurred or blackened vision in one or both eyes, or you may see double.
Headache: A sudden, severe headache, which may be accompanied by vomiting, dizziness or altered consciousness, may indicate you're having a stroke.
Trouble with walking. You may stumble or experience sudden dizziness, loss of balance or loss of coordination.
When to see a doctor: Seek immediate medical attention if you notice any signs or symptoms of a stroke, even if they seem to fluctuate or disappear. Think "FAST" and do the following:
Causes: A stroke may be caused by a blocked artery (ischemic stroke) or the leaking or bursting of a blood vessel (hemorrhagic stroke). Some people may experience only a temporary disruption of blood flow to the brain (transient ischemic attack, or TIA) that doesn't cause permanent damage.
Ischemic stroke: About 80 percent of strokes are ischemic strokes. Ischemic strokes occur when the arteries to your brain become narrowed or blocked, causing severely reduced blood flow (ischemia). The most common ischemic strokes include:
Thrombotic stroke: A thrombotic stroke occurs when a blood clot (thrombus) forms in one of the arteries that supply blood to your brain. A clot may be caused by fatty deposits (plaque) that build up in arteries and cause reduced blood flow (atherosclerosis) or other artery conditions. Embolic stroke. An embolic stroke occurs when a blood clot or other debris forms away from your brain — commonly in your heart — and is swept through your bloodstream to lodge in narrower brain arteries. This type of blood clot is called an embolus.
Hemorrhagic stroke: Hemorrhagic stroke occurs when a blood vessel in your brain leaks or ruptures. Brain hemorrhages can result from many conditions that affect your blood vessels. These include:
Types of hemorrhagic stroke include:
Intracerebral hemorrhage: In an intracerebral hemorrhage, a blood vessel in the brain bursts and spills into the surrounding brain tissue, damaging brain cells. Brain cells beyond the leak are deprived of blood and are also damaged. High blood pressure, trauma, vascular malformations, use of blood-thinning medications and other conditions may cause an intracerebral hemorrhage.
Subarachnoid hemorrhage: In a subarachnoid hemorrhage, an artery on or near the surface of your brain bursts and spills into the space between the surface of your brain and your skull. This bleeding is often signaled by a sudden, severe headache.
A subarachnoid hemorrhage is commonly caused by the bursting of a small sack-shaped or berry-shaped aneurysm. After the hemorrhage, the blood vessels in your brain may widen and narrow erratically (vasospasm), causing brain cell damage by further limiting blood flow.
A Transient Ischemic Attack (TIA) — sometimes known as a ministroke — is a temporary period of symptoms similar to those you'd have in a stroke. A temporary decrease in blood supply to part of your brain causes TIAs, which may last as little as five minutes. Like an ischemic stroke, a TIA occurs when a clot or debris blocks blood flow to part of your nervous system — but there is no permanent tissue damage and no lasting symptoms.
Seek emergency care even if your symptoms seem to clear up. Having a TIA puts you at greater risk of having a full-blown stroke, causing permanent damage later. If you've had a TIA, it means there's likely a partially blocked or narrowed artery leading to your brain or a clot source in the heart.
It's not possible to tell if you're having a stroke or a TIA based only on your symptoms. Even when symptoms last for under an hour, there is still a risk of permanent tissue damage.
Lifestyle risk factors:
Other factors associated with a higher risk of stroke include:
Prevention: Knowing your stroke risk factors, following your doctor's recommendations and adopting a healthy lifestyle are the best steps you can take to prevent a stroke. If you've had a stroke or a transient ischemic attack (TIA), these measures might help prevent another stroke. The follow-up care you receive in the hospital and afterward also may play a role as well.
Exercising, managing stress, maintaining a healthy weight and limiting the amount of sodium and alcohol you eat and drink can all help to keep high blood pressure in check. In addition to recommending lifestyle changes, your doctor may prescribe medications to treat high blood pressure. Lowering the amount of cholesterol and saturated fat in your diet. Eating less cholesterol and fat, especially saturated fat and trans fats, may reduce the plaque in your arteries.
Controlling diabetes: You can manage diabetes with diet, exercise, weight control and medication. Maintaining a healthy weight. Being overweight contributes to other stroke risk factors, such as high blood pressure, cardiovascular disease and diabetes. Losing as little as 10 pounds may lower your blood pressure and improve your cholesterol levels. Eating a diet rich in fruits and vegetables. A diet containing five or Drinking alcohol in moderation, if at all. Alcohol can be both a risk factor and a protective measure for stroke. Heavy alcohol consumption increases your risk of high blood pressure, ischemic strokes and hemorrhagic strokes. However, drinking small to moderate amounts of alcohol.
Treating obstructive sleep apnea (OSA): Your doctor may recommend an overnight oxygen assessment . Treatment for OSA includes oxygen at night or wearing a small device in your mouth to help you breathe. Avoiding illegal drugs. Certain street drugs, such as cocaine and methamphetamines, are established risk factors for a TIA or a stroke. Cocaine reduces blood flow and can narrow the arteries.
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