Overview

Stroke is a medical emergency. If you have a stroke, you need to get treatment right away.

Stroke is the third leading cause of death in the United States and a leading cause of serious long-term disability. It occurs when an artery to your brain becomes blocked or bursts, causing blood flow to stop. When brain cells don’t receive enough oxygen and nutrients, they begin to die — which can cause paralysis, loss of speech, vision or other problems.

The most common type of stroke is called an ischemic stroke, in which a clot blocks blood flow in one or more arteries in your brain. This type of stroke accounts for 87 percent of all strokes. The other common type is called a hemorrhagic stroke, which occurs when a blood vessel ruptures and bleeds into surrounding tissue or collects elsewhere in the brain.

People who suffer strokes may experience:

• Numbness or weakness on one side of their body
• Trouble speaking or understanding others
• Trouble seeing out of one eye (seeing double)

Warning Signs

If someone has had a stroke, it will take time for their brain function to return. Telltale signs of stroke are hard to miss, but it can be hard to know whether they’re due to a stroke or something else.

The following warning signs are associated with stroke:

• Sudden numbness or weakness of face, arm or leg on one side of the body
• Sudden confusion or difficulty understanding speech (may not be able to respond appropriately)
• Sudden trouble seeing in one or both eyes (especially if accompanied by eye pain)
• Sudden trouble walking, dizziness, loss of balance or coordination
• Unexplained falls

Causes

Strokes are caused by a blockage or rupture in one of the blood vessels supplying the brain. The blockage or rupture cuts off the blood supply to part of the brain, which can damage or destroy brain cells.

Stroke is the fourth leading cause of death in the United States and a leading cause of adult disability. About 795,000 people suffer from stroke each year in the United States. More than 130,000 die as a result of stroke each year.

The good news is that many strokes are preventable with simple lifestyle changes, including:

• Not smoking
• Controlling high blood pressure (hypertension) and high cholesterol
• Losing weight if you are overweight or obese
• Maintaining a healthy diet that includes healthy fats and low sodium, while limiting added sugars and processed foods
• Exercising regularly

Types

There are two main types of stroke:

Ischemic stroke. This is caused by a blockage that stops blood flow to the brain. It’s the most common type of stroke, accounting for about 87% of all strokes. About 80% of all ischemic strokes are caused by atherosclerosis — the buildup of fatty deposits, cholesterol and other substances on arterial walls that narrows blood vessels and limits blood flow. The remaining 20% are caused by other types of blockages, such as blood clots that form in narrowed arteries (arterial thrombosis).

Hemorrhagic stroke. This type of stroke occurs when a weakened blood vessel ruptures and leaks or bleeds into surrounding brain tissue or under the skull bone (subarachnoid hemorrhage). It accounts for about 13% of all strokes — most often in people with high blood pressure (hypertension).

Risk Factors

The main risk factors for stroke include:

Age: Risk increases with age. About 80 percent of all strokes occur in people 65 and older. Women are more likely than men to have a stroke between ages 55 and 64; men are more likely than women to have a stroke between ages 45 and 54.

High blood pressure (hypertension): Having high blood pressure puts you at risk for developing heart disease, which increases your chances for having a stroke.

Heart disease: Heart problems can lead to blood clots that block an artery in your brain or heart muscle tissue damage that causes bleeding into the heart muscle itself (hemorrhagic).

Treatment

Stroke treatment options vary depending on the type of stroke you have and your medical history.

If you have had a stroke, your doctor will treat it as an emergency. This means that you may be given medication to help control your symptoms, such as numbness or weakness, until more specific treatment can begin.

Treatment for stroke is aimed at preventing further damage to the brain and reducing further disability. The main treatment methods are:

The use of antiplatelet drugs (such as aspirin) after a stroke can reduce the risk of another stroke by about one-third. If you’ve had a stroke, it’s important to take this medication exactly as prescribed by your doctor.

Endovascular therapy involves inserting a tube into an artery in your leg and guiding it up into the brain where it can release clot-busting drugs directly onto the site of obstruction. This type of intervention is used only in patients with large blood clots or other types of blockages that cannot be removed surgically or mechanically.

Surgery may be needed if there’s bleeding inside the brain or if part of your skull has been removed by surgery during an earlier operation (for example, to drain fluid).

Rehabilitation

Stroke rehabilitation is an important part of recovery from stroke. The goal of stroke rehabilitation is to help you regain as much function as possible.

Rehabilitation for stroke may include:

Physical therapy, which focuses on improving strength, balance and coordination

Occupational therapy, which helps you learn to perform daily activities such as bathing, dressing and eating

Speech therapy, which helps you learn to speak with aphasia or other speech problems