Definition

Stroke is a brain injury caused by an interruption in blood flow. Brain tissue that does not get oxygen and nutrients from blood can die within minutes. The damage to the brain can cause a sudden loss in bodily functions. The changes will depend on the part of the brain that is damaged.

Two blood flow problems can cause a stroke:

• A hemorrhagic stroke is caused by a ruptured blood vessel. It may be:
  • Intracerebral hemorrhage—bleeding in the brain
  • Subarachnoid hemorrhage —bleeding in the tissue around the brain
• An ischemic stroke is caused by a blocked blood vessel.

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Causes

A hemorrhagic stroke happens because of a weakened blood vessel in the brain. Blood vessels may be weakened by:

• Problem with the structure of a blood vessel
• Arterio-venous (AV) malformation —an abnormal knot of blood vessels
• Aneurysm —a weakened spot in a blood vessel wall
• Other illness or medical problems like hypertension
• Damage from trauma like a blow to the head or car accident

Risk Factors

Factors that may increase your chance of stroke include:

• Gender: Men are more likely to have a stroke than women
• Age: 55 years of age or older
• Family history of stroke

Factors that can raise your risk of hemorrhagic stroke include:

• High blood pressure
• Smoking
• Sleep apnea
• Cocaine use
• Alcohol use disorder
• Blood disorders or medicine that can make it harder for the blood to clot.

Symptoms

Symptoms will depend on the part of the brain affected. Rapid treatment is important to decrease the amount of brain damage. Call for emergency medical services right away if you have:

• Sudden weakness or numbness of face, arm, or leg, especially on one side of the body
• Sudden confusion
• Sudden trouble speaking or understanding
• Sudden trouble seeing in one or both eyes
• Sudden lightheadedness, trouble walking, loss of balance, or clumsiness
• Sudden severe headache with no known cause
• Loss of consciousness

Other symptoms that may go along with the above symptoms include:

• Neck stiffness
• Nausea or vomiting
• Sensitivity to light

Diagnosis

A physical exam will be done. The doctor will look for muscle weakness, visual and speech problems. If possible, the doctor will ask about symptoms and past health. A CT scan may be done to confirm the diagnosis.

Images of blood vessels will help to find the cause of the bleeding. Image tests may include:

• MR angiography
• CT angiogram
• Doppler ultrasound

Blood tests will also be done. Tests will show how well the blood can clot. Your doctor may also examine the fluid that surrounds your brain and spine.

Treatment

Brain tissue without blood flow dies quickly. Immediate treatment is needed to stop the bleeding and restore restore blood flow to the brain. Blood spilled in the brain is also trapped in the skull. It can build and put pressure on the brain. That pressure may need to be relieved.

Prevention

Manage and monitor medical issues. This includes aneurysms and high blood pressure. Other habits that may reduce the risk of stroke include:

• Regular exercise.
• Well balanced diet with plenty of fruits, vegetables, and whole grains.
• Quit smoking.
• Maintain a healthy weight.
• Limit alcohol. This means no more than 2 drinks per day for men and 1 drink per day for women.
• Do not use recreational drugs, such as cocaine.