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 types of function that are affected will depend on the part of the brain that is damaged.
There are 2 blood flow problems that cause a stroke. Strokes may be ischemic or hemorrhagic.
Copyright © Nucleus Medical Media, Inc.
Blood flow may be blocked by one or both of the following:
A blockage in a small blood vessel will affect a smaller area of the brain. A blockage in larger blood vessels will block flow to many smaller blood vessels. This will affect more of the brain.
The blockage may be the result of one or more of the following:
Certain factors increase your risk of stroke but cannot be changed, such as:
Other factors that may increase your risk can be changed, such as:
Certain medical condition can increase your risk of stroke. Management or prevention of these conditions can decrease your risk of stroke. Medical conditions that increase your risk include:
Risk factors specific to women include:
Symptoms occur suddenly. Exact symptoms will depend on the part of the brain that is affected. Rapid treatment is important to decrease the amount of brain damage. Brain tissue without blood flow dies quickly.
Call for emergency medical services right away if you notice any of the following sudden symptoms:
A physical exam will be done. The doctor will look for muscle weakness, visual and speech problems, and problems with basic movement. If possible, you will be asked about your symptoms and medical history.
Images of your brain and blood vessels may need to be taken with:
Blood tests can also help determine if there is a bleeding problem.
Immediate treatment is needed to open the blocked blood vessel. This should restore blood flow to the brain tissue and stop further damage. Treatment after immediate care will aim to:
Supportive care may also include:
Some will receive a group of drugs called thrombolytics. These medicines can rapidly dissolve blood clots. They are often given by IV, but can also be delivered directly to the blood clot. These medicines need to be given within hours after the start of symptoms to be most effective. That is why it is important to get medical help right away if stroke symptoms develop.
Aspirin and other medicine may be continued to decrease the risk of future blood clots. This may prevent future strokes from occurring.
To help manage other health issues and decrease the risk of future strokes the doctor may recommend medicine to:
An embolectomy may be needed. It will remove a clot and allow blood flow back into the area. A wire is passed through blood vessels to the clot. Tools will then be passed along the wire to do one of the following:
The stroke and damaged tissue can cause swelling in the brain. Surgery may be needed to relieve the pressure. One common option is to remove a section of the skull. This is called a craniotomy.
If brain tissue was damaged, rehabilitation can be an important part of your recovery. Rehabilitation may include:
Many of the risk factors for stroke can be changed. Lifestyle changes that can help reduce your chance of getting a stroke include:
American Heart Association
National Stroke Association
Heart and Stroke Foundation
Castella CR, Jagoda A. Ischemic stroke: advances in diagnosis and management. Emerg Med Clin North Am. 2017;35(4):911-930.
Furie KL, Kasner SE, Adams RJ, et al. Guidelines for the prevention of stroke in patients with stroke or transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2011;42(1):227-276.
Ischemic strokes (clots). American Stroke Association website. Available at: American Stroke Association website. Available at: http://www.strokeassociation.org/STROKEORG/AboutStroke/TypesofStroke/IschemicClots/Ischemic-Strokes-Clots_UCM_310939_Article.jsp#.Vk3ipE2FPIU. Updated April 26, 2017. Accessed November 10, 2017.
Long-term management of stroke. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T900125/Long-term-management-of-stroke. Updated March 19, 2017. Accessed November 10, 2017.
Mendelson SJ, Prabhakaran S. Pace of progress in stroke thrombolysis: are hospitals running to stand still? Circ Cardiovasc Qual Outcomes. 2017;10(1):e003438.
Stroke (acute management). EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T143427/Stroke-acute-management. Updated November 8, 2017. Accessed November 10, 2017.
11/20/06 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T143427/Stroke-acute-management: Mas JL, Chatellier G, Beyssen B, et al. Endarterectomy versus stenting in patients with symptomatic severe carotid stenosis. N Engl J Med. 2006;355(16):1726-1729.
12/16/2008 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T143427/Stroke-acute-management: Farquhar C, Marjoribanks J, Lethaby A, Suckling J, Lamberts Q. Long term hormone therapy for perimenopausal and postmenopausal women. Cochrane Database Syst Rev. 2008;CD004143.
10/9/2009 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T143427/Stroke-acute-management: Mitchell PH, Veith RC, Becker KJ, et al. Brief psychosocial-behavioral intervention with antidepressant reduces poststroke depression significantly more than usual care with antidepressant: living well with stroke: randomized, controlled trial. Stroke. 2009;40(9):3073-3078.
3/28/2011 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T143427/Stroke-acute-management: Park Y, Subar AF, Hollenbeck A, Schatzkin A. Dietary fiber intake and mortality in the NIH-AARP diet and health study. Arch Intern Med. 2011;171(12):1061-1068.
2/7/2014 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T143427/Stroke-acute-management: Bushnell C, McCollough LD, Awad IA, et al. Guideline for the prevention of stroke in women. Available at: http://stroke.ahajournals.org/content/early/2014/02/06/01.str.0000442009.06663.48. Accessed November 18, 2014.
6/2/2014 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T143427/Stroke-acute-management: Myint PK, Cleark AB, Kwok CS, et al. Bone mineral density and incidence of stroke: European prospective investigation into cancer-Norfolk population-based study, systemic review, and meta-analysis. Stroke. 2014;45(2):373-382.
6/2/2014 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T143427/Stroke-acute-management: Imfeld P, Bodmer M,Schuerch M, Jick SS, Meier CR. Risk of incident stroke in patients with Alzheimer disease or vascular dementia. Neurology. 2013;81(10):910-919.
8/11/2015 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T143427/Stroke-acute-management: Molnar MZ, Mucsi I, Novak M, et al. Association of incident obstructive sleep apnoea with outcomes in a large cohort of US veterans. Thorax. 2015;70(9):888-895.
1/18/2017 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T113766/Coronary-artery-disease-possible-risk-factors: Emdin CA, Odutayo A, Wong CX, Tran J, Hsiao AJ, Hunn BH. Meta-analysis of anxiety as a risk factor for cardiovascular disease. Am J Cardiol. 2016;118(4):511-519.
Last reviewed November 2018 by EBSCO Medical Review Board Rimas Lukas, MD Last Updated: 5/9/2018