Ischemic Stroke(Cerebrovascular Accident; CVA; Cerebral Infarct)
by
Debra Wood, RN DefinitionStroke 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.
Causes TOPBlood 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:
Risk Factors TOPCertain 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 TOPSymptoms 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:
Diagnosis TOPA 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. Treatment TOPImmediate 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:
MedicineSome 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:
SurgeryAn 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. Rehabilitation TOPIf brain tissue was damaged, rehabilitation can be an important part of your recovery. Rehabilitation may include:
Prevention TOPMany of the risk factors for stroke can be changed. Lifestyle changes that can help reduce your chance of getting a stroke include:
RESOURCES:American Heart Association http://www.heart.org National Stroke Association http://www.stroke.org CANADIAN RESOURCES:Health Canada https://www.canada.ca Heart and Stroke Foundation http://www.heartandstroke.com References: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.
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Last reviewed November 2018 by
EBSCO Medical Review Board
Rimas Lukas, MD Last Updated: 5/9/2018 |
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