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Stroke

Stroke: Causes, Symptoms, Diagnosis, Treatment, and Prevention

Stroke: What You Need to Know

A stroke is a serious medical condition that occurs when the blood supply to a part of the brain is interrupted or reduced, or when there is bleeding in the brain. It causes brain cells to die and can cause permanent damage or death. Stroke is the leading cause of disability and death in the United States.

It is possible to suffer a stroke at any time, but some people are more at risk than others. Knowing the signs, causes, and treatments of stroke can help you prevent or treat it more quickly if it happens to you or someone you care about.

Signs and Symptoms of Stroke

The signs and symptoms of stroke depend on which part of the brain is affected and how severe the damage is. However, some common signs and symptoms include:

  • Sudden numbness, weakness, or paralysis of the face, arm, or leg, especially on one side of the body

  • Sudden confusion, trouble speaking, or understanding speech

  • Sudden trouble seeing in one or both eyes

  • Sudden trouble walking, dizziness, loss of balance, or coordination

  • Sudden severe headache with no known cause

If you notice any of these signs or symptoms, you should act FAST and call 911 or your local emergency number right away. FAST stands for:

  • Face: Ask the person to smile. Does one side of the face droop?

  • Arm: Ask the person to raise both arms. Does one arm drift downward or is one arm unable to rise?

  • Speech: Ask the person to repeat a simple phrase. Is their speech slurred or strange?

  • Time: If you observe any of these signs, call for help immediately. Every minute counts.

The sooner a person gets treatment for a stroke, the better their chances of survival and recovery.

Causes and Risk Factors of Stroke

There are two main types of stroke: ischemic and hemorrhagic. Ischemic stroke occurs when a blood clot blocks a blood vessel in the brain, preventing blood flow and oxygen from reaching the brain tissue. During a hemorrhagic stroke, a blood vessel bursts in the brain, causing bleeding and pressure.

Some factors that can increase the risk of stroke include:

  • High blood pressure

  • High cholesterol

  • Diabetes

  • Smoking

  • Obesity

  • Physical inactivity

  • Heart disease

  • Family history of stroke

  • Age (older than 55)

  • Gender (men are more likely to have a stroke than women)

  • Race and ethnicity (African Americans, Hispanics, and Native Americans are more likely to have a stroke than whites)

  • Certain medications, such as birth control pills or hormone replacement therapy

  • Illicit drug use, such as cocaine or methamphetamine

It is possible to modify or control some of these risk factors through healthy lifestyle changes, such as eating a balanced diet, exercising regularly, quitting smoking, managing stress, and taking prescribed medications. Although age, gender, race, and family history cannot be changed, you can still lower your risk by getting regular checkups and screenings and being aware of them.

Diagnosis and Treatment of Stroke

To diagnose a stroke, a doctor will perform a physical examination and ask about the symptoms and medical history of the person. The doctor may also order some tests, such as:

  • Blood tests, to check for clotting problems, infection, or other conditions

  • Imaging tests, such as computed tomography (CT) scan, magnetic resonance imaging (MRI), or ultrasound, to see the location and extent of the damage in the brain

  • Electrocardiogram (EKG), to check the heart rhythm and function

  • Echocardiogram, to check for any sources of clots in the heart that could have traveled to the brain

  • Angiogram, to see the blood flow and blockages in the blood vessels of the brain and neck

The treatment of stroke depends on the type, cause, and severity of the stroke. The main goals of treatment are to restore blood flow, stop bleeding, prevent complications, and reduce the risk of another stroke.

For ischemic stroke, the treatment may include:

  • Medications, such as aspirin, clopidogrel, or tissue plasminogen activator (tPA), to dissolve or prevent blood clots and improve blood flow

  • Procedures, such as angioplasty, stent placement, or thrombectomy, to open up or remove the blockage in the blood vessel

  • Surgery, such as carotid endarterectomy or bypass, to remove plaque or reroute blood flow around the narrowed or blocked artery

For hemorrhagic stroke, the treatment may include:

  • Medications, such as blood pressure drugs, diuretics, or anticonvulsants, to lower blood pressure, reduce swelling, or prevent seizures

  • Surgery, such as aneurysm clipping, coil embolization, or arteriovenous malformation (AVM) removal, to stop the bleeding, repair the blood vessel, or remove the abnormal connection between arteries and veins

For both types of stroke, the treatment may also include:

  • Rehabilitation, such as physical, occupational, speech, or cognitive therapy, to help restore function, mobility, communication, or thinking skills

  • Support, such as counseling, education, or social services, to help cope with the emotional, psychological, or practical challenges of living with a stroke

Prevention of Stroke

The best way to prevent a stroke is to reduce the risk factors that can cause it. Some of the prevention strategies are:

  • Eat a healthy diet, rich in fruits, vegetables, whole grains, lean protein, and low-fat dairy, and low in salt, saturated fat, trans fat, cholesterol, and added sugars

  • Exercise regularly, at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic activity per week, or a combination of both

  • Maintain a healthy weight, with a body mass index (BMI) between 18.5 and 24.9

  • Quit smoking, or avoid exposure to secondhand smoke

  • Limit alcohol intake, to no more than one drink per day for women and two drinks per day for men

  • Manage stress, by practicing relaxation techniques, such as deep breathing, meditation, yoga, or hobbies

  • Control blood pressure, by checking it regularly and taking medications as prescribed

  • Control cholesterol, by checking it regularly and taking medications as prescribed

  • Control diabetes, by checking blood sugar levels regularly and taking medications as prescribed

  • Take preventive medications, such as antiplatelet or anticoagulant drugs, if you have a history of stroke or a high risk of stroke

  • Follow up with your doctor, and get regular check-ups and screenings for stroke and other health conditions

By taking care of your health and seeking help when needed, you can lower your risk of stroke and improve your quality of life. Strokes are serious, but they can be prevented or treated when you know their signs, causes, and treatments.

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