Every year, about 800,000 people have a stroke — which equates to one stroke every 40 seconds. It is the fifth leading cause of death and the leading cause of adult disability in the U.S. Despite these somber statistics, stroke is both preventable and treatable. It is important for anyone who feels they may be at risk for a stroke to learn as much about the condition as possible.

What Is a Stroke?

A stroke occurs when blood flow to an area of the brain is cut off due to a blood clot or ruptured blood vessel. When this happens, the brain cells begin to die as they are not getting enough oxygen or nutrients. Functions like memory and muscle function are controlled by different parts of the brain, and those abilities can be damaged or lost after cell death.

Stages and Types of Stroke

The degree to which a person is affected by their stroke depends on where the stroke occurs in the brain, how much of the brain is damaged, and the type of stroke suffered.

There are three main types of stroke:

  • Ischemic stroke. Ischemic stroke is the most common form of stroke, accounting for about 87% of all cases. This type of stroke occurs when there is an obstruction in a blood vessel that supplies oxygen to the brain. The most common obstructions implicated in a stroke are blood clot and atherosclerosis, which is a hardening of the arteries.
  • Hemorrhagic stroke. This type of stroke, occurring when a weakened blood vessel ruptures, can be due to either an aneurysm or an arteriovenous malformation. An aneurysm occurs when an artery wall weakens and widens abnormally, which causes a blockage, while an arteriovenous malformation is an abnormal tangle of blood vessels connecting arteries and veins, which disrupts normal blood flow and oxygen circulation. The most common culprit for hemorrhagic stroke is uncontrolled high blood pressure (hypertension).
  • Transient ischemic attack (TIA). A TIA is sometimes called a “mini-stroke,” and it is caused by a temporary blood clot. Mini- strokes can serve as a warning sign for future, more serious strokes.

A person who has had a minor stroke may only experience temporary weakness in an arm or a leg, while people who have larger stokes could be permanently paralyzed on one side of the body. More than 66% of stroke survivors develop some form of disability, although some people can completely recover.

Symptoms and Causes

Understanding the signs, symptoms, and causes for stroke can help save a life. It is important for everyone to memorize the primary symptoms of a stroke. The acronym F.A.S.T can help: 

  • Facial drooping. If you are unable to smile without one side falling, this is a typical sign of stroke. 
  • Arm weakness. To test for this symptom, try to raise your arms above your head.
  • Speech slurring. Slurred words, trouble understanding speech, and general confusion are warning signs of a stroke.
  • Time to call 9-11. If the above symptoms are present, seek emergency medical care. 

Sudden numbness, weakness, or paralysis of the face, arm or leg usually happens on just one side of the body during a stroke. Additional symptoms include: 

  • Difficulty with sight. Sudden blurred or blackened vision in one or both eyes could signal a stroke. Seeing double is another sign of a potential stroke.
  • Difficulty walking. Stumbling or experiencing sudden dizziness, loss of balance or loss of coordination could mean you are having a stroke.
  • Headache. A sudden, severe headache with or without vomiting could indicate a stroke.

Prevention and Risks

According to the National Stroke Association, about 80% of strokes can be prevented. The primary prevention strategy to protect against stroke is to manage the key risk factors, especially high blood pressure or hypertension. Uncontrolled blood pressure causes about half of all strokes.

Lifestyle factors that can contribute to high blood pressure and hypertension include:

  • Obesity/being overweight
  • Physical inactivity
  • Heavy or binge drinking
  • Drug use, including illicit drugs like cocaine or methamphetamines
  • Smoking

Beyond high blood pressure, there are other medical risk factors for stroke you should know. These include:

Other general risk factors associated with a higher risk of stroke include:

  • Age. People older than 55 have a higher risk of stroke than younger people do.
  • Race. African-Americans have the highest risk of stroke when compared with people of other races.
  • Sex. Men have a higher risk of stroke than women do, although women are more likely to die of strokes than men are.
  • Use of birth control. Use of birth control or other hormone therapies that contain estrogen can increase your risk of stroke.

Diagnosis and Tests

The early stages of diagnosing a stroke involve determining what type of stroke a patient is having and what areas of the brain are affected. Doctors must also rule out other potential causes for stroke-like symptoms, such as a brain tumor.

Doctors may use one of the following tests to help determine your risk for stroke:

  • Physical examination and discussion of symptoms
  • Blood tests to exam any problems that may create an issue with blood flow to the brain
  • Imaging tests, such as a CT scan or MRI, that give a picture of the brain similar to X-rays
  • Electrical tests to examine the electrical impulses of the brain, which is indicative of activity

Treatments, Procedures, and Medication

Treating a stroke is time-sensitive, and the type of treatment you need will depend on the severity of the stroke you are having. Seek emergency medical care as soon as possible to help you get an early diagnosis and the most effective treatment possible.

Treatment for Ischemic Stroke

Treatment for ischemic stroke, the most common kind of stroke, focuses on quickly restoring blood flow to the brain. Medications to break down the clot are ideally given through an IV, but this treatment can only happen if the drug is administered up to 4.5 hours after stroke symptoms start. The clot-dissolving medication intravenous injection of tissue plasminogen activator (tPA), also called alteplase, is considered the gold standard treatment for stroke. Doctors can also administer tPA by inserting a catheter into an artery in the groin and threading it up to the brain. The sooner you get tPA, the more likely you are to survive the stroke and have fewer complications.

Another option in treating ischemic stroke is for doctors to use a stent retriever to remove the clot from the blocked blood vessel in the brain. People with large clots that cannot be dissolved entirely with tPA are good candidates for this option, although doctors typically also use tPA to help the process.

To prevent future ischemic strokes, doctors may recommend having a stent put in to help open up the artery that was blocked and reduce the chances of future blockages.

Treatment for Hemorrhagic Stroke

Treating hemorrhagic stroke focuses on controlling the bleeding and reducing pressure in the brain. People who take medications to prevent blood clots may be given treatments to counteract the effects of those blood thinners. Medications to lower blood pressure, prevent vasospasm, or prevent seizures may also be used.

When the bleeding stops and pressure in the brain is low, treatment focuses on providing supportive care for the body while it heals and absorbs the blood. If there is a large amount of blood, the doctor may perform surgery to remove it. Surgical blood vessel repair, or in some cases removal, may be performed to help prevent future hemorrhages.

Treatment for TIA

After a TIA, medications are typically the go-to treatment to decrease the likelihood for a full stroke in the future. Treatments the doctor may prescribe include antiplatelet drugs like aspirin or clopidogrel (Plavix) to help make blood cells less likely to stick together and clot.

For all types of stroke, post-stroke rehabilitation can help people overcome or learn to manage disabilities that result from stroke damage.

Healthy Lifestyle Tips

Although medications and procedures are essential factors in treating stroke, the best treatment is actually prevention. Diet and exercise are the tried and true prevention strategies for any health condition affecting the heart.

For overall cardiovascular health, the American Heart Association (AHA) recommends at least 30 minutes of moderate-intensity aerobic activity at least five times per week and at least 25 minutes of vigorous aerobic activity at least three times each week. The AHA also recommends moderate- to high-intensity muscle-strengthening activity at least two days per week for additional health benefits. To lower blood pressure and cholesterol, experts recommend an average 40 minutes of moderate- to vigorous-intensity aerobic activity three or four times per week.

Food and Nutrition-Based Approaches to Prevention and Management

Sticking to a heart-healthy, well-balanced diet is the other important part of preventing stroke or managing your health post-stroke. A heart-healthy diet is one that emphasizes natural and unprocessed foods. Avoiding sodium is the most effective way to reduce blood pressure, and making sure to get sufficient levels of the following foods is essential:

  • Lean proteins
  • Fruits and vegetables
  • Potassium
  • Fiber
  • Omega-3 (healthy fats)

What Type of Doctors to See

A few different types of doctors can be involved in preventing or treating stroke. When considering the initial onset of stroke all the way through post-hospital care, it is best to think of your doctors as a team. This team can involve:

Depending on the type of stroke you have, you may need certain doctors to run diagnostic tests, others to prescribe medications to prevent future strokes, and doctors to help counsel you on lifestyle changes you should make to reduce your risk.

Conclusion

Stroke is a common condition that can result in long-term health consequences or even death. Talk to your doctor today about your risk for stroke and what you can do to prevent it.