A stroke occurs when a blood vessel in the brain ruptures and bleeds, or when there’s a blockage in the blood supply to the brain. The rupture or blockage prevents blood and oxygen from reaching the brain’s tissues. Without oxygen, brain cells and tissue become damaged and begin to die within minutes.
The loss of blood flow to the brain damages tissues within the brain. Symptoms of a stroke show up in the body parts controlled by the damaged areas of the brain.
The sooner a person having a stroke gets care, the better their outcome is likely to be. For this reason, it’s helpful to know the signs of a stroke so you can act quickly. Stroke symptoms can include:
- paralysis
- numbness or weakness in the arm, face, and leg, especially on one side of the body
- trouble speaking or understanding speech
- confusion
- slurring speech
- vision problems, such as trouble seeing in one or both eyes with vision blackened or blurred, or double vision
- trouble walking
- loss of balance or coordination
- dizziness
- severe, sudden headache with an unknown cause
A stroke requires immediate medical attention. If you think you or someone else is having a stroke, have someone call 911 right away. Prompt treatment is key to preventing the following outcomes:
- brain damage
- long-term disability
- death
While some stroke signs are the same in women and men, some are more common in women.
Stroke signs that occur more often in women include:
- nausea or vomiting
- hallucination
- pain
- general weakness
- shortness of breath or trouble breathing
- fainting or losing consciousness
- seizures
- confusion, disorientation, or lack of responsiveness
- sudden behavioral changes, especially increased agitation
Men are more likely to have a stroke in their younger years than women, but they’re less likely to die from it.
Men and women can have some of the same signs and symptoms of stroke (see above). However, some stroke symptoms occur more often in men. These include:
- drooping on one side of the face or an uneven smile
- slurred speech, difficulty speaking, and trouble understanding other speech
- arm weakness or muscle weakness on one side of the body
Strokes fall into three main categories: transient ischemic attack (TIA), ischemic stroke, and hemorrhagic stroke. These categories are further broken down into other types of strokes, including:
- embolic stroke
- thrombotic stroke
- intracerebral stroke
- subarachnoid stroke
The type of stroke you have affects your treatment and recovery process.
During an ischemic stroke, the arteries supplying blood to the brain narrow or become blocked. These blockages are caused by blood clots or blood flow that’s severely reduced. They can also be caused by pieces of plaque due to atherosclerosis breaking off and blocking a blood vessel.
The two most common types of ischemic strokes are thrombotic and embolic. A thrombotic stroke happens when a blood clot forms in one of the arteries supplying blood to the brain. The clot passes through the bloodstream and becomes lodged, which blocks blood flow. An embolic stroke is when a blood clot or other debris forms in another part of the body and then travels to the brain.
An embolic stroke is one of two types of ischemic strokes. It occurs when a blood clot forms in another part of the body — often the heart or arteries in the upper chest and neck — and moves through the bloodstream to the brain. The clot gets stuck in the brain’s arteries, where it stops the flow of blood and causes a stroke.
An embolic stroke may be the result of a heart condition. Atrial fibrillation, a common type of irregular heartbeat, can cause blood clots to develop in the heart. These clots may dislodge and travel through the bloodstream and into the brain.
A transient ischemic attack, often called a TIA or ministroke, occurs when blood flow to the brain is blocked temporarily. Symptoms, which are similar to those of a full stroke, are typically temporary and disappear after a few minutes or hours.
A hemorrhagic stroke happens when an artery in the brain breaks open or leaks blood. The blood from that artery creates excess pressure in the skull and swells the brain, damaging brain cells and tissues.
The two types of hemorrhagic strokes are intracerebral and subarachnoid. An intracerebral hemorrhagic stroke, the most common type of hemorrhagic stroke, happens when the tissues surrounding the brain fill with blood after an artery bursts. The subarachnoid hemorrhagic stroke is less common. It causes bleeding in the area between the brain and the tissues that cover it.
The cause of a stroke depends on the type of stroke. The three main types of stroke are transient ischemic attack (TIA), ischemic stroke, and hemorrhagic stroke.
A TIA is caused by a temporary blockage in an artery that leads to the brain. The blockage, typically a blood clot, stops blood from flowing to certain parts of the brain. A TIA typically lasts for a few minutes up to a few hours, and then the blockage moves and blood flow is restored.
Like a TIA, an ischemic stroke is caused by a blockage in an artery that leads to the brain. This blockage may be a blood clot, or it may be caused by atherosclerosis. With this condition, plaque (a fatty substance) builds up on the walls of a blood vessel. A piece of the plaque can break off and lodge in an artery, blocking the flow of blood and causing an ischemic stroke.
A hemorrhagic stroke, on the other hand, is caused by a burst or leaking blood vessel. Blood seeps into or around the tissues of the brain, causing pressure and damaging brain cells.
There are two possible causes of a hemorrhagic stroke. An aneurysm (a weakened, bulging section of a blood vessel) can be caused by high blood pressure and can lead to a burst blood vessel. Less often, a condition called an arteriovenous malformation, which is an abnormal connection between your veins and arteries, can lead to bleeding in the brain.
Certain risk factors make you more susceptible to stroke. According to the National Heart, Lung, and Blood Institute , the more risk factors you have, the more likely you are to have a stroke. Risk factors for stroke include:
Diet
An unhealthy diet that increases your risk of stroke is one that’s high in:
- salt
- saturated fats
- trans fats
- cholesterol
Inactivity
Inactivity, or lack of exercise, can also raise your risk for stroke.
Regular exercise has a number of health benefits. The CDC recommends that adults get at least 2.5 hours of aerobic exercise every week. This can mean simply a brisk walk a few times a week.
Alcohol consumption
Your risk for stroke also increases if you drink too much alcohol. Alcohol consumption should be done in moderation. This means no more than one drink per day for women, and no more than two for men. More than that may raise blood pressure levels as well as triglyceride levels, which can cause atherosclerosis.
Tobacco use
Using tobacco in any form also raises your risk for stroke, since it can damage your blood vessels and heart. This is further increased when smoking, because your blood pressure rises when you use nicotine.
Personal background
There are certain personal risk factors for stroke that you can’t control. Stroke risk can be linked to your:
- Family history. Stroke risk is higher in some families because of genetic health issues, such as high blood pressure.
- Sex. According to the
CDC , while both women and men can have strokes, they’re more common in women than in men in all age groups. - Age. The older you are, the more likely you are to have a stroke.
- Race and ethnicity. Caucasians, Asian Americans, and Hispanics are less likely to have a stroke than African-Americans, Alaska Natives, and American Indians.
Health history
Certain medical conditions are linked to stroke risk. These include:
- a previous stroke or TIA
- high blood pressure
- high cholesterol
- heart disorders, such as coronary artery disease
- heart valve defects
- enlarged heart chambers and irregular heartbeats
- sickle cell disease
- diabetes
Several medications are used to treat strokes. The type your doctor prescribes depends largely on the type of stroke you had. The goal of some medications is to prevent a second stroke, while others aim to prevent a stroke from happening in the first place.
The most common stroke medications include:
- Tissue plasminogen activator (tPA). This emergency medication can be provided during a stroke to break up a blood clot causing the stroke. It’s the only medication currently available that can do this, but it must be given within 3 to 4.5 hours after symptoms of a stroke begin. This drug is injected into a blood vessel so the medication can start to work as quickly as possible, which reduces the risk of complications from the stroke.
- Anticoagulants. These drugs reduce your blood’s ability to clot. The most common anticoagulant is warfarin (Jantoven, Coumadin). These drugs can also prevent existing blood clots from growing larger, which is why they may be prescribed to prevent a stroke, or after an ischemic stroke or TIA has occurred.
- Antiplatelet drugs. These medications prevent blood clots by making it more difficult for the blood’s platelets to stick together. The most common antiplatelet drugs include aspirin and clopidogrel (Plavix). They can be used to prevent ischemic strokes and are especially important in preventing secondary stroke. If you've never had a stroke before, you should only use aspirin as a preventive medication if you have a high risk of atherosclerotic cardiovascular disease (e.g., heart attack and stroke) and a low risk of bleeding.
- Statins. Statins, which help lower high blood cholesterol levels, are among the
most commonly prescribed medications in the United States. These drugs prevent the production of an enzyme that can turn cholesterol into plaque — the thick, sticky substance that can build up on the walls of arteries and cause strokes and heart attacks. Common statins include rosuvastatin (Crestor), simvastatin (Zocor), and atorvastatin (Lipitor). - Blood pressure drugs. High blood pressure can cause pieces of plaque buildup in your arteries to break off. These pieces can block arteries, causing a stroke. As a result, controlling high blood pressure can help prevent a stroke.
You can take steps to help prevent stroke by living a healthy lifestyle. This includes the following measures:
- Quit smoking. If you smoke, quitting now will lower your risk for stroke.
- Consume alcohol in moderation. If you drink excessively, try to reduce your intake. Alcohol consumption can raise your blood pressure.
- Keep weight down. Keep your weight at a healthy level. Being obese or overweight increases your stroke risk. To help manage your weight:
- Eat a diet that’s full of fruits and vegetables.
- Eat foods low in cholesterol, trans fats, and saturated fats.
- Stay physically active. This will help you maintain a healthy weight and help reduce your blood pressure and cholesterol levels.
- Get checkups. Stay on top of your health. This means getting regular checkups and staying in communication with your doctor. Be sure to take the following steps to manage your health:
- Get your cholesterol and blood pressure checked.
- Talk to your doctor about modifying your lifestyle.
- Discuss your medication options with your doctor.
- Address any heart problems you may have.
- If you have diabetes, take steps to manage it.
Taking all these measures will help put you in better shape to prevent stroke.
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