Ishchemic Stroke – Causes, Symptoms, Diagnosis, And Treatment
What is an ischemic stroke?
A stroke is a sudden interruption of the blood supply to the brain. Ischemic stroke occurs when the blood supply to the brain is caused by blockage of an artery that supplies the brain. If blood supply stopped for longer than a few seconds, the brain cannot get nutrients and oxygen. As a result, brain cells start dying, causing lasting damage.
What causes an ischemic stroke?
Ischemic stroke occurs when a blood vessel that supplies blood to the brain is blocked by a blood clot. This can occur due to two types of blood clots. One, a clot may form in an already narrowed blood vessel and cause the blockage. Ischemic stroke caused due to this is called a thrombotic stroke. Another, a clot may break off from another place in the blood vessels of the brain, or from some other part of the body, and travel up to the brain. The ischemic stroke caused by this is called embolic stroke or cerebral embolism. Ischemic strokes may also be caused by a sticky substance called plaque that can clog arteries.
What are the risk factors for strokes?
The main risk factor for strokes is high blood pressure. The following are the other major risk factors:
- Irregular heartbeat called atrial fibrillation
- Family history of stroke
- High cholesterol
- Heart disease
- Poor blood flow in legsdue to narrowed arteries
- High-fat diet
- Lack of exercise
- Women who take birth control pills
- Pregnant women
- Women who take hormone replacement therapy
What are the symptoms of a stroke?
Symptoms of stroke depend on which part of the brain is damaged. Sometimes, a person may not know that a stroke has occurred. Mostly, symptoms develop suddenly and without warning. Sometimes, symptoms may occur on and off for the first day or two. Symptoms are usually most severe when the stroke first happens, but they may slowly get worse.
The following are the symptoms of a stroke:
- A headache
- Change in alertness (including sleepiness, unconsciousness, and coma)
- Changes in hearing or taste
- Changes in sensation of touch and pain
- Confusion or loss of memory
- Problems swallowing
- Problems writing or reading
- Dizziness or vertigo
- Decreased vision, double vision, or total loss of vision
- Lack of control over the bladder or bowels
- Loss of balance or coordination or trouble walking
- One-sided muscle weakness in the face, arm, or leg
- Numbness or tingling on one side of the body
- Personality, mood, or emotional changes
- Trouble speaking or understanding others who are speaking
How is a stroke diagnosed?
The doctor will do a physical exam to check vision changes, movement, feeling, reflexes, understanding, and speaking. The doctor will also listen to the carotid arteries in the neck with a stethoscope for an abnormal sound, called a bruit, which is caused by abnormal blood flow. Blood pressure is also checked.
The doctor may order the following diagnostic tests to find out the type, location, and cause of the stroke and rule out other problems:
- Angiogram of the head to look for a blood vessel that is blocked or bleeding
- Carotid duplex (ultrasound) to see if the carotid arteries in your neck have narrowed
- Echocardiogram to see if the stroke could have been caused by a blood clot from the heart
- Magnetic resonance angiography (MRA) or CT angiography to check for abnormal blood vessels in the brain
The doctor may also do the following tests:
- Blood tests
- ECG (Electrocardiogram)
How is an ischemic stroke treated?
Urgent treatment is a must, as a stroke is a medical emergency.
People who suffered ischemic stroke are usually treated with the following:
- A clot-busting drug is given to dissolve the clot.
- To be effective, this treatment must be started within 3 to 4 1/2 hours of when the symptoms first started. The sooner this treatment is started, the better the chance of a good outcome.
The following treatments may also be given in the hospital:
- Blood thinners such as heparin, warfarin (Coumadin), aspirin, or clopidogrel (Plavix)
- Medicine to control risk factors, such as high blood pressure, diabetes, and high cholesterol
- Special procedures or surgery to relieve symptoms or prevent more strokes
- Nutrients and fluids
Physical therapy, occupational therapy, speech therapy, and swallowing therapy will all begin in the hospital. If the person has severe swallowing problems, a feeding tube in the stomach (gastrostomy tube) will likely be needed.
The goal of treatment after a stroke is to help you recover as much function as possible and prevent future strokes.
Recovery from your stroke will begin while you are still in the hospital or at a rehabilitation center. It will continue when you go home from the hospital or center. Be sure to follow up with your health care provider after you go home.
This feature is for informational purposes only and is not intended to substitute the expert guidance of a doctor. We advise seeing a doctor if you have any health concerns.