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Identifying a stroke

[JAN. 9, 2007]  SPRINGFIELD -- The following information is from the Illinois Heart Disease and Stroke Prevention Program.

Stroke or "brain attack"

The origination of the term "brain attack" and its application to stroke are credited to two world-renowned neurologists from Canada. The National Stroke Association began to champion the term in 1990 because it characterizes the medical condition and communicates the actual event more clearly to the public than does the word "stroke." The brain is the most delicate organ in the body. In order to give the best chance of limiting damage, brain attacks should be heeded even more urgently than heart attacks.

Besides being the third-leading cause of death, stroke is one of the major causes of serious disability in the United States. It can paralyze the arms and legs and can slur speech.

What causes a stroke?

A stroke occurs when a blood vessel bringing oxygen and nutrients to the brain bursts or is clogged by a blood clot or some other particle. Because of this rupture or blockage, part of the brain doesn't get the blood flow it needs. Deprived of oxygen, nerve cells in the affected area of the brain can't function and die with minutes.

When nerve cells can't function, the part of the body controlled by these cells can't function either. The devastating effects of stroke are often permanent because dead brain cells aren't replaced.

As the brain controls everything we say, do and think, a stroke can have a wide variety of effects. A stroke can affect personality, emotions, behavior and the ability to:

  • Move and coordinate movement.

  • Feel touch, temperature, pain and movement.

  • See or interpret what you see.

  • Think, remember, understand, plan, reason or problem-solve.

Types of stroke

Ischemic stroke

About 80 percent of strokes are ischemic. An ischemic stroke is the result of the interruption of the flow of blood to the brain by a blood clot. The buildup of plaque (atherosclerosis or "hardening of the arteries") is involved in most ischemic strokes.

Doctors often refer to an ischemic stroke as being either "thrombotic" or "embolic."

A thrombotic stroke is caused by a blood clot (thrombus) that forms in an artery going to the brain.

An embolic stroke occurs when a brain artery is blocked by a clot that has formed elsewhere in the body (an embolus) and is carried through the bloodstream to the brain. For example, a blood clot can form in the heart and then travel through the blood vessels to the brain.

A transient ischemic attack, known as a TIA, is a temporary "mini-stroke." It is caused by a temporary interruption of blood flow to the brain. The symptoms (warning signs) of a TIA are similar to those of an ischemic stroke except that they go away in a few minutes or hours (no more than 24 hours). A TIA is an important warning sign that you may be at risk of having an ischemic stroke in the future.

Hemorrhagic stroke

About 20 percent of strokes are hemorrhagic. A hemorrhagic stroke is caused by uncontrolled bleeding in the brain. As well as interrupting the normal flow of blood within the brain, the uncontrolled bleeding "floods" and kills brain cells. High blood pressure increases the risk of hemorrhagic stroke.

There are two main types of hemorrhagic stroke: subarachnoid hemorrhages and intracerebral hemorrhages.

A subarachnoid hemorrhage occurs when there is uncontrolled bleeding on the surface of the brain, in the area between the brain and the skull.

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In an intracerebral hemorrhage, an artery deep within the brain ruptures. High blood pressure is the main cause of intracerebral hemorrhages. Both subarachnoid hemorrhages and intracerebral hemorrhages can be caused by structural problems with the blood vessels in the brain. These structural problems include aneurysms and arteriovenous malformation.

An aneurysm is a weak area in the wall of the blood vessel that fills with blood and bulges outward. It is similar in some respects to a bulge in the wall of a tire. High blood pressure or an accident can cause the bulge to rupture, resulting in uncontrolled bleeding into the brain.

An arteriovenous malformation is another blood vessel problem with which you may be born. An arteriovenous malformation is an area of the brain where there are many thin-walled blood vessels. Under certain conditions, the blood vessels rupture, causing blood to leak into the brain.

Other causes of stroke

In a small number of cases, strokelike damage to the brain can be caused by the stopping of the heart (cardiac arrest). The longer the brain goes without the oxygen and nutrients supplied by the blood flow, the greater the risk of permanent brain damage.

Injuries to the brain also can result in uncontrolled bleeding and permanent brain damage. This is usually referred to as an acquired brain injury.

Risk factors for a stroke

  • High blood pressure. Treat it. Eat a balanced diet, maintain a healthy weight and exercise to reduce blood pressure. Drugs are also available.

  • Cigarette smoking. Quit. Medical help is available to help you.

  • Heart disease. Manage it. Your doctor can treat your heart disease and may prescribe medication to help prevent the formation of clots. If you are over 50, you and your doctor should make a decision about aspirin therapy.

  • Diabetes. Control it. Treatment can delay complications that increase the risk of stroke.

  • Transient ischemic attacks. Seek help. TIAs are small strokes that last only for a few minutes or hours. They should never be ignored and can be treated with drugs or surgery.

Symptoms of a stroke

If you see or have one or more of these symptoms, don't wait; call 911 right away!

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

  • Sudden confusion or trouble speaking or understanding speech.

  • Sudden trouble seeing in one or both eyes.

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

  • Sudden severe headache with no known cause.

Treatment can be more effective if given directly. Every minute counts!

Changing the perception of stroke

  • Myth: Stroke is unpreventable.
    Reality: Stroke is largely preventable.

  • Myth: Stroke cannot be treated.
    Reality: Stroke requires emergency treatment.

  • Myth: Stroke only strikes the elderly.
    Reality: Stroke can happen to anyone.

  • Myth: Stroke happens to the heart.
    Reality: Stroke is a "brain attack."

Other resources

  • National Institute of Neurological Disorders and Stroke

  • 1-800-352-9424


[Illinois Department of Public Health]

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