Stroke

  • Medical Author:
    Benjamin Wedro, MD, FACEP, FAAEM

    Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

  • Medical Editor: Charles Patrick Davis, MD, PhD
    Charles Patrick Davis, MD, PhD

    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

Stroke Symptoms and Signs

The symptoms of a stroke vary depending upon the area of the brain affected by a lack of oxygen. All strokes involve symptoms that relate to impairment of nerve function. The symptoms typically arise suddenly and most commonly occur on one side of the body. Symptoms and signs of stroke can include:

  • numbness,
  • weakness,
  • tingling, or
  • vision loss or changes.

Confusion, changes in the level of consciousness, trouble speaking, trouble understanding speech, vertigo, and balance problems are other common symptoms. Headache, nausea, and vomiting sometimes accompany a stroke, particularly when the stroke involves bleeding inside the brain.

Quick GuideStroke Causes, Symptoms, and Recovery

Stroke Causes, Symptoms, and Recovery

Stroke definition and facts

  • A stroke occurs when part of the brain loses its blood supply and stops working. This causes the part of the body that the injured brain controls to stop working.
  • A stroke also is called a cerebrovascular accident, CVA, or "brain attack."
  • The types of strokes include:
    • Ischemic stroke (part of the brain loses blood flow)
    • Hemorrhagic stroke (bleeding occurs within the brain)
  • Transient ischemic attack, TIA, or ministroke (The stroke symptoms resolve within minutes, but may take up to 24 hours on their own without treatment. This is a warning sign that a stroke may occur in the near future.)
  • A stroke is a medical emergency. The affected individual, family, friends, or bystanders need to call 9-1-1 (activate EMS) to access emergency care.
  • From onset of symptoms, there is only a 3 to 4 1/2 hour window to use clot-busting drugs (thrombolytics) to try to restore blood supply to the affected part of the brain.
  • Remember FAST if you think someone might be having a stroke:
    • Face drooping
    • Arm weakness
    • Speech difficulty
    • Time to call 9-1-1
  • Causes of strokes include ischemia (loss of blood supply) or hemorrhage (bleeding) in the brain occurs.
  • People at risk for stroke include those who have high blood pressure, high cholesterol, diabetes, and those who smoke. People with heart rhythm disturbances, especially atrial fibrillation are also at risk.
  • Stroke is diagnosed by the patient's symptoms, history, and blood and imaging tests.
  • You can prevent stroke by quitting smoking, controlling blood pressure, maintaining a healthy weight, eating a healthy diet, and exercising on a regular basis.
  • The prognosis and recovery for a person that has suffered a stroke depends upon the location of the injury to the brain.

What is a stroke?

A stroke, also known as a cerebrovascular accident or CVA is when part of the brain loses its blood supply and the part of the body that the blood-deprived brain cells control stops working. This loss of blood supply can be ischemic because of lack of blood flow, or hemorrhagic because of bleeding into brain tissue. A stroke is a medical emergency because strokes can lead to death or permanent disability. There are opportunities to treat ischemic strokes but that treatment needs to be started in the first few hours after the signs of a stroke begin. The patient, family, or bystanders, should call 9-1-1 and activate emergency medical services immediately should a stroke be suspected.

A transient ischemic attack (TIA or mini-stroke) describes an ischemic stroke that is short-lived where the symptoms resolve spontaneously. This situation also requires emergency assessment to try to minimize the risk of a future stroke. By definition, a stroke would be classified as a TIA if all symptoms resolved within 24 hours.

What is the NIH Stroke Scale?

Not all strokes affect the brain equally, and stroke symptoms and signs depend upon the part of the brain affected.

  • For example, most people’s speech center is located in the left half of the brain so a stroke affecting the left side of the brain would affect speech and comprehension. It also would be associated with weakness of the right side of the body.
  • A right brain stroke would make the left side of the body weak. And depending on where in the brain the injury occurred, the weakness could be the face, arm, leg or a combination of the three.

The NIH Stroke Scale tries to score how severe a stroke might be. It also monitors whether the person's stroke is improving or worsening as times passes as the patient is re-examined.

There are 11 categories that are scored and include whether the patient

  • is awake,
  • can follow commands,
  • can see,
  • can move their face, arms and legs,
  • has normal body sensations or feelings,
  • has speech difficulties, or
  • has coordination problems.

What are the risk factors for stroke?

Overall, the most common risk factors for stroke are:

Heart conditions like atrial fibrillation, patent foramen ovale, and heart valve disease can also be the potential cause of stroke.

When stroke occurs in younger individuals (less than 50 years old), less common risk factors to be considered include illicit drugs, such as cocaine or amphetamines, ruptured aneurysms, and inherited (genetic) predispositions to abnormal blood clotting.

An example of a genetic predisposition to stroke occurs in a rare condition called homocystinuria, in which there are excessive levels of the chemical homocystine in the body. Scientists are trying to determine whether the non-hereditary occurrence of high levels of homocystine at any age can predispose to stroke.

Medically Reviewed by a Doctor on 12/9/2016

Subscribe to MedicineNet's Heart Health Newsletter

By clicking Submit, I agree to the MedicineNet's Terms & Conditions & Privacy Policy and understand that I may opt out of MedicineNet's subscriptions at any time.

Health Solutions From Our Sponsors