Types of Strokes

There are five main types of strokes

There are five main types of strokes, and the causes and clinical presentation of each of them vary:

• Ischemic stroke
• Hemorrhagic stroke
• Transient ischemic attack (Ministroke)
• Brain stem stroke
• Cryptogenic stroke (stroke of unknown cause)

A stroke, also called cerebrovascular accident (CVA), occurs when the blood supply is cut off or reduced to a part of the brain. This causes a decrease in oxygenation of the brain and prevents the brain tissue from receiving sufficient nutrition. Eventually, brain cells begin to die. This entire process takes place within a few minutes. A stroke is a medical emergency and requires immediate medical attention. Quick diagnosis and treatment can reduce brain damage, disabilities, and other complications that can be permanent.

This is the most common type of a stroke (87% of all strokes). An ischemic stroke occurs when a blood vessel supplying blood to the brain gets blocked. This leads to decreased oxygenation (ischemia) of the part of the brain supplied by that blood vessel.

Causes of an ischemic stroke:

• Atherosclerosis (fatty substance/cholesterol [plaque] gets collected in your arteries and narrows them)
• A blood clot in the blood vessels that supply blood to the brain
• Heart attack
• Defects of the heart valves 
• Arrhythmia (Irregular heart rhythm)

Symptoms of an ischemic stroke:

The symptoms depend on the parts of the brain affected:

• Sudden numbness or weakness of the face, arm, or leg, typically on one side of the body
• Confusion
• Slurring of speech
• Giddiness
• Loss of balance or coordination
• Difficulty walking
• Blurring of vision, diplopia (double vision), or loss of vision 

Transient ischemic attack (TIA) occurs when there is a temporary blockage in blood flow to the brain. The symptoms usually disappear within 24 hours. TIA indicates an increased risk of an ischemic stroke.

Don't take chances if you or someone you know has any symptoms that seem like a stroke. Get medical help in a hurry.

Causes and risk factors for TIA:

TIA can occur because the vessels that bring blood to the brain become narrow or a blood clot in the vessel.

Factors that can increase the risk of TIA include:

• Age
• High blood pressure
• High cholesterol
• Diabetes
• Heart disease
• Obesity
• Smoking
• Family history of strokes

Symptoms of TIA:

The symptoms are usually similar to those of an ischemic stroke, but they disappear within a day:

• Sudden numbness or weakness of the face, arm, or leg, typically on one side of the body
• Confusion
• Slurring of speech
• Giddiness
• Loss of balance or coordination
• Difficulty walking
• Blurring of vision, diplopia (double vision) or loss of vision 
• Severe headaches

This occurs when there is bleeding within the brain, causing damage to the brain tissues. Bleeding can occur in the space between the brain and skull bone (subarachnoid hemorrhage) or inside the brain (intracerebral hemorrhage).

Causes and risk factors for a hemorrhagic stroke:

• High blood pressure
• Trauma
• Bleeding disorders
• Cocaine abuse
• Abnormal blood vessels
• Age above 65 years
• High cholesterol
• High blood pressure
• Uncontrolled diabetes 
• Obesity
• History of strokes
• Family history of strokes
• Smoking 
• Unhealthy diet and lack of exercise 

Symptoms of a hemorrhagic stroke:

Hemorrhagic stroke symptoms usually appear slowly and increase gradually over minutes or a few hours, although subarachnoid hemorrhage may come on suddenly. You might notice:

• Intense headache 
• Confusion
• Nausea 
• Vomiting
• Photophobia (Sensitivity to light)
• Problems with vision
• Loss of consciousness
• Seizures
• Difficulty eating and swallowing 
• Weakness of one or more parts of the body

This type of a stroke occurs in the brain stem. It can affect both sides of the body and leave the patient in a “locked-in” state. They are unable to speak or move below the neck.

Causes and risk factors for a brain stem stroke:

• Blood clots
• Bleeding in the brainstem
• Trauma to an artery 
• Smoking
• High blood pressure
• Uncontrolled diabetes
• Heart disease

Symptoms of a brain stem stroke:

• Giddiness 
• Loss of balance
• Double vision
• Slurred speech
• Loss of consciousness 
• Difficulty breathing
• “Locked in” syndrome (only being able to move the eyes)

Being able to identify a stroke and calling for help could be lifesaving for oneself and for a person having a stroke because brain damage begins within minutes. The acronym F.A.S.T. is helpful to remember the key warning signs of a stroke and react accordingly. Even if the signs of a stroke disappear, medical attention is required.

• F - Face: One side of the face droops or is numb and smile becomes uneven
• A - Arm: Weakness and/or numbness of one arm
• S - Speech: Slurring of speech
• T - Time: Time to call for help (911 in the United States. Helpline numbers are different in different countries) or rush to a hospital, whichever is faster. Sooner the treatment begins, better the prognosis. It is recommended that treatment begins within 4.5 hours.