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Different Types of Stroke: A Look at Risk Factors

Stroke Experiences Differ Greatly

Stroke means many things to many different people. That’s because experiences can vary based on stroke type. The two types of strokes are ischemic stroke and hemorrhagic stroke. There is also a third stroke category called a transient ischemic attack (TIA) that deserves some attention.1  While there is a large degree of overlap between the different types of stroke, it’s essential to know the different characteristics of each to have an idea of what’s needed for prevention and recovery.  

Let’s take a look at the latest information on what we know about the different types of strokes, as well as the latest research in stroke recovery.  

What Happens During a Stroke?

Strokes occur when the blood supply is cut off to a part of the brain. This lapse in oxygen effectively “kills off” brain cells.2  The intensity and duration of a stroke can determine just how extensive of a recovery period is needed.  

Here’s a look at some core facts about stroke from the Centers for Disease Control and Prevention (CDC): 3 

  • Almost 800,000 people suffer from strokes in the United States every year. 
  • Roughly 185,000 of the strokes that happen annually are among people who have had previous strokes. 
  • Strokes happen every 40 seconds in the United States. 
  • Someone dies from a stroke every 3.5 minutes. 
  • One out of every six deaths from cardiovascular disease is due to stroke. 
  • Almost 87 percent of strokes are ischemic strokes. 
  • Stroke is the leading cause of severe long-term disability in the United States. 
  • More than half of stroke survivors over the age of 65 experience reduced mobility due to a stroke event. 
    Risk Factors - Stroke

    What Are the Risk Factors for Stroke? 

    Stroke research is unveiling a lot about why strokes occur. While some strokes appear to be random occurrences that are impossible to predict, the majority of people who are affected by strokes possess risk factors that can be both detectable and preventable.  

    There are several known risk factors for strokes. High blood pressure, obesity, high cholesterol, smoking, diabetes, age, drug use, and excessive alcohol consumption are all associated with higher stroke risks.4 

    In addition, it is believed that genetic factors can contribute to stroke risks. Here’s a rundown of all the major stroke risk factors to know about: 

    • High blood pressure/Hypertension: Researchers call hypertension the most prevalent risk factor for stroke.5 Having a blood pressure of 140/90 or higher can damage the blood vessels that supply blood to the brain, increasing your risk of something going wrong. 
    • Heart disease: The buildup of fatty plaque in the arteries that occurs with heart disease is a leading cause behind why strokes happen.6 
    • Diabetes: In addition to increasing stroke risks, diabetes is also associated with higher rates of adverse events and mortality after stroke.7 
    • Smoking: Up to a quarter of stroke deaths can be attributed to cigarette smoking.8 
    • Birth control pills (oral contraceptives): Oral contraceptives create an elevated risk for blood clots. Some studies suggest that birth control can double the risk of stroke.9 
    • Obesity: While obesity is a stroke risk factor for all, research indicates that obesity is a specific risk factor for young-onset ischemic stroke.10 
    • Gender: Stroke is more common in men than women.11 
    • Any disease or genetic predisposition that causes a high red blood cell count also increases the risk for clots that can raise stroke risks.4  
    • Abnormal heart rhythm or other cardiac issues.11  
    • Genetic or chronic cardiac structural abnormalities.11 
    • A sedentary lifestyle lacking sufficient exercise.4 
    • Drug use and excessive alcohol consumption.4 
    • Stroke heredity: Some people are more likely to have a stroke due to genetic factors.11  

      Having a stroke risk factor doesn’t mean that a person will inevitably have a stroke. Moreover, there’s no guarantee that a person won’t have a stroke just because they don’t have any known risk factor. However, one thing that is for certain is that controlling risk factors that can be managed using lifestyle changes, various therapies, and appropriate medications can drastically reduce the likelihood of stroke. 

      What are the Different Types of Strokes?  

      There are three main types of stroke, according to the American Stroke Association.1 

      Ischemic Strokes 

      An ischemic stroke is the leading type of stroke. Ischemic strokes are caused by blockages that form in arteries. These blockages ultimately cut off blood supply to the brain. There are two types of ischemic stroke. The first is a thrombotic stroke, which involves a blood clot forming inside a blood vessel in the brain. This type of stroke event is seen commonly with older stroke victims who have diabetes, high cholesterol, and other health conditions. Symptoms can be quite subtle and staggered with thrombotic strokes because they often occur gradually over the course of several hours or days.1 

      The second type of ischemic stroke is an embolic stroke, which involves a blood clot forming outside the brain. This clot ultimately travels to a blood vessel to create a life-threatening situation. Embolic strokes often occur suddenly. While not everyone who experiences an embolic stroke suffers from heart disease, there is a heavy correlation between embolic stroke and heart disease.11 

      Hemorrhagic Strokes  

      There is a known connection between hemorrhagic strokes and high blood pressure. A hemorrhagic stroke occurs when a blood vessel within the brain ruptures or leaks. While hemorrhagic strokes are far less common than ischemic strokes, they still account for roughly 40% of all stroke deaths. In addition, many hemorrhagic strokes are caused by aneurysms.13 

      Like an ischemic stroke, hemorrhagic stroke also has two subcategories. The first one is called an intracerebral stroke. Ruptured arteries cause intracerebral strokes in the brain. The second subcategory is a subarachnoid stroke that creates bleeding in the area between the brain and the tissue that surrounds the brain.13 

      Transient Ischemic Attack (TIA) 

      This third category of stroke is considered to be the least severe. In fact, TIAs are often referred to as “miniature strokes.” 14  Most people who experience them do not experience any adverse long-term side effects. One of the characteristics of a TIA is that it does not cause brain damage. A TIA is a short interruption of blood flow to the brain. Unlike a true stroke, a TIA will resolve independently without intervention. However, it’s important not to dismiss a TIA as harmless. A TIA can be a significant warning sign. Research shows that up to 40% of people who experience a TIA will go on to have a true stroke.14 

      Stroke, brain image

      Are Strokes Always Fatal? 

      While it’s true that stroke is a leading cause of death in the United States, not all strokes are fatal. The way that a stroke affects the body is impacted by the location of the stroke, the severity of the stroke, and how quickly a person can receive treatment. The figure works out to approximately one out of every eight strokes resulting in death within the first month. That expands to one out of every four when looking at fatality rates within a year of having a stroke.3 However, many people survive strokes. It’s even possible to thrive again after a stroke. An early emergency intervention allows some people to walk away with minimal damage. However, the stakes are high. 

      When blood flow to the brain is interrupted, brain cells begin dying within minutes. Each lost cell chips away at brain function. This is why a stroke carries such a heavy risk for permanent disability. Sadly, death is the ultimate result when the brain is deprived of oxygen for too long to survive. The good news is that new stroke research is being done to help people recover from strokes.  

      Patient and therapist

      Healing After Stroke – The Latest Research  

      In the past, doctors couldn’t do very much for stroke victims. There wasn’t much you could do 15  Dr. Kevin Sheth MD, the Chief of Neurocritical Care and Emergency Neurology, told Yale. Thankfully, that is changing. New innovations in stroke rehabilitation allow people to regain the skills and abilities lost due to stroke. In many cases, support that enables a person to retrain their brain following a stroke makes it possible to resume many daily activities enjoyed before a stroke event.   

      Robot-assisted stroke therapy is one of the most promising developments to come on the horizon in recent years. State-of-the-art rehabilitation robots use artificial intelligence to help patients recover faster and better. Interested in learning about the benefits of upper extremity robot-assisted therapy? Check out our summary article on the new whitepaper or read the full paper: Using IoT Data to Quantify InMotion® Therapy Gains on Upper Extremity Motor Impairments.

      Final Thoughts

      There is power in learning about the different types of stroke in the brain. It’s also important to know that the story goes on for many following a stroke, thanks to new technologies that offer new hope to patients and their families. After all, most of us will have our lives touched by a stroke somehow.  

       References

      1. American Stroke Association. (2019). Types of Stroke. Retrieved June 21, 2022, from https://www.stroke.org/en/about-stroke/types-of-stroke.  
      2. CDC. Learn about Stroke. Centers for Disease Control and Prevention, 2 Aug. 2021, Retrieved June 21, 2022, from www.cdc.gov/stroke/about.htm#:~:text=A%20stroke%2C%20sometimes%20called%20 
      3. Centers for Disease Control and Prevention. (2022, April 5). Stroke facts. Centers for Disease Control and Prevention. Retrieved June 21, 2022, from https://www.cdc.gov/stroke/facts.htm   
      4. Boehme, A. K., Esenwa, C., & Elkind, M. S. V. (2017, February 3). Stroke risk factors, genetics, and prevention. Circulation research. Retrieved June 21, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5321635/   
      5. Wajngarten, M., & Silva, G. S. (2019, July 11). Hypertension and stroke: Update on treatment. European cardiology. Retrieved June 21, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6659031/ 
      6. Atherosclerosis & ischemic stroke treatment. Mount Sinai Health System. (n.d.). Retrieved June 30, 2022, from https://www.mountsinai.org/locations/cerebrovascular-center/conditions/stroke/atherosclerosis-ischemic-stroke  
      7. Liao, C.-C., Shih, C.-C., Yeh, C.-C., Chang, Y.-C., Hu, C.-J., Lin, J.-G., & Chen, T.-L. (2015, December). Impact of diabetes on stroke risk and outcomes: Two nationwide retrospective cohort studies. Medicine. Retrieved June 21, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5291606/   
      8. Shah, Reena S, and John W Cole. Smoking and Stroke: The More You Smoke the More You Stroke. Expert Review of Cardiovascular Therapy, U.S. National Library of Medicine, July 2010, Retrieved June 21, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2928253 
      9. Carlton, Caitlin, et al. Oral Contraceptives and Ischemic Stroke Risk. Stroke, 16 Mar. 2018, Retrieved June 21, 2022, from https://www.ahajournals.org/doi/10.1161/STROKEAHA.117.020084.   
      10. Mitchell, Andrew B, et al. Obesity Increases Risk of Ischemic Stroke in Young Adults. Stroke, U.S. National Library of Medicine, June 2015, Retrieved June 21, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4458137/.   
      11. Hopkins Medicine. Health Risk Factors For Stroke. 2022. Retreived June 30th 2022 from https://www.hopkinsmedicine.org/health/conditions-and-diseases/stroke/risk-factors-for-stroke  
      12. American Stroke Association, Ischemic Strokes (Clots). www.stroke.org, Retrieved June 21, 2022, from  https://www.stroke.org/en/about-stroke/types-of-stroke/ischemic-stroke-clots.   
      13. American Stroke Association. Hemorrhagic Strokes (Bleeds). www.stroke.org, https://www.stroke.org/en/about-stroke/types-of-stroke/hemorrhagic-strokes-bleeds.  
      14. Khare, S. (2016). Risk factors of transient ischemic attack: An overview. Journal of mid-life health. Retrieved June 21, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4832890/   
      15. Yale Medicine. (2020, November 9). 3 breakthroughs in stroke research. Yale Medicine. Retrieved June 21, 2022, from https://www.yalemedicine.org/news/3-stroke-breakthroughs   
      Want to learn more more about stroke rehabilitation?
      Visit us at www.bioniklabs.com.