What is a Stroke? Symptoms, Causes, and Treatment
Stroke and its Prevalence
Stroke is a word that can change life in a flash. However, so much about strokes is still shrouded in mystery for those who are either untouched or newly touched by stroke. In addition to being one of the top five causes of death in the United States, stroke is also a leading cause of disability. Roughly 795,000 people in the United States have strokes each year.1Â Â
The stroke event isn’t the end of the story for the millions of people who have survived. There is a need to look forward while recognizing the reality that 26 percent of all stroke victims will have recurrences within five years.2Â Â
No two stroke experiences are exactly alike. Therefore, everyone’s post-stroke health management will be different. Knowing what causes stroke, how to prevent stroke, how to recognize stroke symptoms quickly, and what’s available for stroke rehabilitation can help. Â
Take a look at the basics. Â
What Causes a Stroke?
“A stroke occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot or bursts (or ruptures),” according to the American Stroke Association. The affected part of the brain cannot get enough oxygen, so those cells die.3Â Â
Blocked Artery
When a blocked artery causes a stroke, this is known as an ischemic stroke. An ischemic stroke is the most common form of stroke. During an ischemic stroke, blood flow to the brain drops significantly because blood vessels in the brain have become extremely narrow or blocked. The underlying cause of the narrowing or blockage is a buildup of fatty deposits, debris, or blood clots in the bloodstream. According to the CDC, about 87% of all strokes are ischemic strokes.4Â
Leaking or Ruptured Blood VesselÂ
When a stroke is caused by a leaking or ruptured blood vessel, this is what’s known as a hemorrhagic stroke. This form of stroke can be caused by high blood pressure, physical trauma from an accident, aneurysms, weakened wall vessels caused by protein deposits, and/or overuse of blood thinners. However, underlying health and biological factors that can contribute to a hemorrhagic stroke aren’t always apparent. Roughly 13% of all strokes are hemorrhagic strokes.5Â
Transient Ischemic Attack (TIA)Â
TIA accounts for a small percentage of strokes. Often referred to as a mini stroke, a TIA results when there is a temporary decrease in blood supply to the brain that lasts only a few minutes. TIAs are caused by clots or debris blocking blood flow to the nervous system.6 In addition, research shows that the risk of stroke is significantly greater after experiencing a TIA. While TIAs don’t cause permanent damage, it’s still essential to seek emergency medical attention if you suspect a TIA to confirm that you aren’t having a full-blown stroke.6Â
What Are the Symptoms of a Stroke?Â
Every second is critical when a stroke occurs. Recognizing stroke symptoms allows people to spring into action without wasting time. Here’s a rundown of the most common stroke symptoms:7Â
- Difficulty speakingÂ
- Slurred wordsÂ
- ConfusionÂ
- Difficulty understanding what others are sayingÂ
- Paralysis affecting the face, arms, or legs. Stroke paralysis typically only affects one-half of the bodyÂ
- Weakness in the face, arms, or legsÂ
- A drooping mouthÂ
- Severe headacheÂ
- Vomiting Â
- Blurry visionÂ
- Double visionÂ
- Blackened visionÂ
- Loss of balanceÂ
- Loss of coordinationÂ
- DizzinessÂ
- Difficulty walking
Anyone witnessing what they believe to be a stroke can do some simple tests to confirm that a serious medical event is happening. Staying in continuous communication with the person having a stroke is essential. There’s a technique called FAST that is easy to remember.7 Take a look:Â
- FACE: Ask the person experiencing symptoms to smile. This will allow you to see if they are experiencing drooping on one side of the face.Â
- ARMS: Ask the person to raise both arms. This allows you to see if they are capable of lifting both arms equally.Â
- SPEECH: Ask the person to repeat a simple phrase that will allow you to observe any slurred or unusual speech. Even a person who appears “normal” may suddenly be shocked to discover that they cannot form words properly.Â
- TIME: You don’t have much of it if you notice any of the signs above. Call for emergency help immediately.
What Happens During a Stroke? Â
The stroke may affect a person’s ability to speak, eat, control emotions, move, and think, depending on what part of the brain is damaged. When blood flow to the brain is blocked, this causes the brain cells to die.3Â Â
The longer that blood flow is blocked, the more damage is done. That’s why it’s essential to get help quickly for someone if they are displaying any of the signs above. Some people appear to be “themselves” even though they are displaying some mild stroke symptoms.3 This doesn’t mean that intervention isn’t necessary. Allowing a stroke to go without medical intervention can drastically increase the potential for brain damage, disability, and death.3Â Â
Related:Â
Stroke Risk Factors Â
There are many different risk factors for stroke. These factors put you at greater risk of having a stroke. This is vital knowledge to have when creating a plan for stroke awareness and prevention because having risk factors in your life can create the motivation necessary to follow strict protocols to reduce your chances of having either a first or recurrent stroke.Â
Some risk factors can be controlled through lifestyle changes. Others are slightly more “set in place” simply because they have to do with biological factors that can’t be changed. Here is a list of the major risk factors for stroke.8Â
Sedentary lifestyle – Leading a sedentary lifestyle with limited exercise and physical activity and exercise is a risk factor. Â
Obesity – Being overweight or obese can increase the risk of stroke.  Â
Alcohol or drug use – Heavy drinking, binge drinking, and using illegal drugs are risk factors. Â
High blood pressure – Chronic high blood pressure over 140/90 is a big risk factor for increasing stroke risks. Â
High cholesterol – This condition causes fatty deposits to build up in the arteries, which increases the risk for stroke, especially the ischemic type. Â
Diabetes – People with diabetes have a higher risk of stroke. Â
Cardiac issues – Cardiovascular diseases related to heart failure, defects, and infections also pose stroke risks. This also extends to disorders that cause irregular heart rhythm. Some people are also at greater risk for stroke due to a family history of stroke and heart attack. Â
Cigarette smoking – It’s widely known that cigarette smoking significantly increases stroke risk.Â
Age is a significant risk factor for stroke. While strokes can occur in people of different ages, most people who have strokes are over the age of 55. Â
Gender – Men are also more predisposed to strokes than women. Â
Race and Ethnicity – It’s also known that African Americans and Hispanics have greater rates of stroke than people of other races and ethnicities. Â
Can Strokes be Prevented?
Stroke prevention invokes a mix of lifestyle management and education. While not all strokes can be prevented, there are some things you can do to reduce the risk. One of the most important is to control the lifestyle-related risks discussed above. Â
If you’ve had a stroke, stroke prevention and management is an essential aspect of stroke therapy. That is because 80 percent of second clot-related strokes could be preventable with stroke prevention strategies.9 Some strategies that should be integrated into a rehab plan include:9Â
- Taking steps to control high blood pressure.Â
- Following a diet that’s low in cholesterol and saturated fat.Â
- Eating plenty of fruits, vegetables, and lean proteins.Â
- Quitting tobacco products.Â
- Integrating exercise and physical activity into your life.Â
- Maintaining a healthy weight.Â
- Treating obstructive sleep apnea (OSA).Â
Lifestyle isn’t the whole story for every patient. In some cases, it’s necessary to use medications that can help reduce your risk for stroke if you’re in a high-risk category due to a history of stroke, underlying health conditions, or obesity.9Â
What Is Stroke Rehabilitation and How Can It Help?Â
Stroke rehabilitation is integral to restoring quality of life following a stroke. Rehabilitation is tailored to meet the unique needs of each patient. Stroke therapy can include exercises that build motor skills and coordination, mobility training involving canes and wheelchairs, range-of-motion therapy, activities of daily living (ADL) training, cognitive and language reeducation and much more. Goals of rehabilitation can include preventing a future stroke, relearning lost mobility and functional skills, regaining strength, regaining independence, and restoring cognitive function.9Â Â
Many people who feel hopeless after a stroke are surprised to discover that there is a world of innovation waiting to help them relearn all the things the stroke took from them. In fact, robot-assisted neurological rehabilitation is one of the innovations changing the lives of stroke victims in ways that were impossible just a decade ago. Â
The bottom line is that knowledge is vital for preventing stroke. However, the journey of learning must continue into the rehabilitation phase if prevention isn’t enough to stop a stroke.Â
 References
- U.S. Department of Health and Human Services. (n.d.). How many people are affected by/at risk for stroke? Eunice Kennedy Shriver National Institute of Child Health and Human Development. Retrieved June 21, 2022, from https://www.nichd.nih.gov/health/topics/stroke/conditioninfo/risk  Â
- Flach, C., Clare Flach Correspondence to: Clare Flach, Muruet, W., Walter Muruet King’s College London, Wolfe, C. D. A., Charles D.A. Wolfe King’s College London, Bhalla, A., Ajay Bhalla King’s College London, Douiri, A., Abdel Douiri King’s College London, For Sources of Funding and Disclosures, & Al., E. (2020, July 10). Risk and secondary prevention of stroke recurrence. Stroke. Retrieved June 21, 2022, from https://www.ahajournals.org/doi/10.1161/STROKEAHA.120.028992  Â
- American Stroke Association. About stroke. www.stroke.org. (n.d.). Retrieved June 21, 2022, from https://www.stroke.org/en/about-stroke  Â
- 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.htmÂ
- American Stroke Association. Hemorrhagic strokes (bleeds). www.stroke.org. (n.d.). Retrieved June 21, 2022, from https://www.stroke.org/en/about-stroke/types-of-stroke/hemorrhagic-strokes-bleeds#:~:text=Hemorrhagic%20strokes%20make%20up%20about,compresses%20the%20surrounding%20brain%20tissue  Â
- American Stroke Association. What is a tia. www.stroke.org. (2022, April 1). Retrieved June 21, 2022, from https://www.stroke.org/en/about-stroke/types-of-stroke/tia-transient-ischemic-attack/what-is-a-tia  Â
- Centers for Disease Control and Prevention. (2022, May 4). Stroke signs and symptoms. Retrieved June 21, 2022, from https://www.cdc.gov/stroke/signs_symptoms.htm#:~:text=Sudden%20numbness%20or%20weakness%20in,balance%2C%20or%20lack%20of%20coordination  Â
- Risk factors for stroke. Johns Hopkins Medicine. (2021, November 15). Retrieved June 21, 2022, from https://www.hopkinsmedicine.org/health/conditions-and-diseases/stroke/risk-factors-for-stroke  Â
- American Stroke Association. Life after stroke guide. (n.d.). Retrieved June 21, 2022, from https://www.stroke.org/-/media/stroke-files/life-after-stroke/life-after-stroke-guide_7819.pdf?la=en Â