Ischemic Stroke: Causes, Warning Signs and Treatment

A stroke happens when part of the brain loses its blood supply. Without the oxygen and nutrients blood brings, brain cells begin to die within minutes, which can cause lasting brain damage, long-term disability or death.

There are two main types of stroke, ischemic and hemorrhagic. Ischemic stroke, the more common, happens when a blood clot blocks a blood vessel in the brain. Fast treatment can save a life and improve the chances of recovery.

Causes

Ischemic strokes usually result from one or more of:

• a blood clot, which can form in an artery supplying the brain (thrombosis) or travel there from elsewhere in the body (embolism)
• atherosclerosis, the buildup of plaque, a sticky substance of cholesterol, fat and other material, inside the arteries
• irregular heart rhythms such as atrial fibrillation, which can let clots form in the heart and travel to the brain
• other heart and blood conditions, such as heart valve disease or sickle cell disease

A transient ischemic attack (TIA) is a brief blockage of blood flow to the brain, usually lasting a few minutes. It can be a sign of risk for a more serious stroke.

Warning signs

Stroke symptoms usually come on suddenly:

• numbness or weakness of the face, arm or leg, especially on one side of the body
• confusion, or trouble speaking or understanding speech
• trouble seeing in one or both eyes
• trouble walking, dizziness, or loss of balance or coordination
• a severe headache with no known cause

Think F.A.S.T.:

• Face drooping on one side when smiling
• Arm weakness: one arm drifts downward when both are raised
• Speech that is slurred or strange
• Time to call 911

Diagnosis

A provider will do a physical exam, ask about symptoms and medical history, and use imaging tests. Heart tests may help find the cause.

Treatment

Strokes should be treated as quickly as possible. Common treatments include:

• medicines: blood thinners, or thrombolytics that break up and dissolve clots, to prevent or treat ischemic stroke
• surgery or stenting to open narrowed arteries or remove plaque from the carotid arteries, which carry blood to the brain
• rehabilitation afterward, to regain lost skills and independence

Providers may also prescribe medicines to control blood pressure, cholesterol and other conditions, such as diabetes, that raise stroke risk.

Prevention

The best way to prevent stroke is to make heart-healthy lifestyle changes that lower risk. If those are not enough, a provider may prescribe medicine to manage risk factors.

Sources

• MedlinePlus (National Library of Medicine), "Ischemic Stroke," from the National Institute of Neurological Disorders and Stroke. https://medlineplus.gov/ischemicstroke.html