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Heart disease and Stroke

What are the different types of stroke?





A stroke occurs when there is a sudden disruption to the blood and oxygen supply to a part of the brain. There are three main types of stroke, which doctors treat in different ways.
Stroke is the fifth leading cause of death in the United States. Around 87% of strokes are ischemic strokes, which occur when something prevents adequate blood flow through a brain artery.
Stroke kills brain tissue. This can be fatal. In fact, according to the Centers for Disease Control and Prevention (CDC), strokes are responsible for around 1 in 19 deaths.
This article looks at the different types of stroke. It will also explore what causes each type of stroke, the potential symptoms of each, and some treatment options.


A man holding his chests as he is experiencing one of the types of strokesShare on Pinterest
A person may have a stroke when there is a sudden disruption to the blood and oxygen supply to the brain.
An ischemic stroke is the most common type of stroke. It occurs when a clot in a blood vessel interferes with adequate blood flow to the brain. This can happen when a person has atherosclerosis, for example.
A blood clot that travels from one area of the body to a blood vessel in the brain may also cause an ischemic stroke.

Symptoms

Symptoms of an ischemic stroke include:
  • sudden numbness in any area of the body
  • weakness on one side of the body
  • drooping on one side of the face
  • vision changes, especially in just one eye
  • dizziness or a loss of coordination
  • difficulty walking
  • confusion
  • a sudden, very intense headache with no known cause

Risk factors

Although anyone can experience an ischemic stroke, certain groups have a higher risk. Some risk factors for ischemic stroke include:
  • being female, as females live longer and are therefore more likely to live long enough to have a stroke
  • having vasculitis, which is a type of blood vessel inflammation
  • having atherosclerosis, which is a condition that causes fatty plaques to build up in the walls of arteries
  • smoking
  • drinking lots of alcohol
  • not getting very much exercise
  • being over the age of 65
  • having atrial fibrillation (A-fib), which is a heart condition that causes a rapid or irregular heart rate

Treatment

There is currently no cure for ischemic stroke. Instead, urgent treatment focuses on removing the clot and preventing further brain damage.
The first line of treatment tends to include a tissue plasminogen activator, or alteplase. Administering this treatment through a vein in the arm can help quickly dissolve the blood clot and improve blood flow to the affected area of the brain.
In some situations, it may be necessary to surgically dissolve or remove the clot using a procedure called thrombectomy. Thrombectomy works best when a surgeon performs it within 6 hours of the onset of stroke symptoms. However, thrombectomy may improve outcomes up to 24 hours after a stroke.
To help a person regain functioning and cope with the stress of having a stroke, they may need a variety of supportive treatments. These may include:
  • speech therapy
  • occupational therapy
  • physical therapy
  • psychological therapy
A doctor may also recommend making certain lifestyle changes, such as adopting a lower fat diet or exercising more often, to reduce the risk of experiencing another stroke.


A transient ischemic attack (TIA), sometimes called a ministroke, is similar to an ischemic stroke in that it temporarily blocks blood flow to the brain. However, unlike an ischemic stroke, health professionals do not believe that TIAs cause lasting brain damage.

Symptoms

TIAs may cause symptoms similar to those of an ischemic stroke, including:
  • confusion
  • trouble walking
  • drooping on one side of the face
  • tingling or numbness
However, the symptoms tend to be less severe and last just a few minutes. Unlike an ischemic stroke, a TIA resolves on its own, when the clot either moves or dissolves.

Risk factors

The risk factors for a TIA are the same as those for an ischemic stroke and include:
  • being older
  • smoking
  • getting little exercise
  • having cardiovascular disease
  • having A-fib
TIAs occur before about 15% of strokes. This means that many people who experience a TIA will experience an ischemic stroke in the future.

Prevention

A person who has a TIA should talk to a doctor about the lifestyle changes, medications, and other treatment options that can reduce the risk of experiencing an ischemic stroke.

A hemorrhagic stroke occurs when a blood vessel either ruptures or leaks, causing bleeding into the brain. The blood that accumulates from the bleed compresses the surrounding brain tissue.
Like other strokes, a hemorrhagic stroke can cause rapid tissue death.

Symptoms

The symptoms of a hemorrhagic stroke are similar to those of an ischemic stroke and include:
  • numbness
  • loss of function, especially on one side of the body
  • drooping on one side of the face
  • trouble speaking
  • loss of consciousness
  • confusion
  • severe headache
  • seizure

Risk factors

Two potential causes of hemorrhagic stroke are aneurysms and arteriovenous malformations (AVMs).
An aneurysm is an enlarged, ballooning blood vessel. This change in a blood vessel’s size and shape increases the risk that it will rupture, causing a bleed.
Many people with aneurysms do not have symptoms, and most aneurysms will appear after the age of 40.
An aneurysm can be congenital or hereditary, or it can develop due to risk factors. Risk factors for an aneurysm include:
  • having high blood pressure
  • smoking
  • drinking a lot of alcohol
  • using drugs, such as cocaine
  • being female
  • having experienced head trauma
An AVM, on the other hand, is a misshapen blood vessel. Only about 1% of the population have an AVM. Most people with an AVM are born with it.
The misshapen blood vessel may rupture or bleed, causing a hemorrhagic stroke.
Rarely, a hemorrhagic stroke can happen due to a sudden blood vessel injury, such as from:
  • whiplash
  • head trauma
  • holding the head in an unusual position
Isolated reports suggest that chiropractic neck treatments can cause bleeding in some people. In these cases, it is likely that the person had underlying risk factors, such as an aneurysm.

Treatment

Sometimes, a health professional can surgically remove the blood and repair the blood vessel. However, it is often necessary to manage hemorrhagic strokes with fluid control and monitor for effects such as seizures.
To reduce the risk of brain damage, a doctor may also give medication to control blood pressure.

When a health professional cannot determine the cause of disrupted blood flow to the brain, they call it a “cryptogenic” stroke.
The symptoms of a cryptogenic stroke are similar to those of other strokes. However, treatment can be challenging because doctors do not know what causes them.
For this reason, a doctor may perform a wide variety of diagnostic tests. They may also recommend treatment to reduce brain damage or advise making certain lifestyle changes to reduce the risk of experiencing another stroke.
Another type of stroke is a brain stem stroke. This is an ischemic or hemorrhagic stroke that occurs in the stem of the brain.
Brain stem strokes often cause complex symptoms and can be difficult to diagnose.
Some symptoms of a brain stem stroke include:
  • dizziness
  • confusion
  • numbness
  • trouble walking
Most strokes cause symptoms on only one side of the body. Brain stem strokes, however, may cause symptoms on both sides of the body. In some cases, they may even lead to paralysis.
Treatment for a brain stem stroke will be the same as it is for other strokes: removing the clot or stopping the bleeding, depending on the likely cause. A brain stem stroke can also affect breathing, so emergency respiratory support may also be necessary.

Health professionals recommend using the acronym “FAST” to recognize and quickly intervene when someone is having a stroke. FAST stands for:
  • F: face drooping
  • A: arm weakness
  • S: speech difficulties
  • T: time to seek emergency medical attention
A stroke is a medical emergency. The person must begin treatment as soon as possible.

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