Acute Ischemic Stroke
Acute Ischemic Stroke
What is a stroke? — Stroke is the term doctors use when a part of the brain is damaged because of a problem with blood flow. Strokes can happen when:
An artery going to the brain gets clogged or closes off, and part of the brain goes without blood for too long
An artery breaks open and starts bleeding into or around the brain
How do strokes affect people? — The effects of a stroke depend on a lot of things, including:
Which part and how much of the brain is affected
How quickly the stroke is treated
Some people who have a stroke have no lasting effects. Others lose important brain functions. For example, some people become partly paralyzed or unable to speak. Stroke is one of the leading causes of death and disability in the world.
How can you tell if someone is having a stroke? — There is an easy way to remember the signs of a stroke. The symptoms usually come on suddenly. Just think of the word "FAST" (figure 1). Each letter in the word stands for one of the things you should watch for and what to do about it:
Face – Does the person's face look uneven or droop on one side?
Arm – Does the person have weakness or numbness in one or both arms? Does one arm drift down if the person tries to hold both arms out?
Speech – Is the person having trouble speaking? Does his or her speech sound strange?
Time – If you notice any of these stroke signs, call for an ambulance (in the US and Canada, dial 9-1-1). You need to act FAST. The sooner treatment begins, the better the chances of recovery.
Other symptoms can also be signs of a stroke. These include trouble seeing in one or both eyes, trouble walking, and loss of balance or coordination.
How are strokes treated? — The right treatment depends on what kind of stroke you are having. You need to get to the hospital very quickly to figure this out.
People whose strokes are caused by clogged arteries can:
Get treatments that help reopen clogged arteries. These treatments can help you recover from the stroke.
Get medicines that prevent new blood clots. These medicines also help prevent future strokes.
People whose strokes are caused by bleeding can:
Have treatments that might reduce the damage caused by bleeding in or around the brain
Stop taking medicines that increase bleeding, or take a lower dose
Have surgery or a procedure to treat the blood vessel to prevent more bleeding (this is not always possible to do)
Can strokes be prevented? — Many strokes can be prevented, though not all. You can greatly lower your chance of having a stroke by:
Taking your medicines exactly as directed. Medicines that are especially important in preventing strokes include:
•Blood pressure medicines
•Medicines called statins, which lower cholesterol
•Medicines to prevent blood clots, such aspirin or blood thinners
•Medicines that help to keep your blood sugar as close to normal as possible (if you have diabetes)
Making lifestyle changes:
•Stop smoking, if you smoke
•Get regular exercise (if your doctor says it's safe) for at least 30 minutes a day on most days of the week
•Lose weight, if you are overweight
•Eat a diet rich in fruits, vegetables, and low-fat dairy products, and low in meats, sweets, and refined grains (such as white bread or white rice)
•Eat less salt (sodium)
•Limit the amount of alcohol you drink
-If you are a woman, do not drink more than 1 drink a day
-If you are a man, do not drink more than 2 drinks a day
Another way to prevent strokes is to have surgery or a procedure to reopen clogged arteries in the neck. This type of treatment is appropriate for only a small group of people.
What is a "TIA"? — A TIA is like a stroke, but it does not damage the brain. TIAs happen when an artery in the brain gets clogged or closes off and then reopens on its own. This can happen if a blood clot forms and then moves away or dissolves. TIA stands for "transient ischemic attack."
Even though TIAs do not cause lasting symptoms, they are serious. If you have a TIA, you are at high risk of having a stroke. It's important that you see a doctor and take steps to prevent that from happening. Do not ignore the symptoms of a stroke even if they go away!
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 15328 Version 11.0
Release: 28.2.2 - C28.105
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