What is a Stroke?

A stroke occurs when the blood supply to the brain is interrupted, either because of a blood clot that blocks or plugs a blood vessel – known as an ischemic stroke – or because of a blood vessel that breaks and bleeds into the brain (hemorrhagic stroke).

Ischemic strokes are more common. They occur when the arteries to the brain become narrowed or blocked. This can occur when a blood clot forms in one of the arteries that supply blood to the brain. The clot may be due to fatty deposits that build up in arteries and lead to reduced blood flow or by other conditions affecting the arteries. Ischemic strokes can also be caused when a blood clot or other debris forms away from the brain (like in the heart) and is swept through the bloodstream, lodging in a narrow brain artery. This is known as an embolic stroke.

Hemorrhagic strokes can occur due to uncontrolled high blood pressure, weak spots in the blood vessel walls, overuse of blood-thinning medications and other conditions.

Baptist Health is known for advanced, superior care in diagnosing and treating strokes. Our 24/7 inpatient neurology, neurosurgery and outpatient and Home Health physical, occupational, cognitive and speech therapy services are available to help treat people with stroke. In addition, we have the region’s only advanced 3Tesla MRI, MRI spectroscopy and functional MRI, MRI angiography, CT angiography and conventional cerebral angiography technology to accurately diagnose all manner of neurologic disease, including multiple strokes.

You will appreciate timely appointments and a professional, friendly atmosphere where we take time to listen to your concerns. At Baptist Health, you have access to the region’s most comprehensive, multidisciplinary team of specialists and innovative therapies, including many available only through specialized clinical trials. In every way, we work to demonstrate the utmost excellent care to those who trust us with their health.

Signs and Symptoms

Stroke symptoms may include:

• A sudden, very severe headache
• Confusion or altered consciousness
• Dizziness
• Loss of balance or coordination
• Paralysis or numbness of the face, arm or leg
• Seizure
• Slurred speech or difficulty understanding speech
• Trouble walking
• Vision problems in one or both eyes
• Vomiting

Diagnosis

To determine if someone is having a stroke, we perform a physical examination, checking for signs of a stroke like drooping facial muscles, inability to lift an arm, slurred or jumbled speech and more. We then use advanced diagnostic procedures and technology to effectively diagnose, inform treatment and carefully monitor the condition. Diagnostic procedures can include:

Blood tests: These can tell physicians and emergency staff how fast a person’s blood clots, if blood sugar is abnormally high or low, if blood chemicals are out of balance or if an infection is present.

Carotid ultrasound: In this test, sound waves create images of the carotid arteries in the neck, showing blood flow and buildup of fatty plaques.

Cerebral angiogram: During this procedure, the physician inserts a thin, flexible catheter into a large artery — typically in the groin — and threads it past the heart to the arteries in the brain. He or she then injects a special dye into the catheter that travels to arteries throughout the brain. A series of X-ray images can then reveal details about the conditions of the arteries.

Computerized tomography (CT) scan: This test uses X-rays and computers to create images of the brain. Sometimes, contrast dye is injected to make bleeding in the brain easier to see.

Echocardiogram: This test uses sound waves to create detailed images of the heart and can find a source of clots in the heart that may have led to a stroke.

Magnetic resonance imaging (MRI): This test uses a powerful magnet and radio waves to produce images of the brain. It can detect bleeding in the brain and damage to brain tissue caused by an ischemic stroke.

Causes

Certain lifestyle and medical risk factors can increase a person’s chances of having a stroke. These include:

• Diabetes
• Excessive alcohol use
• High blood pressure
• High cholesterol
• Obesity
• Physical inactivity
• Sleep apnea
• Smoking
• Use of illegal drugs, like cocaine and methamphetamine

Risk Factors

Risk factors that may contribute to stroke include:

Aging: Most strokes develop in people age 55 and over.

Birth control pills or hormone therapies: These can slightly increase a woman’s risk of developing a stroke.

Cardiovascular disease: Conditions like heart failure, heart defects, abnormal heart rhythms or heart infections greatly increase the risk of developing a stroke.

Ethnicity: African-Americans have a higher risk of stroke than people of other races.

Family history: People with close relatives who have suffered strokes are at a higher risk.

Gender: Men have a higher risk of stroke than women. However, strokes are often more dangerous for women.

Prevention

Though not all strokes are preventable, there are things you can do to greatly reduce your risk including:

Practice good health: Watch what you eat, exercise, avoid smoking and excessive drinking and do not use illegal drugs.
See your doctor: Get regular checkups to monitor your health.
Take medications as prescribed: Take your medications as directed to manage high blood pressure, high cholesterol, diabetes or heart conditions.

Prognosis

The outlook for a person who has suffered a stroke depends on its severity and how quickly he or she was treated. Ischemic strokes often carry a better prognosis. Hemorrhagic strokes often have more complications due to the pressure a ruptured blood vessel puts on the brain.

Treatment and Recovery

Treatment for a hemorrhagic stroke may include:

Emergency Interventions

In the emergency room, a person suffering this type of stroke may be given drugs to counteract the effects of blood thinners, reduce pressure in the brain, reduce blood pressure, prevent seizures or prevent spasms of the blood vessels. When bleeding stops, a person will receive supportive medical care.

Surgery

In some cases, the surgeon may need to remove blood and relieve pressure in the brain. Surgery can also repair blood vessel abnormalities associated with these types of strokes and may include clamping of the aneurysm, inserting a coil into an aneurysm, surgical removal of an aneurysm, and performing a surgical bypass of intracranial blood vessels to improve blood flow.

Treatment for an ischemic stroke may include:

Emergency Procedures

A surgeon may use a catheter to insert a tiny device to break up or remove a clot and/or deliver clot-busting drugs directly into the area where a stroke is occurring.

Emergency Medications

Therapy with clot-busting drugs administered within three hours of a stroke’s development can be very effective in ensuring survival and reducing complications. Some people may also be give aspirin to reduce the likelihood of another stroke or an injection of recombinant tissue plasminogen activator (TPA), which restores blood flow by dissolving a clot.

Other Procedures

A surgeon may remove plaques from carotid arteries in the neck or insert a balloon to expand the artery and insert a stent to improve blood flow.

Complications

Strokes can cause complications including:

Changes in behavior and abilities: People who have had strokes may become more withdrawn or more impulsive. They may need help with grooming and performing everyday activities.

Difficulty speaking or swallowing: A stroke may affect the way the muscles in the mouth and throat move, making it difficult to speak clearly, eat or drink. Stroke sufferers may also have difficulties understanding speech, reading or writing. 

Emotional problems: People who have had strokes may become depressed or have trouble controlling emotions.

Memory or thinking problems: Many people experience some memory loss after a stroke and others may have trouble concentrating, making decisions, reasoning or understanding concepts.

Pain or abnormal sensations: Some people develop pain, numbness or tingling in areas of the body affected by the stroke or become more sensitive to temperature and touch.

Paralysis or loss of muscle movement: After a stroke, some people lose control of certain muscles or become paralyzed on one side of the face or body.