What is a Stroke - The Basics

As a Stroke neurologist I see a lot of ischemic strokes and hemorrhagic strokes. However, many patients tell me that they were not sure if they should call 911. That is because they did not recognize the symptoms of a stroke. So this is a basic guide about what is a stroke.

Let's begin...

What is a stroke? — Stroke is the term doctors use when a part of the brain dies because it goes without blood for too long. Strokes can happen when the blood supply to a part of the brain is cut off, because:

• An artery in the brain gets clogged or closes off, or
• An artery in the brain starts bleeding.

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 United States. 

How can you tell if someone is having a stroke? — There is an easy way to remember the signs of a stroke. Just think of the word “FAST”. Each letter in the word stands for one of the things you should watch for:

• 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 9-1-1. You need to act FAST. The sooner treatment begins, the better the chances of recovery.

How are strokes treated? — The right treatment depends on what kind of stroke you are having, ischemic stroke or hemorrhagic stroke. To figure this out, you need to get to the hospital quickly.

People whose strokes are caused by clogged arteries (ischemic stroke) can:

• Get stroke medications that break up blood clots. These stroke medications can help reopen clogged arteries.
• Get medicines that prevent new blood clots. These medicines also help prevent a second stroke.

People whose strokes are caused by bleeding (hemorrhagic stroke) can:

• Have treatments that reduce the damage caused by bleeding in or around the brain
• Stop taking medicines that increase bleeding, or take a lower dose
• Have surgery to repair the artery or stop the bleeding (this is not always possible to do)

Can strokes be prevented? — Yes. To lower your risk factors for stroke, you should:

• Lower your blood pressure, if it is high
• Keep your blood sugar as close to normal as possible, if you have diabetes
• Lower your cholesterol, if it is high
• Stop smoking, if you smoke
• Do something active 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

• Take your medicines exactly as directed. Medicines that are especially important in preventing strokes include:

• Blood pressure medicines
• Medicines to prevent blood clots, such as daily aspirin, warfarin (brand name: Coumadin), and other newer medications that deal with atrial fibrillation (afib) and stroke
• Medicines called statins, which lower cholesterol

Another way to prevent strokes is to have surgery to reopen clogged arteries in the neck. This surgery is appropriate for only a small group of people.

What is a “TIA”, or mini stroke? — A TIA, or mini stroke, 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.” (Check out "Transient ischemic attack" for more information on this very important disease)

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!

For those of you who need an in-depth review of Cerebrovascular Accidents and Stroke, I got you covered, check out “What is a Stroke –In-depth Overview”.