Stroke
Benjamin Wedro, MD, FACEP, FAAEM
Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Charles Patrick Davis, MD, PhD
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
- Stroke facts
- What is a stroke?
- What causes a stroke?
- What are the risk factors for stroke?
- What is a transient ischemic attack (TIA)?
- What is the impact of strokes?
- What are stroke symptoms?
- What should be done if you suspect you or someone else is having a stroke?
- How is a stroke diagnosed?
- What is the treatment of a stroke?
- What complications can occur after a stroke?
- What can be done to prevent a stroke?
- What is in the future for stroke treatment?
- Stroke FAQs
- Patient Comments: Stroke - Symptoms
- Patient Comments: Stroke - Therapy
- Patient Comments: Stroke - Risk Factors
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Stroke facts
- Stroke is the sudden death of brain cells due to lack of oxygen.
- Stroke is caused by the blockage of blood flow or rupture of an artery to or in the brain.
- Sudden tingling, weakness, or paralysis on one side of the body or difficulty with balance, speaking, swallowing, or vision can be a symptom of a stroke.
- Any person suspected of having a stroke or TIA should present for emergency care immediately.
- Clot-busting drugs like tPA can be used to reverse a stroke, but the time frame for their use is very narrow. Patients need to present for care as soon as possible so that tPA therapy can be considered.
- Stroke prevention involves minimizing risk factors, such as controlling high blood pressure, elevated cholesterol, tobacco abuse, and diabetes.
What is a stroke?
Brain cell function requires a constant delivery of oxygen and glucose from the bloodstream. A stroke occurs when blood supply to part of the brain is disrupted, leading to inadequate oxygen supply and causing brain cells to die. Blood flow can be compromised in a variety of ways. Stroke is also referred to as cerebrovascular accident (CVA).
Blockage of an artery
- Narrowing of the small arteries within the brain can cause a lacunar stroke (lacune means "empty space"). Blockage of a single arteriole can affect a tiny area of brain causing that tissue to die (infarct).
- Hardening of the arteries (atherosclerosis) leading to the brain. There are four major blood vessels that supply the brain with blood. The anterior circulation of the brain's two cerebral cortices controls most motor activity, sensation, thought, speech, and emotion is supplied by the two carotid arteries. The posterior circulation, which supplies the brainstem and the cerebellum, controlling the automatic parts of brain function and coordination, is supplied by the two vertebrobasilar arteries.
If these main arteries become narrowed as a result of atherosclerosis, plaque or cholesterol debris can break off and float downstream, clogging the blood supply to a part of the brain. As opposed to lacunar strokes, larger parts of the brain can lose blood supply, and this may produce more symptoms, with loss of brain and body function, more than seen with a lacunar stroke.
- Embolism to the brain from the heart. In some instances a thrombus or blood clot can form within the heart and the potential exists for them to break off and travel (embolize) to the arteries in the brain and cause a stroke. Atrial fibrillation, an irregular heart rhythm, is the most common cause of thrombus formation.
Rupture of an artery (hemorrhage)
- Cerebral hemorrhage (bleeding within the brain substance). The most common reason to have bleeding within the brain is uncontrolled high blood pressure. Other situations include aneurysms that leak or rupture or arteriovenous malformations (AVM) in which there is an abnormal collection of blood vessels that are fragile and can bleed.
Next: What causes a stroke?
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