Stroke Symptoms and Treatment (cont.)
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.
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.
In this Article
- Stroke definition and facts
- What is a stroke?
- What is the NIH Stroke Scale?
- What are the risk factors for stroke?
- What are the warning signs and symptoms of a stroke?
- What are the signs and symptoms of a stroke?
- What is a transient ischemic attack (TIA)?
- What are the types of stroke?
- What causes a stroke?
- What tests diagnose stroke?
- What is the treatment for stroke?
- Is recovery after a stroke possible?
- What is stroke rehabilitation?
- What is the prognosis for a person that suffers a stroke?
- Which specialties of doctors treat stroke?
- Can strokes be prevented?
- Stroke FAQs
- Find a local Doctor in your town
What are the warning signs and symptoms of a stroke?
There may be no warning signs of a stroke until it occurs. It is why high blood pressure (hypertension), one of the risk factors for stroke, is called the silent killer.
Some patients may experience transient ischemic attack (TIA) that can be thought of as a stroke that has resolved itself. The symptoms may be mild or dramatic and can mimic a stroke with weakness, numbness, facial droop, and speech difficulties, but these symptoms may only last few minutes. TIAs should not be ignored since they may offer an opportunity to look for potentially reversible or controllable causes of stroke. As well, there is no guarantee that the symptoms of stroke will resolve on their own. For that reason, a TIA should be considered an emergency and medical care should be accessed immediately.
Amaurosis fugax describes the temporary loss of vision in one eye that occurs because of an embolus of blood clot or debris to the artery that supplies the eye. While it only involves vision, this situation should be considered a type of TIA.
What are the signs and symptoms of a stroke?
Symptoms of stroke depend upon what are of the brain has stopped working due to loss of its blood supply. Often, the patient may present with multiple symptoms including the following:
- Acute change in level of consciousness or confusion
- Acute onset of weakness or paralysis of half or part of the body
- Numbness of one half or part of the body
- Partial vision loss
- Double vision
- Difficulty speaking or understanding speech
- Difficulty with balance and vertigo
The symptoms of ischemic and hemorrhagic stroke may be the same but patients with hemorrhagic stroke may also complain more of headache and vomiting.
What is a transient ischemic attack (TIA)?
A transient ischemic attack (TIA, mini-stroke) is a short-lived stroke that gets better and resolves spontaneously. It is a short-lived episode (less than 24 hours) of temporary impairment of brain function that is caused by a loss of blood supply. A TIA causes a loss of function in the area of the body that is controlled by the portion of the brain affected. The loss of blood supply to the brain is most often caused by a clot that spontaneously forms in a blood vessel within the brain (thrombosis). However, it can also result from a clot that forms elsewhere in the body, dislodges from that location, and travels to lodge in an artery of the brain (emboli). Arterial spasm and, rarely, a bleed into brain tissue are other causes of a TIA. Many people refer to a TIA as a "mini-stroke."
Some TIAs develop slowly, while others develop rapidly. By definition, all TIAs resolve within 24 hours. Strokes take longer to resolve than TIAs, and with strokes, complete function may never return and reflect a more permanent and serious problem. Although most TIAs often last only a few minutes, all TIAs should be evaluated with the same urgency as a stroke in an effort to prevent recurrences and/or strokes. TIAs can occur once, multiple times, or precede a permanent stroke. A transient ischemic attack should be considered an emergency because there is no guarantee that the situation will resolve itself and function will return spontaneously without the help of medical intervention.
A TIA from a clot in the blood vessel that supplies the retina of the eye can cause temporary visual loss (amaurosis fugax), which is often described as the sensation of a black, dark curtain coming down. A TIA that involves the carotid artery (the largest blood vessel supplying the brain) can produce problems with movement or sensation on one side of the body, which is the side opposite to the actual blockage. An affected patient may experience temporary double vision; dizziness (vertigo); loss of balance; one-sided weakness or complete paralysis of the arm, leg, face or one whole side of the body; or be unable to speak or understand commands.
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