Ischemic Stroke (Clots): Causes, Symptoms, and Treatment (2023)

general description

What is an ischemic stroke?

Ischemic stroke is a life-threatening medical condition that occurs when there is a lack of blood flow to a part of the brain. They usually occur due to blood clots, but they can occur for other reasons as well.

Ischemia (pronounced "iss-key-me-uh") occurs when cells in the body do not have enough blood flow, causing them to die. When this happens in areas of the brain, the abilities controlled by those areas of the brain are lost. If these brain cells die, it can lead to permanent brain damage and even death.

IMPORTANT:A stroke is a life-threatening condition where every second counts. If you or someone with you has symptoms of a stroke, you should do thisIMMEDIATELYCall 911 (or your local emergency services number). The longer treatment lasts, the more likely a stroke will cause permanent brain damage or death.

To recognize the warning signs of a stroke, be sure to think aboutFAST:

• F face. Ask that person to smile. Look for drooping on one or both sides of the face, which is a sign of muscle weakness or paralysis.
• and like an arm. A stroke survivor often has muscle weakness on one side. Ask them to raise their hand. If you have a one-sided weakness (and you didn't before), one arm will stay higher while the other will hang down and down.
• s of speech. Strokes often result in loss of the ability to speak. They may stutter when speaking or have trouble finding the right words.
• t It's on time. Time is critical, so don't wait for help! If possible, look at your watch or watch and remember when the symptoms start. Telling your healthcare professional about your symptoms can help you determine which treatment options are best for you.

What is the difference between an ischemic stroke and a hemorrhagic stroke?

Ischemic stroke involves blockage of blood flow in the brain. Hemorrhagic stroke involves bleeding in or around the brain that disrupts blood flow.

Who is affected?

Ischemic stroke is more common in people who have a problem that affects blood flow to the brain. These problems tend to be age-related, so ischemic strokes are more common in older people.

Approximately two-thirds of all strokes occur in people over the age of 65. However, younger people are still at risk of ischemic stroke. There are also certain medical conditions that can cause this type of stroke or make it more likely that it will occur.

How common is ischemic stroke?

Strokes are very common. Worldwide, stroke is the second leading cause of death. In the United States they rank fifth. Strokes are also one of the leading causes of disability worldwide. Ischemic strokes account for approximately 85% of all strokes.

How does this condition affect my body?

An ischemic stroke is the cerebral version of a heart attack. When you have an ischemic stroke, part of your brain doesn't get enough blood. Brain cells need blood flow to supply them with oxygen, essential nutrients, and more.

Different areas of the brain control specific abilities. Stroke symptoms occur because brain cells in the affected area of ​​the brain do not receive enough blood flow, so they stop working as they should and begin to die. If the blood isn't restored fast enough, many brain cells in that area die, and you permanently lose any ability they control. In severe cases or those left untreated for too long, it can also lead to death.

symptoms and causes

What are the symptoms of an ischemic stroke?

Symptoms of an ischemic stroke may include one or more of the following:

• Unilateral weakness orparalysis.
• Aphasia(difficulty or loss of ability to speak).
• Slurred or distorted speech (dysarthria).
• Loss of muscle control on one side of the face or face drooping.
• Sudden loss -partial or complete- of one or more senses (vision,audience,smell,gustoand touch).
• blurred ordouble vision (diplopia).
• Loss of coordination or clumsiness (ataxia).
• Dizzinesslubricantdizziness.
• nausea and vomiting.
• Neck numbness.
• Emotional instability and personality changes.
• Confusion or agitation.
• Memory loss (amnesia).
• Headaches (usually sudden and severe).
• fainting or fainting.
• Coma.

Transient ischemic attack (TIA)

Atransient ischemic attack (TIA)(sometimes called a "mini-stroke") resembles an ischemic stroke, but its effects are temporary and usually go away on their own. These are often warning signs that a person is at very high risk of having an actual stroke soon. For this reason, a person suffering from TIA needs urgent medical attention as soon as possible.

What causes ischemic strokes?

Ischemic strokes usually involve certain processes. These are:

• Formation of blood clots in the brain (thrombosis).
• A piece of a clot that has formed in another part of the body that breaks free and travels through the blood vessels to lodge in the brain (embolism).
• Obstruction of small vessels (lacunar infarction).
• Unknown causes (these are cryptogenic strokes; the word "cryptogenic" means "hidden origin").

Blood clots and other forms of ischemia can occur for a number of reasons, including:

• atherosclerosis.
• Coagulation disorders.
• atrial fibrillation(especially when it's for a reasonSleep apnea).
• heart defects (atrial septal defectlubricantventricular septal defect).
• Microvascular ischemic disease(which can block smaller blood vessels in the brain).
• Fat emboli, that is, groups of fat particles that circulate in the blood and have become stuck in the blood vessels of the brain.
• Infected tissue entering the bloodstream and reaching the brain where it becomes clogged and blocks a blood vessel (this is a major complication).septicemiadeadly overreaction of the immune system to an infection that spreads through the body).

Related terms

There are other conditions and circumstances that may not directly cause a stroke, but nevertheless affect the risk or severity of the stroke. They include:

• alcohol use disorder.
• High blood pressure (can contribute to blood vessel damage, making you more likely to have an ischemic stroke).
• High cholesterol (hyperlipidemia).
• Type 2 diabetes.
• from smokingand other forms of tobacco use (includingvapearand smokeless tobacco).
• Recreational drug use or misuse of prescription drugs.

Is ischemic stroke contagious?

Ischemic strokes are not contagious and cannot be passed from person to person.

Diagnosis and tests.

How is an ischemic stroke diagnosed?

A health professional can diagnose a stroke based on a combination of a neurological exam, diagnostic imaging, and other tests. For a neurological exam, the doctor will ask you to move your arms, feet, legs, eyes, and head in certain ways and answer some questions. As you perform these tasks or answer these questions, the provider will look for signs or clues that indicate a problem with the work of various areas of the brain. This can help them determine if you are having a stroke and can even tell you where in the brain it is happening.

What tests will be done to diagnose an ischemic stroke?

The most common tests performed by a healthcare professional when a suspected ischemic stroke is diagnosed include:

• Computed tomography (CT)..
• Laboratory blood tests (to look for signs of infection or damage to the heart, check blood clotting ability and blood sugar levels, assess kidney and liver function, etc.).
• Electrocardiogram (abbreviated ECG or ECG)to make sure the cause of the problem is not a heart problem.
• Magnetic resonance imaging (MRI) scans..
• Electroencephalogram (EEG), although less common, can rule out seizures or related problems.

Management and treatment

How is ischemic stroke treated?

The main priority in ischemic stroke is to restore circulation to the affected areas of the brain. This is because rapid restoration of circulation can limit damage and preserve brain tissue. The less permanent the brain damage, the more likely it is that you will retain all or most of the abilities you had before the stroke.

Is there something I should not eat or drink with this disease?

If you are at risk of having a stroke, your doctor can do thisRecommend changing your diet to maintain or lower your blood pressure.It can also help control blood sugar and cholesterol levels. This dietary change includes avoiding or reducing:

• Caffeinated beverages such as coffee, tea, soft drinks, etc.
• Foods high in salt or sodium that can increase blood pressure (consume no more than 2 grams per day, or less if your doctor recommends less).
• Foods rich in refined sugars.
• Highly processed foods like sausages.
• Foods rich in saturated fat, such as fried foods, etc.
• Alcohol or recreational stimulants (marijuana, cocaine, amphetamine/methamphetamine, etc.).

What medications or treatments are used?

Treatment of ischemic stroke largely depends on the time elapsed since the onset of stroke symptoms. This is one of the main reasons why it's so important not to delay going to the ER if you have stroke symptoms.

thrombolytic drugs

thrombolytic drugsthey are possible in the first three to four and a half hours after the onset of stroke symptoms. These drugs dissolve existing clots (their name is a combination of the Greek words 'thrombus' meaning 'clot' and 'lysis' meaning 'to loosen/dissolve'). However, they are only an option within three to four and a half hours, as they increase the risk of dangerous bleeding complications after this time.

Intravascular mechanical thrombectomy

This is a procedure in which a clot is removed from the brain using a catheter.thrombectomymeans "operation to remove a blood clot." The term "endovascular" means "within the blood vessels." Thrombectomy procedures are also urgent and are usually only possible within the first 24 hours after the onset of symptoms.

During this procedure, a healthcare professional will insert a small, tubular device called a catheter into a major blood vessel somewhere in the body. Once the catheter is in the vessel, the doctor will insert it into the clot in the brain. Once the tip of the catheter reaches the clot, you can either aspirate it directly or break the clot and suction out the fragments.

Supportive treatments and other methods.

Here are some examples:

• mild hypothermia: Brain cells die more easily when the body temperature is higher. Lowering body temperature increases the resistance of brain cells to damage caused by a stroke.
• blood sugar management: Brain cells need glucose, a type of sugar, for fuel. Too little glucose in the blood slows down the regeneration of the brain. However, too much glucose in the blood can also cause problems with the brain's ability to repair itself.
• anticoagulants: This includes giving medicines to keep your blood from clotting too easily. This is only one option for ischemic strokes caused by blood clots, as they can make a hemorrhagic stroke much worse.
• Oxygen: Stroke reduces the amount of oxygen available in the blood, which means the brain has less oxygen to use. Providing extra oxygen to breathe makes it easier for the body to deliver oxygen to the brain.

Rehabilitation after a stroke

It is common for there to be lingering effects of the stroke in the days and months after the stroke. For many, the effects of a stroke will be slightly worse in the first few days after the stroke and then wear off.

Because people often experience long-term problems after a stroke, rehabilitation and therapy methods that help people recover from a stroke are common. In some cases, therapy simply helps you return to the state you were in before your stroke. In other cases, this type of therapy can help you relearn certain activities.

Your brain has an amazing ability called "neuroplasticity" (pronounced "new-row-plass-tiss-it-ee"). This means that your brain can adapt and change when necessary. In some cases, your brain will "remap" the ability, transferring control over it to the unaffected part of your brain. Many stroke therapies take advantage of this ability and speed up the process.

Rehabilitation after a stroke can take many forms, including:

• Speech therapy: This type of therapy focuses on the parts of the brain responsible for the ability to speak and understand others when they speak. It can also help with any weakness or loss of ability to control the muscles in the mouth and throat. Speech therapy can help with speaking, as well as with breathing, swallowing, eating, and drinking.
• physical therapy: This therapeutic approach focuses on improving the strength and control of muscles, especially the muscles of the arms, hands, legs, and feet. This type of therapy can help you regain skills such as walking, dressing, and eating. It can also help with adjustment if you lose any skills permanently or long-term.
• Cognitive therapy: This type of therapy helps to strengthen the mind, especially the ability to think, concentrate and remember.

Other treatments are possible, depending on the case and the circumstances. Your doctor is the best person to tell you what treatment might help you.

Complications/side effects of treatment.

Possible side effects or complications can vary depending on the part of the brain where the stroke occurred, the treatment given, medical history, and many other factors. Your doctor can tell you more about what side effects you can or should expect and what you can do to manage or even prevent them.

How can I take care of myself and control my symptoms?

Stroke is a life-threatening condition, so don't try to diagnose it yourself. If you or someone with you has symptoms of a stroke, it is very important that you call 911 (or your local emergency services number) immediately. Any delay in stroke treatment increases the risk of permanent brain damage and even death.

How soon will I feel better after treatment?

The time it takes to feel better after treatment and the time it takes to recover from a stroke can vary from person to person. This is because many factors affect how you feel over time. If you have questions about your likely treatment and recovery schedule, your doctor is the best person to answer your questions and provide you with the most accurate information for your situation.

Prevention

How can I reduce my risk of an ischemic stroke or prevent it altogether?

There are many things you can do to reduce your risk of ischemic stroke. While this doesn't mean you can prevent a stroke, it can reduce your risk: Actions you can take include:

• Improve your lifestyle. Eating a healthy diet and adding exercise to your daily routine can improve your lifestyle. You should also make sure you get enough sleep (the recommended amount is seven to eight hours).
• Avoid risky lifestyle choices or make changes to your behavior.. Smoking and tobacco use, including vaping, recreational or prescription drug abuse, and alcohol abuse, can increase the risk of stroke. It is important to stop them or never start them. If you have problems with any of these, it's important to talk to your doctor. Your provider can offer tips and resources to help you change your lifestyle and avoid these behaviors.
• Manage your health problems and risk factors.. There are several medical conditions such as obesity, abnormal heart rhythms, sleep apnea, high blood pressure, type 2 diabetes, or high cholesterol that can increase the risk of ischemic stroke. If you have one or more of these conditions, it is very important that you do everything you can to manage them, especially by taking your medications, such as blood thinners, as prescribed by your doctor. By doing this early in life, you can avoid serious stroke problems later in life.
• Visit your primary care doctor for a checkup or wellness visit every year.. Annual visits to a wellness center can detect health problems, especially those that contribute to a stroke, long before any symptoms appear.

Perspectives / Forecasts

What can I expect if I have an ischemic stroke?

If you have had a stroke, many factors affect what you can expect. These include, but are not limited to, the size of the stroke and the specific areas of the brain it affects. In general, the older the stroke, the more severe the symptoms. Larger strokes are also associated with a higher risk of adverse outcomes. Some strokes may be minor, but can still be serious if they affect a critical area of ​​the brain. An example of this is a stroke, which affects the areas of the brain that control the ability to speak. These can seriously disrupt your life, but are less likely to be life-threatening.

The more severe an ischemic stroke is, the more likely it is to lose some abilities, at least temporarily. Larger strokes are also more likely to cause permanent damage or death. That is why it is so important to seek medical help quickly. The sooner you receive medical attention for stroke symptoms, the more likely these effects will be temporary or less severe.

Stroke can occur very differently from person to person. While there are many similarities in the course and symptoms of stroke, not all cases are the same. For this reason, your doctor is the best person to tell you what you can and should expect.

How long does an ischemic stroke last and when can I go back to school, work or my daily activities?

Even after the stroke has been treated and blood flow has returned to the affected areas of the brain, you may experience lasting effects. Some of these effects are short-lived and will go away in the next few days, but others may last weeks or months before improving. Some effects may be permanent. Your doctor is the best person to tell you how long to expect to feel the effects of a stroke, but this can still be hard to predict and can vary greatly from person to person.

What is the prognosis for this condition?

The prognosis of ischemic stroke can vary greatly from person to person. This is because many factors affect how this disease affects you. In general, getting care quickly increases the chances of getting a better outcome. Your doctor is the best person to tell you what your outlook is based on your specific situation.

Want

How to take care of yourself after an ischemic stroke?

If you have an ischemic stroke, your doctor will provide information and resources that can help you recover. They may recommend that you take certain medications, especially blood thinners, to help prevent another stroke.

The best things you can do to take care of yourself after a stroke are:

• Take your medications as directed. This can help prevent another stroke.
• See your provider as directed and schedule treatment/rehabilitation appointments.. These types of visits can be very helpful during recovery from a stroke. Doing your best during these sessions can also speed up your recovery or help you regain more of your skills than you would otherwise.
• Don't neglect your mental health. Stroke survivors often battle depression, anxiety, and other mental health issues. It is important to see your doctor for care about these effects.
• If possible, make the recommended lifestyle changes.. Changing your lifestyle in small but significant ways can make a big difference in preventing another stroke.

When should I see my doctor?

Your doctor will schedule follow-up appointments for you. You should also call or see them if you notice any changes or symptoms that may be related to your stroke. You should also talk to them if you notice symptoms or problems that are interfering with your life or routine, even if those symptoms are not related to your stroke or don't seem very important.

When should I go to the emergency room?

You should call 911 (or your local emergency services number) and go to the nearest emergency department if you have any symptoms of another stroke (seeFASTcriteria that appear at the beginning of this article on the symptoms to take into account).

You should also go to the hospital if you have any of the symptoms of the dangerous complications that often occur after a stroke. The most common complicated diseases include:

• Pneumonia.
• Deep vein thrombosis (DVT).
• pulmonary embolism.
• Myocardial infarction.
• attacks.

Frequent questions

How serious is an ischemic stroke?

Ischemic strokes are a life-threatening condition. It is important to seek medical help right away if you notice symptoms of one of these symptoms or if you are with someone who has these symptoms.

Note from the Cleveland Clinic

Ischemic stroke is a life-threatening condition that requires immediate attention. These types of strokes can have sudden and frightening symptoms. Fortunately, there are many things you can do to prevent this or reduce the risk of it happening.

If you notice that you have these symptoms or are with someone who does, it is important to seek medical attention immediately. With prompt medical attention, many people recover from ischemic stroke and regain most or all of their abilities.