Stroke

What is a Stroke?

A stroke happens when blood flow to part of the brain is interrupted. Without oxygen and nutrients, brain cells begin to die within minutes. This can cause lasting brain damage, disability, or death.

If you think someone may be having a stroke, call 911 immediately. Quick treatment can save a life and improve recovery.

Types of Stroke

• Ischemic stroke – caused by a blood clot blocking a vessel in the brain (about 80% of strokes).
• Hemorrhagic stroke – caused by a ruptured blood vessel bleeding into the brain.
• Transient ischemic attack (TIA) – often called a “mini-stroke.” Symptoms are temporary, but a TIA greatly increases stroke risk.

Risk Factors

You may be more likely to have a stroke if you have:

• High blood pressure (primary risk factor)
• Diabetes
• Heart conditions, including atrial fibrillation
• Smoking habits
• Personal or family history of stroke or TIA
• Older age
• African American or Hispanic heritage

Other contributors include alcohol or drug use, physical inactivity, high cholesterol, obesity, and an unhealthy diet.

Symptoms

Stroke symptoms usually appear suddenly and may include:

• Numbness or weakness in the face, arm, or leg (often one side)
• Confusion, trouble speaking, or understanding speech
• Sudden vision problems
• Trouble walking, dizziness, or loss of balance
• Severe headache without known cause

Think F.A.S.T.:

• Face – one side droops when smiling
• Arm – one arm drifts downward when raised
• Speech – slurred or unusual speech
• Time – call 911 right away

Diagnosis

Providers may use:

• Medical history and physical exam (checking alertness, coordination, strength, and speech)
• Brain imaging tests (CT scan, MRI)
• Heart tests such as electrocardiogram (EKG) or echocardiogram

Treatment

Treatment depends on stroke type and stage:

Ischemic Stroke (blocked vessel):

• tPA medicine to dissolve clots (must be given within 4 hours of symptom onset)
• Blood thinners or antiplatelet medicines
• Procedures to open blocked carotid arteries

Hemorrhagic Stroke (bleeding):

• Blood pressure medicine if hypertension caused bleeding
• Surgery for aneurysm clipping, coil embolization, or AVM repair (surgery, injections, or radiation to stop bleeding)

Rehabilitation:

Therapies to regain lost skills and improve independence.

Prevention of another stroke:

Ongoing lifestyle changes and medicines to control blood pressure, cholesterol, or clotting risk.

Prevention

Steps to lower stroke risk include:

• Eating a heart-healthy diet
• Staying physically active
• Managing weight and stress
• Controlling blood pressure and cholesterol
• Quitting smoking

Medicines may also be needed to reduce risk factors.

NIH: National Institute of Neurological Disorders and Stroke (NINDS)

What is it?

An ischemic stroke occurs when a blood clot blocks a vessel in the brain. It is the most common type of stroke, accounting for about 80% of cases. When blood flow is interrupted, brain cells are deprived of oxygen and nutrients, causing damage within minutes. Quick treatment can save a life and improve recovery.

Causes

• Blood clots (thrombosis in brain arteries or embolism traveling from elsewhere)
• Atherosclerosis (plaque buildup inside arteries)
• Irregular heart rhythms such as atrial fibrillation
• Other blood or heart conditions (e.g., valve disease, sickle cell disease)
• Transient ischemic attack (TIA), or “mini-stroke,” signals increased risk of a full stroke

Symptoms

Symptoms appear suddenly and may include:

• Numbness or weakness of the face, arm, or leg (especially on one side)
• Confusion or trouble speaking/understanding
• Sudden vision problems
• Dizziness, loss of coordination, or difficulty walking
• Severe headache with no known cause

Think F.A.S.T.:

• Face drooping
• Arm weakness
• Speech slurred
• Time to call 911

Diagnosis

• Physical exam and symptom review
• Imaging tests (CT or MRI)
• Heart tests to identify clot sources

Treatment

• Medicines such as blood thinners or thrombolytics (to break up clots)
• Surgery or stenting to open narrowed arteries or remove plaque
• Rehabilitation to restore lost skills
• Medicines to control blood pressure, cholesterol, or diabetes

Prevention

• Heart-healthy lifestyle (diet, exercise, weight management, quitting smoking)
• Medicines to control risk factors when needed

NIH: National Institute of Neurological Disorders and Stroke (NINDS)

What is it?

A hemorrhagic stroke occurs when a blood vessel bursts and bleeds into or around the brain. Though less common than ischemic strokes, it is often more severe. The bleeding increases pressure in the skull, damaging brain tissue and causing rapid cell death.

Types

• Intracerebral hemorrhage: bleeding directly into brain tissue (most common type)
• Subarachnoid hemorrhage: bleeding between the brain and its outer coverings, often from a ruptured aneurysm

Causes

• Aneurysm (weakened, bulging artery wall that bursts)
• Arteriovenous malformation (AVM), an abnormal tangle of blood vessels
• High blood pressure (weakening vessel walls)
• Head trauma

Symptoms

Sudden onset of:

• Weakness or numbness on one side of the body
• Confusion, trouble speaking, or understanding speech
• Vision changes
• Dizziness, loss of balance, difficulty walking
• Severe headache with no known cause

Think F.A.S.T.:

• Face drooping
• Arm weakness
• Speech slurred
• Time to call 911

Diagnosis

• Medical history and physical exam
• Imaging tests (CT or MRI) to confirm bleeding

Treatment

• Medicines to lower blood pressure or manage other causes
• Surgery to stop bleeding, repair aneurysms/AVMs, or relieve brain pressure
• Rehabilitation to support recovery and independence

Prevention

• Managing blood pressure and cholesterol
• Heart-healthy habits (diet, physical activity, weight management

NIH: National Institute of Neurological Disorders and Stroke (NINDS)

What is Stroke Rehabilitation?

Stroke rehabilitation is a program designed to help people recover skills lost after a stroke. Since a stroke damages brain cells by cutting off blood flow, it can affect movement, speech, memory, and daily living skills. Rehabilitation focuses on regaining independence and improving quality of life.

Who Needs It?

Rehabilitation is recommended for anyone affected by a stroke. Most people who participate in a structured program recover better than those who do not. Disabilities vary depending on the area of the brain affected and may include:

• Paralysis or movement problems
• Pain or sensory issues
• Trouble with speech or language
• Memory and thinking challenges
• Emotional or behavioral changes

When to Begin

The sooner rehab starts, the better. In most cases, treatment begins within 24–48 hours after a stroke, often while the person is still in the hospital.

What Does It Include?

Stroke rehabilitation is tailored to each person’s needs. It may involve:

• Speech-language therapy – to improve speaking, understanding, reading, writing, or swallowing
• Physical therapy – to restore movement, strength, balance, and coordination
• Occupational therapy – to relearn daily activities such as bathing, eating, and dressing
• Cognitive therapy – to help with memory, problem-solving, learning, and planning
• Mental health counseling – therapy, medicine, or support groups to address emotional or behavioral issues
• Medicines – for pain, complications, or mental health conditions
• Vocational rehabilitation – to prepare for returning to school or work

Where It Happens

Depending on your needs, rehab may take place in:

• An inpatient rehabilitation clinic
• An outpatient facility
• A skilled nursing facility
• A home-based program

How Long It Lasts

Recovery speed varies by person. Some recover quickly, but most need long-term rehabilitation that adapts as their needs change. Motivation, family support, and consistent effort all play key roles in achieving the best results.

NIH: National Institute of Neurological Disorders and Stroke (NINDS)

What is a TIA?

A transient ischemic attack (TIA), often called a “mini-stroke,” happens when blood flow to the brain is blocked briefly. Symptoms mimic a stroke but usually resolve within an hour (and always within 24 hours).

Symptoms

Sudden onset of:

• Numbness or weakness (especially on one side)
• Confusion or trouble speaking/understanding
• Vision changes in one or both eyes
• Dizziness, imbalance, or difficulty walking

Because TIAs and strokes share symptoms, you must seek emergency care immediately.

Why It Matters

A TIA does not cause permanent damage, but it is a serious warning sign of a future stroke.

Prevention and Treatment

• Medicines – such as blood thinners or antiplatelet drugs to lower clot risk
• Surgery – may be recommended if the arteries are narrowed
• Lifestyle changes – quitting smoking, limiting alcohol, exercising, and following a healthy diet
• Managing health conditions – controlling high blood pressure, cholesterol, and diabetes

NIH: National Institute of Neurological Disorders and Stroke (NINDS)