Stroke is a medical emergency in which blood flow to part of the brain is interrupted or a blood vessel in the brain ruptures, causing brain injury.
Stroke is one of the major causes of death and long-term disability. The two main categories are ischemic stroke, caused by blocked blood flow, and hemorrhagic stroke, caused by bleeding in or around the brain. The exact treatment depends on the stroke type, timing, location and overall health.
The brain receives blood through major arteries including the carotid and vertebrobasilar systems, which branch into cerebral vessels. Brain regions control movement, sensation, speech, vision, coordination, memory and other functions.
Ischemic stroke begins when a brain artery becomes blocked, commonly by a clot or atherosclerotic disease. Hemorrhagic stroke begins when a brain blood vessel ruptures and blood enters brain tissue or surrounding spaces.
A stroke occurs when brain tissue is deprived of adequate blood and oxygen because of a blocked blood vessel (ischemic stroke) or bleeding from a ruptured vessel (hemorrhagic stroke). Brain cells can be injured within minutes, so rapid assessment and treatment are critical.
Stroke is broadly classified as ischemic or hemorrhagic. Ischemic stroke includes thrombotic and embolic mechanisms. Hemorrhagic stroke includes intracerebral hemorrhage and subarachnoid hemorrhage.
The major types are ischemic stroke and hemorrhagic stroke. A transient ischemic attack (TIA) causes temporary neurological dysfunction from focal brain ischemia and is an important warning event requiring urgent evaluation.
Sudden weakness or numbness of the face, arm or leg, especially on one side
Sudden trouble speaking or understanding speech
Sudden vision loss or visual disturbance
Sudden dizziness, loss of balance or coordination
Sudden severe headache without a known cause
Sudden confusion or difficulty understanding
Sudden difficulty walking
Sudden difficulty swallowing
Common causes include blood clots, atherosclerotic narrowing of arteries, emboli from the heart, atrial fibrillation, small-vessel disease, uncontrolled hypertension and rupture of abnormal blood vessels.
High blood pressure
Diabetes mellitus
High cholesterol and atherosclerotic cardiovascular disease
Smoking or tobacco exposure
Atrial fibrillation and other heart disease
Obesity and physical inactivity
Previous stroke or transient ischemic attack
Diagnosis includes neurological examination and urgent brain imaging such as CT or MRI. Vascular imaging, ECG or heart monitoring, blood tests and other investigations may be used to determine the stroke mechanism and guide prevention.
Sudden facial asymmetry
Arm or leg weakness or numbness
Speech or language difficulty
Abnormal gait, balance or coordination
Visual-field or vision abnormality
Altered alertness or cognition
Abnormal neurological examination
Blood glucose
Complete blood count
Electrolytes and kidney function
Coagulation tests when clinically indicated
Lipid profile
Cardiac biomarkers when indicated
Other targeted blood tests based on suspected cause
Non-contrast CT brain
MRI brain
CT angiography or MR angiography
Carotid or other vascular ultrasound when indicated
Electrocardiogram
Continuous or prolonged cardiac rhythm monitoring
Echocardiography
Swallowing assessment
Specialist neurological and vascular evaluation
Transient ischemic attack
Low blood glucose
Seizure with postictal weakness
Migraine with neurological aura
Intracranial mass or other structural brain disease
Peripheral nerve or spinal disorders
Stroke is not usually staged like cancer. Clinicians instead assess onset, severity, affected brain region, stroke type, complications and functional disability. Rehabilitation progress is assessed using functional measures.
Staging or grading systems differ between diseases. The information here is educational and should be interpreted by a qualified healthcare professional in the context of the individual case.
Treatment depends on stroke type and timing. Ischemic stroke may be treated with intravenous thrombolysis in eligible patients and mechanical thrombectomy for selected large-vessel occlusions. Hemorrhagic stroke requires blood-pressure management, reversal of relevant anticoagulation when appropriate, management of raised intracranial pressure and sometimes surgery or endovascular treatment. Rehabilitation and secondary prevention are essential.
Antiplatelet therapy for appropriate ischemic stroke patients
Anticoagulation for selected cardioembolic conditions such as atrial fibrillation when appropriate
Blood-pressure-lowering medicines for secondary prevention
Statin therapy when indicated for vascular risk reduction
Glucose-lowering treatment when required for diabetes
Other medicines directed at specific complications or symptoms
Medicines listed here are for educational information only. Do not start, stop, or change a medicine without professional medical advice.
Possible complications include weakness or paralysis, speech and language problems, swallowing difficulty, aspiration pneumonia, seizures, cognitive changes, depression, falls, blood clots, pressure injuries and recurrent stroke.
Sudden facial drooping, arm weakness or speech difficulty
Sudden loss of vision or severe visual disturbance
Sudden severe dizziness with inability to walk or loss of coordination
Sudden severe headache with neurological symptoms
New seizure or sudden loss of consciousness
Any new sudden neurological deficit
If symptoms are severe, rapidly worsening, or life-threatening, seek emergency medical care immediately.
Outcome depends on stroke severity, location, age, medical conditions, complications and how quickly effective treatment begins. Some people recover substantially while others have persistent disability.
Survival statistics describe outcomes in groups of people and cannot predict exactly what will happen to one individual. Prognosis depends on factors such as cancer stage, tumor biology, treatment response, overall health, and follow-up.
Stroke affects people worldwide and is a major cause of death and disability. The burden is strongly associated with modifiable vascular risk factors, particularly hypertension.
The most important preventive measures are blood-pressure control, diabetes and cholesterol management, tobacco cessation, physical activity, healthy nutrition, appropriate weight management and treatment of atrial fibrillation or other cardiovascular conditions.
What type of stroke occurred and what caused it?
Was the stroke ischemic or hemorrhagic?
What did the CT or MRI show?
Is reperfusion treatment appropriate?
Do I need antiplatelet or anticoagulant treatment?
What rehabilitation therapies are recommended?
What symptoms should trigger emergency care?
How can my risk of another stroke be reduced?
BimariDur provides educational health information to help people understand diseases, symptoms, tests, and treatment concepts. It does not replace examination, diagnosis, or treatment by a qualified healthcare professional.
Do not delay professional medical care because of information read on BimariDur.