Symptoms
Symptoms of an ischemic stroke appear suddenly and can include:
Sudden numbness or weakness of the face, arm, or leg (especially on one side of the body)
Sudden trouble speaking or understanding speech
Sudden trouble seeing in one or both eyes
Sudden dizziness, loss of balance, or coordination
Sudden severe headache with no known cause Think FAST:
Face drooping: Does one side of the face droop or is it numb? Ask the person to smile.
Arm weakness: Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
Speech difficulty: Is speech slurred?
Time to call 911: If someone shows any of these symptoms, even if they go away, call 911 immediately.
Causes
The primary cause is a blockage in an artery supplying blood to the brain. This blockage is most often caused by:
Thrombosis: A blood clot forms in an artery that supplies blood to the brain. This can occur in arteries damaged by atherosclerosis (plaque buildup).
Embolism: A blood clot or other debris forms elsewhere in the body (usually the heart) and travels through the bloodstream to the brain, where it lodges in a smaller artery.
Other less common causes: These may include blood clotting disorders, vasculitis (inflammation of blood vessels), or dissection (a tear in the wall of an artery). Risk factors for ischemic stroke include:
High blood pressure
High cholesterol
Heart disease (atrial fibrillation, coronary artery disease)
Diabetes
Smoking
Obesity
Family history of stroke
Age (risk increases with age)
Race (African Americans are at higher risk)
Medicine Used
Tissue plasminogen activator (tPA): This is a clot-busting drug (thrombolytic) that can dissolve the clot if administered within 4.5 hours of symptom onset. It is the standard treatment for ischemic stroke when appropriate.
Aspirin: Aspirin may be given to help prevent further clot formation.
Other antiplatelet drugs: Such as clopidogrel.
Anticoagulants: Such as warfarin or newer oral anticoagulants (NOACs) are used to prevent future clots, especially in individuals with atrial fibrillation or other heart conditions.
Medications to control risk factors: These include blood pressure medications, cholesterol-lowering drugs (statins), and diabetes medications.
Is Communicable
No, ischemic stroke is not a communicable disease. It is not caused by an infectious agent and cannot be spread from person to person.
Precautions
Prevention focuses on managing risk factors:
Control blood pressure: Regular monitoring and medication if needed.
Lower cholesterol: Diet, exercise, and statins if necessary.
Manage diabetes: Diet, exercise, and medication if needed.
Quit smoking: Smoking significantly increases stroke risk.
Maintain a healthy weight: Diet and exercise.
Eat a healthy diet: Low in saturated and trans fats, cholesterol, and sodium. High in fruits, vegetables, and whole grains.
Exercise regularly: Aim for at least 30 minutes of moderate-intensity exercise most days of the week.
Treat atrial fibrillation: Anticoagulation therapy is often recommended.
Limit alcohol consumption: Excessive alcohol intake increases stroke risk.
Regular check-ups with your doctor.
How long does an outbreak last?
Ischemic stroke is not an infectious disease and therefore does not have outbreaks. This question does not apply. Recovery time from a stroke, if any, varies greatly.
How is it diagnosed?
Diagnosis typically involves:
Physical and Neurological Exam: Assessing reflexes, strength, sensation, vision, coordination, and mental status.
Brain Imaging:
CT scan: Often the first imaging test to rule out hemorrhage (bleeding in the brain).
MRI: Provides more detailed images of the brain and can detect smaller strokes.
Blood Tests: To check blood sugar, cholesterol levels, clotting factors, and other relevant markers.
Electrocardiogram (ECG/EKG): To check for heart problems, such as atrial fibrillation.
Carotid Ultrasound: To assess for narrowing of the carotid arteries in the neck.
Cerebral Angiogram: X-ray of the blood vessels in the brain using contrast dye.
Timeline of Symptoms
Symptoms appear suddenly. The timeline can be summarized as follows:
Minutes: Brain cells begin to die due to lack of oxygen. The sooner treatment is initiated, the better the outcome.
Hours: Symptoms are at their worst initially. Treatment is most effective within the first few hours (especially within the 4.5-hour window for tPA).
Days/Weeks/Months: After initial treatment, the focus shifts to rehabilitation and preventing future strokes. Some improvement in function may occur over time with therapy, but the extent of recovery varies greatly. The speed of recovery is most rapid in the initial days and weeks, then slows over months.
Important Considerations
Time is critical: The faster treatment is received, the better the chance of recovery. Call 911 immediately if you suspect someone is having a stroke.
Individualized treatment: Treatment plans are tailored to the individual based on the cause and severity of the stroke, as well as other medical conditions.
Rehabilitation is essential: Physical therapy, occupational therapy, and speech therapy can help individuals regain lost function.
Long-term management: Lifelong attention to risk factor control is crucial to prevent future strokes.
Psychological support: Stroke can have a significant impact on mental health. Counseling and support groups can be helpful.
Communication is key: Open communication between the patient, family, and medical team is essential for optimal care.