Ischemic StrokeEn Español (Spanish Version)More InDepth Information on This Condition
Stroke is a brain injury caused by an interruption in blood flow. Brain tissue that does not get oxygen and nutrients from blood can die within minutes. The damage to the brain can cause a sudden loss in bodily functions. The types of function that is affected will depend on the part of the brain that is damaged.
There are two blood flow problems that cause a stroke. Strokes may be ischemic or hemorrhagic.
- An ischemic stroke is caused by a blocked blood vessel. It is the most common cause of stroke.
- A hemorrhagic stroke is caused by a ruptured blood vessel.
Hemorrhagic vs. Ischemic Stroke
Copyright © Nucleus Medical Media, Inc.
An ischemic stroke occurs when something stops the flow of blood. It may be a buildup or swelling of the walls of the blood vessels and/or something in the blood that becomes lodged in the blood vessel. A blockage in a small blood vessel will affect a smaller area of the brain. A blockage in larger blood vessels can block the flow of blood to several smaller blood vessels, leading to more brain damage.
The blockage may be the result of one or more of the following:
- Atherosclerosis—a build-up of fatty substances along the inner lining of the artery that gradually decrease the area the blood can flow through
- A blood clot that has traveled from other parts of the body such as the neck or heart
- Inflammation of the blood vessels
Factors that may increase your risk of stroke include:
- Sex: Men are more likely to have strokes than women but women are more likely to die of strokes than men
- African American, Hispanic or Asian/Pacific Islander descent
- Age: Risk of stroke increases with age particularly after 55 years of age.
- Family history of stroke
Medical conditions that can increase your risk of stroke include:
Lifestyle factors that can increase your risk of stroke include:
Symptoms occur suddenly. Exact symptoms will depend on the part of the brain affected. Rapid treatment is important to decrease the amount of brain damage. Brain tissue without blood flow dies quickly.
Call for medical help right away if you notice any of the following:
- Sudden weakness or numbness of face, arm, or leg, especially on one side of the body
- Sudden confusion
- Sudden trouble speaking or understanding
- Sudden trouble seeing in one or both eyes
- Sudden dizziness, trouble walking, loss of balance, or coordination
- Sudden severe headache with no known cause
The doctor will do a physical exam and look for muscle weakness, visual and speech problems, and movement difficulty. If possible, you will be asked about your symptoms and medical history. Your doctor may use a CT scan or MRI scan
of the brain to confirm a stroke or rule out other conditions.
Your doctor may also order tests that create detailed images of blood vessels. These test will help see which blood vessels may be creating the problem:
Blood tests can also help determine if there is a bleeding problem.
Immediate treatment is needed to open the blocked blood vessel. This should restore blood flow to the brain tissue and stop further damage.
Treatment after immediate care will aim to:
- Reduce the chance of later strokes
- Improve function affected by the stroke
- Overcome disabilities
Supportive care may also include:
Certain patients will receive a group of drugs called thrombolytics. These medications can rapidly dissolve blood clots. They are often given by IV but can be delivered directly to the arteries where the blood clot is. These medications need to be given within hours after the start of symptoms to be effective. That is why it is important to get medical help right away if stroke symptoms develop.
Aspirin and other medications that decrease the risk of blood clot formation may be recommended after immediate care is done. These medications may prevent future strokes from occuring.
To help manage other health issues and decrease the risk of future strokes the doctor may recommend medication to:
A surgery may be done to allow blood flow back into the affected area such as:
- Extracranial/intracranial bypass—blood vessel from the scalp is used to reroute blood supply around the blocked artery
- Embolectomy—a catheter is threaded through blood vessels to the clot. It can remove the clot or deliver clot-dissolving medicine directly to the area
A stroke can cause swelling in the brain. A decompressive surgery, such as craniotomy
, may be needed to relieve the pressure in the brain to prevent damage.
Other surgeries may be performed following a stroke to prevent a recurrence. These surgical options include:
If brain tissue was damaged, rehabilitation can be an important part of your recovery. Rehabilitation may include:
- Physical therapy—to regain as much movement as possible
- Occupational therapy—to assist in everyday tasks and self care
- Speech therapy—to improve swallowing and speech challenges
- Psychological therapy—to improve mood and decrease depression
Many of the risk factors for stroke can be changed. Lifestyle changes that can help reduce your chance of getting a stroke include:
- Exercise regularly.
. Limit dietary
- Stop smoking
- Increase your consumption of fish.
- Drink alcohol only in moderation (1-2 drinks per day).
- Maintain a healthy weight.
- Check blood pressure frequently
. Follow your doctor's recommendations for keeping it in a safe range.
- Take a low dose of aspirin (50-325 milligrams per day) if your doctor says it is safe.
- Keep chronic medical conditions under control. This includes high cholesterol and diabetes.
- Talk to your doctor about the use of a statins. These types of drugs may help prevent certain kinds of strokes in some people.
- Seek medical care if you have symptoms of a stroke, even if symptoms stop.
- Stop the use of recreational drugs (eg, cocaine, heroin, amphetamines).
American Heart Association
National Stroke Association
Heart and Stroke Foundation of Canada
Public Health Agency of Canada
Ischemic stroke. American Heart Association American Stroke Association website. Available at: http://www.strokeassociation.org/STROKEORG/AboutStroke/TypesofStroke/IschemicClots/Ischemic-Strokes-Clots_UCM_310939_Article.jsp. Accessed June 6, 2013.
Long term management of stroke. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed/what.php. Updated April 30, 2013. Accessed June 6, 2013.
Stroke (acute management). EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed/what.php. Updated May 2, 2013. Accessed June 6, 2013.
Nueroimaging for acute
stroke. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed/what.php. Updated May 15, 2013. Accessed June 6, 2013.
Furie KL, Kasner SE, Adams RJ, et al. Guidelines for the Prevention of Stroke in Patients With Stroke or Transient Ischemic Attack: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association.
. 2010 October 21. Available at:
. Updated October 21, 2010. Accessed September 4, 2012.
Signs and symptoms. National Stroke Association website. Available at:
A Accessed September 4, 2012.
Stroke (acute management). EBSCO Publishing DynaMed website. Available at:
. Updated August 30, 2012. Accessed September 4, 2012.
11/20/06 DynaMed's Systematic Literature Surveillance
: Mas JL, Chatellier G, Beyssen B, et al. Endarterectomy versus stenting in patients with symptomatic severe carotid stenosis.
N Engl J Med
12/16/2008 DynaMed's Systematic Literature Surveillance
: Farquhar C, Marjoribanks J, Lethaby A, Suckling J, Lamberts Q. Long term hormone therapy for perimenopausal and postmenopausal women.
Cochrane Database Syst Rev
10/9/2009 DynaMed's Systematic Literature Surveillance
: Mitchell PH, Veith RC, Becker KJ, et al. Brief psychosocial-behavioral intervention with antidepressant reduces poststroke depression significantly more than usual care with antidepressant: living well with stroke: randomized, controlled trial.
3/28/2011 DynaMed's Systematic Literature Surveillance
: Park Y, Subar AF, Hollenbeck A, Schatzkin A.
Dietary Fiber Intake and Mortality in the NIH-AARP Diet and Health Study.
Arch Intern Med
. 2011 Feb 14. [Epub ahead of print]
Last Reviewed June 2013