If you or someone you know is experiencing symptoms of a stroke, seek emergency medical care right away. Time is critical to reduce damage and improve outcomes.
In ischemic stroke, blood flow to the brain is stopped by a clot. It can be a clot that forms inside an artery or breaks off from another part of the body and travels to an artery in the brain.
Ischemic Stroke
There are two main types of stroke, ischemic vs hemorrhagic stroke. Both types require immediate medical attention.
This is usually because of a blood clot that forms in a blood vessel that leads to the brain. Blockage in an artery due to the buildup of fatty deposits inside can cause narrowing and atherosclerosis.
Other causes of an ischemic stroke include heart disease, atrial fibrillation, blood clotting disorders, and blood pressure that’s too low (hypotension). Symptoms of an ischemic stroke may sometimes go away and come back, which is a sign of a temporary type of stroke called a transient ischemic attack, or TIA.
Hemorrhagic Stroke
A hemorrhagic stroke is a type of stroke that happens when there is bleeding inside the brain instead of a clot blocking blood flow. It occurs due to the rupture of a blood vessel in the brain, which leads to increased pressure on the brain tissue. The pressure can harm and even cause the death of brain cells.
Like ischemic stroke, hemorrhagic stroke can be prevented by lowering your risk factors. Hemorrhagic strokes can also be treated with medicine that dissolves a blood clot, like tPA, but it must be given within 4.5 hours after the symptoms start to improve your outcome. Hemorrhagic strokes may also be treated with surgery or by reducing the bleeding by boosting your body’s clotting processes or decreasing your blood pressure. It can be hard to do because the bleeding often happens inside your brain.
Symptoms
Ischemic strokes happen when a blood clot prevents oxygen-rich blood from reaching brain cells. It can be caused by a burst plaque in an artery (an atherosclerosis-related stroke) or a clot that breaks off from elsewhere in the body — often because of a heart disorder, such as atrial fibrillation or a heart valve defect.
If you have an ischemic stroke, call 999 immediately. Treatment within 6 hours can sometimes help reduce damage by removing the clot and saving undamaged tissue.
Doctors diagnose a stroke with imaging tests, such as computed tomography (CT) or magnetic resonance imaging (MRI). They also check for symptoms of other conditions that can cause a stroke, such as diabetes and a low blood sugar level (hypoglycemia). Medications that break up or prevent blood clots and make the blood less likely to clot are usually prescribed.
Diagnosis
The most common type of stroke, ischemic strokes, happen when blood clots prevent oxygen-rich blood from reaching brain tissue. This is often caused by atherosclerosis (clogged arteries) or other conditions that lead to narrowing of the artery walls over time.
Symptoms of hemorrhagic stroke can include severe headache, neck stiffness, and seizures. The type of hemorrhagic stroke a person has determines the treatment they receive.
A person with a hemorrhagic stroke needs prompt treatment to minimize bleeding in other parts of the body. They might be given a clot-dissolving medication, called a thrombolytic medicine (e.g., tPA or alteplase), within 4.5 hours of the start of symptoms. Other blood thinners and clot removal surgery may be used as well.
Treatment
Distinguishing between ischemic and hemorrhagic stroke is essential to help plan treatment. Doctors can use simple clinical findings but also need diagnostic imaging.
When someone has an ischemic stroke, doctors give them a medication called tissue plasminogen activator (tPA) to dissolve the blood clot that’s blocking blood flow in their brain. They must provide this medication within 4.5 hours of the start of their symptoms to get the best results.
Doctors may use a stent retriever to remove a clot from the brain. This is an endovascular procedure performed by a trained specialist who threads the device through the blood vessels to the clot. It is usually only done in hospitals that have expertise in both stroke treatments and this type of surgery.