Ischemic Stroke

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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 are affected will depend on the part of the brain that is damaged.

Causes of Stroke

Two blood flow problems can cause a stroke:

  • A blocked blood vessel causes an ischemic stroke. This is the most common cause of stroke
  • A ruptured blood vessel causes a hemorrhagic stroke
diagram of ischemic stroke in the brain
Copyright © Nucleus Medical Media, Inc.

An ischemic stroke occurs when something stops the flow of blood, like:

  • A buildup or swelling of blood vessel walls
  • Something in the blood is stuck in the blood vessel

Blockage can result of one or more of the following:

  • Atherosclerosis
  • A blood clot that has traveled from other parts of the body such as the neck or heart
  • Inflammation of the blood vessels

Who is at Risk for Stroke?

People of African American, Hispanic or Asian/Pacific Islander descent are at increased risk.

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
  • Age: Older than 55 years of age
  • Family history of stroke

Medical conditions that can increase your risk of stroke include:

  • High blood pressure
  • High blood homocysteine level
  • Atherosclerosis
  • High cholesterol levels
  • Diabetes mellitus or impaired glucose tolerance
  • Atrial fibrillation
  • Blood disorders such as sickle cell disease and polycythemia
  • Disease of heart valves, such as mitral stenosis
  • Prior stroke or cardiovascular disease, such as heart attack
  • Peripheral artery disease
  • Transient ischemic attack (TIA) — a warning stroke with stroke-like symptoms that go away shortly after they appear
  • Conditions that increase your risk of blood clots such as:
    • Cancer
    • Pregnancy

Lifestyle factors that can increase your risk of stroke include:

  • Drug abuse from cocaine, amphetamines or heroin use
  • Smoking
  • Use of birth control pills, especially if you are over 35 years old and smoke
  • Long-term use of hormone replacement therapy
  • Physical inactivity

Stroke Symptoms

Symptoms occur suddenly. Exact symptoms 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 emergency medical services right away if you notice any of the following sudden symptoms:

  • Weakness or numbness of face, arm or leg, especially on one side of the body
  • Confusion
  • Trouble speaking or understanding
  • Trouble seeing in one or both eyes
  • Lightheadedness, trouble walking, loss of balance or coordination
  • Severe headache with no known cause

Diagnosing a Stroke

A doctor will examine you to look for for muscle weakness, visual and speech problems and movement difficulty.

Images may be taken of your bodily structures. This can be done with:

  • CT scan
  • MRI scan
  • Magnetic resonance angiography (MRA)
  • CT angiogram (CTA)
  • Doppler ultrasound

Blood tests can also help determine if there is a bleeding problem.

Stroke Treatments

A blocked blood vessel requires immediate treatment. This should restore blood flow to the brain tissue and stop further damage.

Treatment after immediate care aims to:

  • Reduce the chance of later strokes
  • Improve function affected by the stroke
  • Overcome disabilities

Supportive care may also include:

  • Oxygen therapy
  • Precautions to prevent choking

Medications: Thrombolytics & Others

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. 

Your doctor may recommend aspirin and other medications that decrease the risk of blood clot formation after immediate care is done. These medications may prevent future strokes from occurring.

To help manage other health issues and decrease the risk of future strokes your doctor may recommend medication to:

  • Decrease blood pressure
  • Correct irregular heart rhythms

Surgery for Stroke

To allow blood flow back into the affected area, you may require surgery, such as:

  • Embolectomy — your doctor threads a catheter through blood vessels to the clot; It can remove the clot or deliver clot-dissolving medication directly to the area.
  • Extracranial/intracranial bypass — blood vessel from the scalp reroutes blood supply around the blocked artery

A stroke can cause swelling in the brain. You may need decompressive surgery, such as craniotomy,  to relieve the pressure in the brain to prevent damage.

You might need more surgery following a stroke to prevent a recurrence. These surgical options include:

  • Carotid endarterectomy (CEA) — your doctor removes fatty deposits from major arteries in the neck
  • Carotid angioplasty and stenting — a procedure to widen and support the major artery in the neck with a mesh tube; This helps to open the artery and allow better blood flow.


Content was created using EBSCO’s Health Library. Edits to original content made by Rector and Visitors of the University of Virginia. This information is not a substitute for professional medical advice.