Stroke

A stroke is a life-threatening event that happens when blood flow to your brain stops. It requires emergency medical care from trained professionals. The health care teams at Atrium Health Floyd and Harbin Clinic have demonstrated excellence in stroke response. They work quickly to increase your chance of survival and recovery.

What is stroke?

A stroke occurs when blood doesn’t flow to the brain as it should. Brain cells need a constant supply of oxygen and nutrients. Within minutes of an interruption in blood flow, brain cells begin to die.

Stroke is the fifth leading cause of death in the U.S. and one of the top causes of disability in adults. Recognizing the signs of stroke and getting medical treatment as quickly as possible can improve the outcome.

Stroke types

There are two main types of stroke:

• Ischemic stroke: This type of stroke is caused by a blockage in a blood vessel in the brain, usually from a blood clot. Ischemic strokes account for nearly 90% of all strokes. In some cases, the blood flow to the brain is only briefly interrupted. This temporary stroke is called a transient ischemic attack (TIA) and may be a warning sign of a larger ischemic stroke.
• Hemorrhagic strokes: In this type of stroke, one or more blood vessels in the brain leak or burst, spilling blood into surrounding tissues. The bleeding causes swelling and increased pressure inside the skull, both of which can damage brain cells. A hemorrhagic stroke can occur near the surface of the brain (subarachnoid hemorrhage) or in deeper tissues (intracerebral hemorrhage).

Stroke symptoms

A stroke is a medical emergency. If you think someone is having a stroke, call 911. The greatest chance for recovery from a stroke occurs when emergency treatment is started as soon as possible.

Use “BE FAST” to help you recognize the signs of a stroke and act quickly:

• Balance: Does the person have a sudden problem with balance or coordination?
• Eyes: Are there vision changes, such as a loss of vision in one or both eyes, blurriness or double vision?
• Face: Is the face numb or drooping on one or both sides? You can check this by asking the person to smile.
• Arms: Does the person have weakness or numbness in one arm? Ask them to raise both arms – one arm may drift downward.
• Speech: Can the person speak? Are they slurring their words or difficult to understand when asked to repeat a simple phrase?
• Time: Call 911 immediately, even if these symptoms go away.

Causes of stroke

Ischemic and hemorrhagic strokes occur in different ways.

Causes of ischemic stroke and transient ischemic attack (TIA)

Blockages in the arteries of the brain are usually caused by plaque or blood clots. Plaque is a fatty substance that builds up on the inner walls of the arteries and hardens (atherosclerosis). Over time, the artery can become partially or completely blocked, causing:

• Carotid artery disease: Plaque builds up in the carotid arteries in the neck.
• Thrombosis: Plaque builds up in an artery in your brain.

In addition, pieces of plaque can break off, causing blood clots that block arteries. A stroke caused by a blood clot from somewhere else in your body (embolism) is called an embolic stroke. In some cases, other conditions cause blood clots by slowing blood flow in your heart or making blood more likely to clot.

Causes of hemorrhagic stroke

Hemorrhagic stroke usually occurs when the walls of the blood vessels become weak. Conditions associated with hemorrhagic stroke include:

• Aneurysm: A bulging area in an artery
• Arteriovenous malformations (AVMs): A tangle of blood vessels that can leak or burst
• High blood pressure: High pressure that can cause a blood vessel, especially one that’s weak from an aneurysm or AVM, to break open

Stroke diagnosis

Doctors conduct rapid assessments in the emergency department if they suspect a stroke. They review your symptoms and medical history as well as perform a physical exam. When time is critical, a CT scan is a quick way to check the blood vessels in your brain. Your doctor may also order blood tests and other imaging studies.

Stroke risk factors

Certain traits, such as older age and male gender, increase stroke risk. You’re also at higher risk if you have a family history of stroke or are Black, American Indian or Alaska Native.

Diseases and lifestyle habits that increase your chance of having a stroke include:

• Brain aneurysms and AVMs
• Diabetes
• Heart disease
• High blood pressure
• High cholesterol
• Previous stroke
• Smoking

The more risk factors you have, the more likely you are to have a stroke.

Stroke prevention

While you can’t control all stroke risk factors, you can change some, such as smoking and high blood pressure. Following a healthy lifestyle can reduce your risk of stroke. You may also need to take medicines to better manage a health condition.

Stroke treatment 

The main treatment for ischemic strokes is a clot-dissolving (thrombolytic) drug. This drug must be given within three hours of symptom onset.

For hemorrhagic strokes, treatment includes medications to reduce swelling and surgery to repair the damaged blood vessel. Minimally invasive procedures are often used in place of surgery. These procedures access the hemorrhage through a small incision in your wrist or groin.

Atrium Health Floyd Medical Center is certified as a Primary Stroke Center, treating patients within one hour of arrival at the hospital. Atrium Health Polk Medical Center is a certified Acute Stroke Ready Hospital. This designation means we quickly treat and stabilize patients prior to sending them to a higher-level stroke center.

The effects of a stroke depend on where in the brain the stroke occurs and how quickly blood flow is restored. Some people recover fully while others have lifelong disabilities. Ongoing care, neurorehabilitation and emotional support can help you recover and may help prevent another stroke.