Your brain is the control center for your whole body. It lets you see, hear, taste, smell, feel, think and move around. Each area has special tasks to do, and some areas work together to get their jobs done. When your heart beats, it sends blood through arteries and veins to every part of your body. Blood carries oxygen to brain cells through arteries in and around the brain. Oxygen keeps the brain cells alive and working well.
Brain cells die when the brain’s blood flow stops or leaks into the wrong place. This is called a stroke. Brain cells that die will not recover (permanent brain damage). Other brain cells are in shock, and will start working again after a while. No one can tell just how long it will take for these cells to begin working again. Most healing happens in the first year, but people may improve their skills for much longer. Also, people may learn new skills to replace the ones they have lost.
The Stroke Center at Prisma Health aims to reduce the effects of a stroke with quick identification, assessment, treatment and recovery.
Any of the following can be a sign of stroke – and they do not all have to happen at once:
If any of these signs happen, call 911 as soon as possible. The ambulance team will call the hospital and tell them your signs. The stroke team will be ready to care for you when you arrive.
There are three main types of stroke: transient ischemic attack, ischemic stroke and hemorrhagic stroke.
Transient ischemic attack
A transient ischemic attack or TIA (“mini stroke”) is a temporary blockage of blood flow to the brain. TIAs usually last only a few minutes. Although symptoms may go away soon, a TIA is a warning sign that a stroke may occur in the near future. About one-third of people who have a TIA go on to have a severe stroke within the first year. Steps should be taken immediately to prevent a stroke. Diagnostic workup for TIA is the same as for ischemic stroke.
An ischemic (iss-KEE-mik) stroke is the most common type of stroke and makes up 87 percent of all strokes. Ischemic stroke occurs when there is a blockage in a vessel that supplies blood to the brain. If an ischemic stroke is caught early enough, debilitating effects may be reversed with treatment.
Hemorrhagic (bleeding) strokes account for about 13 percent of strokes. Hemorrhagic stroke occurs when a weakened blood vessel ruptures, allowing blood to leak into the brain. This leakage will cause that part of the brain not to function properly.
Ask your doctor—What type of stroke did I have?
When you show symptoms of a stroke, the emergency team will need to evaluate the type of stroke you are having and the areas of your brain affected by the stroke. Your doctor may use several tests to determine your risk of stroke, including:
Diagnostic tests are used to examine how the brain looks, works and obtains its blood supply. They can outline the injured area of the brain and sometimes determine the cause of the stroke. Diagnostic tests that may be ordered include:
CT (computerized tomography) scan is a test that uses radiation to create a picture of the brain. It is ordered first when diagnosing a stroke.
CTA (CT angiography) uses intravenous contrast dye to show major arteries supplying the brain blood and detect the type and location of a stroke.
CTP (CT perfusion) is a specialized CT test used to evaluate blood flow to brain tissue when an ischemic stroke is suspected.
MRI (magnetic resonance imaging) is a test that uses a large magnetic field to create detailed image of the brain. The image produced by MRI is sharper and more detailed than a CT scan and can be used to diagnose small, deep injuries.
MRA (MR angiography) uses intravenous contrast dye to view the blood flow of the head and neck. The MRA allows the doctor to look at smaller blood vessels to detect the type and location of a stroke.
Cerebral angiogram (arteriogram) is the most definitive way to view the blood vessels of the brain and provides the highest level of detail. In addition to providing high-resolution images, an angiogram also provides information about the blood flow in your brain. For the procedure, a small catheter is placed through an artery in the wrist or groin and carefully moved up through the main blood vessels in the chest and neck. Contrast dye then is injected and X-ray images are taken to construct a 3D view of your vessels.
Echocardiogram is a test that uses sound waves to create a moving picture of the heart. It can provide pictures of the heart’s valves and chambers and help evaluate the pumping action of the heart.
TEE (transesophageal echocardiogram) is a test that uses sound waves from a transducer that is placed in the esophagus to produce a very detailed picture of the heart, especially the back of the heart.
EEG (electroencephalogram) is a diagnostic test that uses small metal discs placed on the scalp to pick up electrical impulses. These electrical impulses can show areas of the brain injury and may help identify seizure activity.
Carotid ultrasound (Doppler testing) is a blood flow test that uses ultrasound to provide detailed information about the condition of the carotid and vertebral arteries that supply blood to the brain.
Treatment of an acute ischemic stroke: Time is brain
Timing is everything and will affect what treatments are used. Treatment choices can include medications to break up the blood clot or surgery to remove the blood clot.
Treatments of hemorrhagic stroke
Risk factors are traits and lifestyle habits that increase the risk of disease. The more risk factors you have, the higher your chances of having a stroke. The best way to prevent a stroke is to reduce your stroke risk factors. A healthcare provider can help you change factors that result from lifestyle or environment.
Modifiable risk factors (start managing):
Modifiable risk factors (stop!):
Non-modifiable risk factors:
March 25, 2020