Overview

A stroke—sometimes called a "brain attack"—occurs when normal blood flow to the brain is cut off. When this happens, the brain isn't getting the oxygen that it needs, and brain cells can die quickly.

There are two types of stroke: ischemic and hemorrhagic.

Ischemic is the most common, and often stems from:

• Clots within a blood vessel of the brain or neck that block or plug supply (thrombosis)
• Clots that break off from another part of the body and go to the brain (embolism)
• Narrowing of the blood vessels supplying the brain (stenosis)

Hemorrhagic stroke happens when a blood vessel in the brain bursts and bleeds into the brain.

Just like a heart attack can damage the heart, a stroke can injure the brain. The part of the brain that is damaged may not work or be able to control the body as it once did.

You may have heard of "mini-stroke," also called transient ischemic attack (TIA). These occur when less blood than usual makes it to the brain. They are short-lived and do not result in any permanent damage; however, they can be a warning sign of a more serious stroke.

If you think you are having a stroke or "mini-stroke," call 911 right away. It could save your brain and your life.

• High blood pressure is the strongest predictor of a stroke; in fact someone with high blood pressure has a much greater chance of stroke before age 80
• Older age; although stroke can occur at any age, the risk doubles every decade between the ages of 55 and 85
• Race; African Americans and Hispanics are more prone to stroke
• Smoking can lead to blood clots and raise blood pressure
• Mini-strokes or TIAs
• Physical inactivity or being obese
• Diabetes
• High cholesterol

Stroke and heart disease share many risk factors. Over time, high cholesterol, high blood pressure, not getting enough exercise, and being overweight, can cause changes in the heart or blood vessels that can lead to stroke and other cardiac events.

Certain conditions, including atrial fibrillation (irregular heartbeat), heart valve disorders and an enlargement of one of the heart's chambers can result in clots breaking loose and blocking blood supply to the brain.

Strokes strike quickly—typically without warning. That's why it's critical to know the signs of stroke, and act fast.

You might experience sudden:

• Numbness, tingling, weakness or loss of movement in your face, leg or arm, especially on one side
• Confusion
• Trouble speaking or understanding
• Severe headache for unknown reasons
• Vision changes in one or both eyes
• Loss of balance and/or coordination

If you or a loved one have one or more of these symptoms, don't delay. Call 911 immediately.

To prevent brain damage and permanent disability, blood flow must be restored quickly. Every second counts. The faster you can get to the hospital, the sooner doctors can help restore blood flow to the brain, usually by giving a medication (tissue plasminogen activator) to dissolve or break up the blood clot. This medicine needs to be given within three hours of the start of a stroke. Other medicines can help prevent a new or future stroke.

Some strokes are mild, but others can lead to severe brain damage—even premature death. How stroke affects someone will depend on where the stroke occurred and how quickly treatment is given, as well as their age, overall health and other factors.

Stroke can lead to:

• Paralysis (being unable to move parts of the body)
• Problems with balance or weakness on one side
• Loss of speech
• Impaired judgment or behavior
• Memory loss
• Issues with bladder or bowel function
• Difficulty swallowing
• Emotional disturbances

If you've survived a stroke, there are ways to regain lost function and relearn skills. Rehabilitation can help and may include a combination of physical, occupational and speech therapy. The goal is to give you the best possibly recovery.

If you are at risk for stroke—or have already had one—there are steps you can take to help prevent having one. Try to:

• Lower your blood pressure if it is high and be sure to keep track of your number
• Get tested for diabetes
• Eat a healthy diet with little to no salt
• Don't smoke and avoid secondhand smoke
• Stay active
• Get to and maintain a healthy weight
• Keep up with your doctor's visits and learn what your numbers mean, especially if your blood pressure is high
• Always take your medications as directed

Remember: know the warning signs of a stroke and be prepared to seek medical attention right away.

Talk with your health care team about stroke, especially if you already have heart disease. Here are some questions to help get you started:

• Does my heart condition make me more likely to have a stroke?
• How can I lower my risk of stroke?
• Should I be on aspirin therapy or other blood-thinning medication?
• Does hormone therapy increase my risk?
• What are my chances of having another stroke?
• What heart conditions increase the likelihood of stroke?
• What are some of the main considerations for rehabilitation after stroke?

In addition to resources on CardioSmart.org, you can find out more about stroke and how to prevent it at:

American Stroke Association
1-888-4-STROKE (1-888-478-7653)
strokeassociation.org

National Institute of Neurological Disorders and Stroke
1-800-352-9424
ninds.nih.gov