A stroke is an injury to the brain caused by the obstruction of blood flow to a brain artery-usually by a blood clot or a direct bleed into the brain itself. It can be due to weakness in the vessel wall commonly caused by high blood pressure or cerebral aneurysm.
Stroke is the third leading cause of death and the number one cause of disability in the United States. Stroke or “brain attack” can occur in all ages and nearly one quarter of strokes occurs in people under age 65.
The warning signs of stroke include motor weakness, sensory change (i.e. numbness or tingling of the face, arm or leg), speech difficulty or visual disturbance. Pain is present only in patients with the hemorrhagic form of stroke (a bleed in the brain) which represents only 15 percent of all strokes.
For the most part, the treatment of hemorrhagic stroke remains conservative with therapeutic options to reverse brain injury being very limited. Treatment is surgical only when a blood clot in the brain becomes life threatening. Surgery or catheter-based neurointerventional procedures are often used in patients who suffer bleeds from cerebral aneurysms to prevent a second hemorrhage.
Neurointerventional treatments are becoming more common in treating patients with ischemic stroke-strokes caused by vessel blockage. Along with intravenous clot-busting drugs (called tPA), intra-arterial delivery of these same drugs, as well as new technologies such as intravascular suction catheters and sophisticated mechanical devices, are increasingly being used for patients who either fail medical therapy or who present outside the three-hour time window reserved for the administration of intravenous tPA.
The keys to successful stroke treatment remain time and prevention. The earlier the stroke treatment is initiated, the higher the likelihood of a good outcome, because “time is brain”. Smoking cessation and blood pressure control are vitally important, along with an active lifestyle and healthy diet.
Stroke outcomes will only improve as the public becomes aware of the risk factors, identifies warning signs and seeks medical attention as quickly as possible.
For more information about the signs of stroke and treatment, go to the Stroke Center at Cushing Neuroscience Institute.