Stroke Symptoms, Causes & Conditions
Our physicians offer leading-edge expertise in the diagnosis and treatment of a wide spectrum of strokes and related conditions such as transient ischemic attacks (TIAs), vascular dementia and carotid artery dissection.
Types of Strokes
There are two main categories of stroke:
- Ischemic stroke – This is the most common type of stroke and is caused by a blocked blood vessel. It is caused by a blood clot blocking an artery. Ischemic strokes may also occur when a blood clot forms in the heart, breaks off and travels to the brain, blocking off the blood supply. Atherosclerosis, which is the development of fatty deposits lining the blood vessel wall, can be a factor with an ischemic stroke.
- Hemorrhagic stroke – This is caused by a burst in a blood vessel near or in the brain. Bleeding in the brain can prevent oxygen from reaching areas of the brain.
The Stroke Center treats the following conditions:
- Aphasia – This is a term used to describe damage to the portions of the brain that are responsible for language. Primary signs of the disorder include difficulty in expressing oneself when speaking, trouble understanding speech, and/or difficulty with reading and writing. Aphasia is not a disease, but a symptom of brain injury.
- Arteriosclerotic dementia – Also known as vascular dementia, arteriosclerotic dementia disrupts the normal blood flow to the brain, as well as the cognitive functions in the patient. Blood vessels narrow or become completely blocked, reducing the amount of blood received by the brain.
- Basilar artery syndrome – A complicated yet uncommon type of migraine which results in brain stem dysfunction and can lead to stroke or coma.
- Brain hemorrhage – Bleeding in the brain caused by the rupture of a blood vessel within the head.
- Carotid artery dissection – The carotid arteries, located in the front of the neck, are the main supplier of blood to the brain. When the lining of the artery ruptures and breaks, blood leaks into the artery wall and may cause clotting within the artery.
- Carotid artery stenosis – Stenosis of the carotid artery occurs when atherosclerotic plaques and fatty material build up on the inside of the artery wall and reduce blood flow to the brain.
- Carotid body tumor – This vascular tumor, also known as a chemodectoma, originates from the external layer of the carotid artery and extends into the internal and external carotid arteries.
- Cerebral hemorrhage – A type of stroke, a cerebral hemorrhage occurs when a defective artery in the brain bursts, flooding the surrounding tissue with blood.
- Cerebral ischemia – This is low blood flow and poor oxygen delivery to brain tissue that injures the portion of the neuron that transmits impulses for normal brain function.
- Cerebral thrombosis – Also known as balloon embolization, cerebral thrombosis is a procedure performed on patients for whom surgery is too risky. This term may also be associated with the blocking of a blood vessel within the brain resulting in a stroke.
- Cerebral vascular accident (CVA) – This is the clinical term used to describe a stroke. Stroke is now often referred to as a "brain attack" to denote the fact that it is caused by a lack of blood supply to the brain. It can be hemorrhagic or embolic (blood clot) in nature.
- Cerebral vascular disease – This disease causes a significant decrease of blood flow to the brain, which may lead to a stroke when the blood flow is eventually cut off.
- Cerebral vasculitis – An inflammation of the vascular system within the cerebrum, cerebral vasculitis causes a narrowing or blockage of the blood vessels that nourish the brain, spinal cord or peripheral nerves. Symptoms include headaches, fever, rapid weight loss and confusion or forgetfulness.
- Embolism (cerebral) – A blood clot from one part of the body that is carried by the bloodstream to the brain where it blocks an artery.
- Intracerebral hematoma -- Also known as a contusion, an intracerebral hematoma is a bruise to the brain itself that causes bleeding and swelling inside of the brain around the area where the head was struck.
- Moyamoya disease – A rare, progressive cerebrovascular disorder, Moyamoya disease is caused by blocked arteries at the base of the brain in an area called the basal ganglia. The name "moyamoya" means "puff of smoke" in Japanese and describes the look of the tangle of tiny vessels formed to compensate for the blockage. Individuals with this disorder may have disturbed consciousness, speech deficits (usually aphasia), sensory and cognitive impairments, involuntary movements and vision problems.
- Syncope – This is the temporary loss of consciousness due to a sudden decline in blood flow to the brain. It may be caused by an irregular cardiac rate or rhythm or by changes of blood volume or distribution.
- Transient ischemic attack (TIA) – Lasting only a few minutes, a transient stroke occurs when the blood supply to part of the brain is briefly interrupted. TIA symptoms, which usually occur suddenly, are similar to those of stroke but do not last as long.
Learn to recognize the signs of a stroke and call 911 immediately if you experience any of these stroke warning signs:
- Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
- Sudden confusion, trouble speaking or understanding
- Sudden trouble seeing in one or both eyes
- Sudden trouble walking, dizziness, loss of balance or coordination
- Sudden severe headache with no known cause
Stroke, also referred to as a Cerebrovascular Attack (CVA) or a "brain attack," occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot (ischemic stroke) or bursts and causes bleeding (hemorrhagic stroke). As a result, part of the brain tissue cannot get the blood and oxygen it needs and it starts to die, affecting the part of the body it controls.
Risk Factors for Stroke:
Risk factors that can be changed or controlled
- High blood pressure
- Tobacco use (one cigarette in the past 30 days)
- Carotid or other artery disease
- Atrial fibrillation
- Other heart disease
- A history of transient ischemic attacks (TIAs). TIAs are "warning strokes" that produce stroke-like symptoms with no lasting damage
- Blood disorders that result in a high red blood cell count
- High cholesterol
- Physical inactivity and obesity
- Excessive alcohol consumption (more than one alcoholic drink on average per day for women or more than two for men)
Risk Factors that cannot be changed or controlled:
- Increasing age – People of all ages, including children, have strokes. But the older you are, the greater your risk for stroke.
- Heredity (family history) and race – Your stroke risk is greater if a parent, grandparent, sister or brother has had a stroke. African-Americans have a much higher risk of death from a stroke than Caucasians.
- Prior stroke or heart attack – Someone who has had a stroke is at much higher risk of having another one. If you've had a heart attack, you're at higher risk of having a stroke, too.
Diagnostic tests for stroke can usually outline the injured brain area by examining how the brain looks, works and gets its blood supply. The majority of these tests are safe and painless.
Imaging tests develop a picture of the brain similar to X-rays.
- Computed tomography (CT) scans – create a picture of the brain using radiation. The test results offer important information about the cause of the stroke, the location of the stroke and the extent of brain injury. Thus, CT scans are usually one of the first tests given to patients suspected of stroke.
- Magnetic Resonance Imaging (MRI) – creates an image of the brain using a large magnetic field. Similar to the CT scan, the test results show the location and extent of brain injury. MRI images are often used to diagnose small, deep injuries, as they are sharper and more detailed than CT scans.
Blood-flow tests show the condition of the arteries that may be causing changes in blood flow to the brain:
- Angiography (arteriography orarteriogram) – Special dyes are injected into the blood vessels (through a catheter), and an X-ray is taken. This test evaluates the size and location of blockages.
- Doppler testing – A probe is placed over the suspect artery, usually in the neck or at the base of the skull, and the amount of blood flow is determined.
To make an appointment at the Stroke Center:
Cushing Neuroscience Institute’s Stroke Center makes it easy for you to take the first steps in ensuring the best neurological and neurosurgical care for yourself or your family. Simply email us at firstname.lastname@example.org, call us at (516) 562-3064 or fill out our Request an Appointment form.