Ischemic Stroke
 

Ischemic Stroke

What is a stroke?
A stroke is an interruption of the blood supply to any part of the brain.  If blood flow is blocked for longer than a few seconds, the brain does not get enough oxygen leading to brain cells death.

 

There are two kinds of strokes: 

Ischemic Stroke:  Ischemic stroke results from an artery being clogged, or by the gradual buildup pf plaque and other fatty deposits. 

Hemorrhagic Stroke:  Hemorrhagic stroke occurs when a blood vessel is weakened and ruptures, bleeding into the brain. 

TIA (Transient Ischemic Attack):  Often called a “mini-stroke” and is caused by a temporary blockage in the blood vessel.  Symptoms are exactly that of a stroke, but resolve within 24 hours. 

 

Signs of a stroke

  • Sudden numbness or weakness of the face, arm or leg, especially on one side of the body. 

  • Sudden confusion, trouble speaking, understanding language or thinking.

  • Sudden trouble seeing in one or both eyes, dimmed vision or double vision.

  • Sudden trouble walking, dizziness, loss of balance or coordination, clumsiness. 

  • Sudden severe headache with no known cause.

 

Use the F.A.S.T test for recognizing and responding to stroke symptoms

F (Face)

Ask the person to smile – Does one side of the face
droop?

A (Arms) 

Ask the person to raise both arms – Does one arm drift 
downward?

S (Speech)

Ask the person to repeat a simple sentence.  Does the                       
speech sound slurred or strange?

T (Time)

If you observe any of these signs, it’s time to call 9-1-1
or get to the nearest hospital.

  
Risk of stroke you have NO control over:

  •  Age – your chance of having a stroke increases with age

  •  Gender – Men have more strokes than women

  •  Race – Blacks, Latinos and Asians are at higher risk for stroke than Caucasains

  •  Family History – A family history of heart disease or stroke can increase your risk

  •  Previous history of stroke / TIA – If you have already had a stroke or TIA, you are at greater risk of having another stroke.

     

Risks you DO have control over:

  • High Blood Pressure  – High blood pressure can put stress on your blood vessels.  This can lead to a stroke from blood clots or from bleeding.

  • High Cholesterol – When fatty substance (plaque) builds up; blood cannot travel to your heart. Too much plaque forms and blocks blood flow to your vessels.  This can cause heart disease, peripheral artery disease and strokes.

  • Smoking– Smoking doubles your risk of stroke.

  • Alcohol – Heavy drinking can increase your risk for a stroke.

  • Atrial Fibrillation – An irregular heart beat causes your heart to beat too quickly and out of rhythm.  Blood can pool in your heart and form clots.

  • Carotid Artery Disease – When plaque builds up in the neck arteries, it increases the risk of stroke. 

 

Treatments for a stroke
The sooner you receive treatment, the less damage will occur.  It is important to understand stroke warning signs and to get to the hospital as soon as possible.  Time is an important factor in determining whether you are eligible for certain stroke treatments. 

   

tPA
tPA is used to speed up the dissolving of a clot.  IV tPA should be given within 3 hours of the onset of symptoms. 

Intra-arterial tPA (intra-arterial thrombolysis) should be given with in 6 hours of symptoms.  This is administered through a catheter which is placed through a nick in the skin at the groin.  The catheter is advanced through the artery in the leg all the way to the arteries in the brain where the clot busting medication is used or Mechanical Thrombectomy is performed.

 

Mechanical Thrombectomy

MERCI Retrieval System – This system has a tiny corkscrew shaped device that works by wrapping around the clot and trapping it.  The clot is then retrieved and removed from the blood vessel.

Penumbra System – This system allows for revascularization of occluded vessels by aspirating the blood clot out of the vessel.

Acute strokes are treated on an emergent basis.  A team of physicians, including ER Physicians, Neurologists, and Interventional Neuroradiologists are available 24 hours a day, 7 days a week to treat these patients. Often a patient is taken directly from the ambulance for a CT Scan then directly to the Interventional Neuroradiology Suite where treatment can be administered.