The cerebrum is the largest part of the brain. It is made of a left and a right hemisphere. In most people, the left hemisphere is in charge of the functions on the right-side of the body. It is also involved in abilities such as the ability to speak, or use language.
A left-side stroke happens when the blood supply to the left side of the brain is interrupted. Without oxygen and nutrients from blood, the brain tissue quickly dies.
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There are two main types of stroke ischemic and hemorrhagic. An ischemic stroke is the most common type of stroke.
An ischemic stroke is caused by a blockage of the blood flow, which may be due to: A clot from another part of the body like the heart or neck. The clot breaks off and flows through the blood until it becomes trapped in a blood vessel supplying the brain.A clot that forms in an artery that supplies blood to the brain.A tear in an artery supplying blood to the brain. Called an arterial dissection.
A hemorrhagic stroke is caused by a burst blood vessel. Blood spills out of the broken blood vessel and pools in the brain. This interrupts the flow of blood and causes a build up of pressure on the brain.
Hemorrhagic vs. Ischemic Stroke
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Certain factors increase your risk of stroke but can not be changed, such as: Race—People of African American, Hispanic, or Asian/Pacific Islander descent are at increased risk. Age: Older than 55 years of ageFamily history of stroke
Other factors that may increase your risk can be changed such as: Drug abuse
from cocaine, amphetamines, or heroin use
Certain medical condition that can increase your risk of stroke. Management or prevention of these conditions can significantly decrease your risk. Medical conditions include: High blood pressureHigh cholesterol levels—specifically high-LDL bad cholesterolObesity and metabolic syndromeHigh blood homocysteine levelAtherosclerosisDiabetes mellitus
or impaired glucose tolerance
Atrial fibrillationBlood disorders such as sickle cell disease
and polycythemiaDisease of heart valves, such as
Prior stroke or cardiovascular disease, such as
heart attackPeripheral artery diseaseTransient ischemic attack (TIA)
—a warning stroke with stroke-like symptoms that go away shortly after they appearConditions that increase your risk of blood clots such as: CancerCertain autoimmune diseasesMigraine with auraHaving a blood vessel abnormality
Risk factors specific to women include: Previous pre-eclampsiaUse of birth control pills,
especially if you are over 35 years old and smoke
Long-term use of
hormone replacement therapyMenopausePregnancy—due to increased risk of blood clots
Symptoms occur suddenly. Exact symptoms will depend on the part of the brain affected. Rapid treatment is important to decrease the amount of brain damage. Brain tissue without blood flow dies quickly.
Call for emergency medical help
right away if you notice any of the following: Sudden weakness or numbness of face, arm, or leg, especially on the right side of the bodySudden confusionSudden trouble speaking or understandingSudden trouble seeing in one or both eyesSudden dizziness, trouble walking, loss of balance, or coordinationSudden severe headache with no known cause
If you or someone you know has any of these symptoms,
call for emergency medical services right away. Brain tissue without blood flow dies quickly. Early care can decrease damage.
Longer-lasting effects of the stroke may include problems with: Left-sided weakness and/or sensory problemsSpeaking and swallowingVision (eg, inability for the brain to take in information from the left visual field)Perception and spatial relationsAttention span, comprehension, problem solving, judgmentEmotionsInteractions with other peopleActivities of daily living (eg, going to the bathroom)
Mental health (eg,
, frustration, impulsivity)
The doctor will do a physical exam and look for muscle weakness, visual and speech problems, and movement difficulty. If possible, you will be asked about your symptoms and medical history. Your doctor may use a CT scan or
of the brain to confirm a stroke or rule out other conditions.
Your doctor may also order tests that create detailed images of blood vessels. These test will help see which blood vessels may be creating the problem: Magnetic resonance angiography
—maps blood flow
CT angiogram (CTA)—creates detailed images of the blood vessels and their blood flowDoppler ultrasound
—evaluates flow of blood in the head and neck
Blood tests can also help determine if there is a bleeding problem.
Immediate treatment is needed to: Dissolve or remove a clot causing an ischemic strokeStop the bleeding during a hemorrhagic stroke
may be needed.
For an ischemic stroke, medication may be given to: Dissolve clots and prevent new ones from formingThin bloodControl blood pressureTreat an irregular heart rateTreat high cholesterol
For a hemorrhagic stroke, the doctor may give medication to: Work against any blood-thinning drugs you may regularly takePrevent seizuresReduce how your brain reacts to bleedingControl blood pressure
A rehabilitation program focuses on: Physical therapy—to regain as much movement as possibleOccupational therapy—to assist in everyday tasks and self-careSpeech therapy—to improve swallowing and speech challengesPsychological therapy—to help adjust to life after the stroke
Many of the risk factors for stroke can be changed. Lifestyle changes that can help reduce your chance of getting a stroke include: Exercise regularly.
. Limit dietary
Increase your consumption of fish.Drink alcohol only in moderation (1-2 drinks per day).Maintain a healthy weight.Check blood pressure frequently
. Follow your doctor's recommendations for keeping it in a safe range.
Take aspirin if your doctor says it is safe.Keep chronic medical conditions under control. This includes high cholesterol and diabetes.Talk to your doctor about the use of a statins. These types of drugs may help prevent certain kinds of strokes in some people.Seek medical care if you have symptoms of a stroke, even if symptoms stop.Stop the use of recreational drugs such as cocaine.