The cerebrum is the largest part of the brain. It is made of a left and a right hemisphere. The right hemisphere is in charge of the functions on the left-side of the body and many cognitive functions.
A right-side stroke happens when the blood supply to the right side of the brain is interrupted. Without oxygen and nutrients from blood, the brain tissue quickly dies.
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There are 2 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—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 age.Family history of stroke.
Other factors that may increase your risk can be changed, such as: Drug abuse
, 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 cholesterol
Low bone mineral density, especially in womenObesity
metabolic syndromeSleep apneaHigh blood homocysteine levelAtherosclerosisType 2 diabetes
or impaired glucose tolerance
Blood disorders such as
sickle cell disease
Disease 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 appear
Conditions that increase your risk of blood clots such as:
CancerCertain autoimmune diseasesMigraine with auraHaving a blood vessel abnormalityPsychological disorders, such as depression or anxiety
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 left side of the bodySudden confusionSudden trouble speaking or understanding—aphasiaSudden trouble seeing in one or both eyesSudden lightheadedness, trouble walking, loss of balance, or coordinationSudden severe headache with no known causeDifficulty understanding or expressing the tone of languageDifficulty with learned movementsLack of attention to the left side of the body
Longer-lasting effects of the stroke may include problems with: Left-sided weakness and/or sensory problemsSpeaking and swallowingVision, including an inability of the brain to take in information from the left visual fieldPerception and spatial relationsAttention span, comprehension, problem solving, and judgmentEmotionsInteractions with other peopleActivities of daily living, such as going to the bathroom
Mental health, including
, frustration, and impulsivity
You will be asked about your symptoms and medical history. A physical exam will be done to look for muscle weakness, visual and speech problems, and movement difficulty.
Images may be taken of your bodily structures. This can be done with: CT scanMRI scanMagnetic resonance angiography
CT angiogram (CTA)Doppler ultrasound
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 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, medication may be given to: Work against any blood-thinning drugs you may regularly takePrevent seizuresReduce how your brain reacts to bleedingControl blood pressure
For an ischemic stroke, procedures may be done to: Reroute blood supply around a blocked arteryRemove the clot or deliver clot-dissolving medicationRemove fatty deposits from arteries in the neck—carotid endarterectomyWiden the carotid artery and add a mesh tube to keep it open—atherectomy of noncoronary vessel
For a hemorrhagic stroke, the doctor may: Place a clip or tiny coil in the aneurysm to stop it from bleeding
Remove a piece of the skull
to relieve pressure on the brain—craniotomy
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
talk to your doctor about ways to quit.
Increase your consumption of fish.Limit alcohol to 1-2 drinks per day.Maintain a healthy weight.Check blood pressure frequently
. Follow your doctor's advice 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.If you use drugs, talk to your doctor about rehabilitation programs.
Furie KL, Kasner SE, Adams RJ, et al. Guidelines for the prevention of stroke in patients with stroke or transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association.
Hemorrhagic stroke. National Stroke Association website. Available at:
Accessed November 18, 2015.
Hemorrhagic strokes (bleeds). American Stroke Association website. Available at:
http://www.strokeassociation.org/STROKEORG/AboutStroke/TypesofStroke/HemorrhagicBleeds/Hemorrhagic-Strokes-Bleeds_UCM_310940_Article.jsp#.Vk3h_k2FPIU. Updated June 22, 2015. Accessed November 18, 2015.
Ischemic strokes (clots). American Stroke Association website. Available at:
http://www.strokeassociation.org/STROKEORG/AboutStroke/TypesofStroke/IschemicClots/Ischemic-Strokes-Clots_UCM_310939_Article.jsp#.Vk3ipE2FPIU. Updated August 7, 2015. Accessed November 18, 2015.
Mena F, Fruns M, Contreras A, Soto F, Mena I. Acute brainstem infarct: multidisciplinary management. Alasbimn Journal website. Available at:
http://www.alasbimnjournal.cl/revistas/5/mena5.htm. Accessed November 18, 2015.
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2/7/2014 DynaMed's Systematic Literature Surveillance
http://www.dynamed.com/topics/dmp~AN~T566761/Prevention-of-stroke: Bushnell C, McCollough LD, Awad IA, et al.
Guideline for the prevention of stroke in women.
Available at: http://stroke.ahajournals.org/content/early/2014/02/06/01.str.0000442009.06663.48. Accessed November 18, 2015.
6/2/2014 DynaMed's Systematic Literature Surveillance
http://www.dynamed.com/topics/dmp~AN~T580145/Stroke-rehabilitation: Myint PK, Cleark AB, Kwok CS, et al. Bone mineral density and incidence of stroke: European prospective investigation into cancer-Norfolk population-based study, systemic review, and meta-analysis. Stroke. 2014;45(2):373-382.
Last reviewed November 2015 by Rimas Lukas, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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