Blood Supply Of The Brain
To understand stroke, it is helpful to know how blood circulates to the brain . Blood is pumped from the heart and carried to the brain by two paired arteries, the internal carotid arteries and the vertebral arteries . The internal carotid arteries supply the anterior areas and the vertebral arteries supply the posterior areas of the brain. After passing through the skull, the right and left vertebral arteries join together to form a single basilar artery. The basilar artery and the internal carotid arteries communicate with each other in a ring at the base of the brain called the Circle of Willis. The middle cerebral artery is the artery most often blocked during a stroke.
When First Responders Arrive
When the ambulance shows up, they’re going to act fast. They start by making sure you’re breathing and you have a pulse. If not, you’ll get CPR. In some cases, they’ll give you oxygen.
Then, they’ll do a quick check to look for signs of stroke. There are different ways to do this. Often, first responders use the Cincinnati Prehospital Stroke Scale , where they ask you to:
- Smile so they can see if your face looks crooked or droops on one side
- Hold both arms out straight for 10 seconds to see if one arm drifts downward or doesn’t move at all
- Say a simple phrase, like “The sky is blue,” to check if you slur your words or have trouble understanding what they’re saying
They’ll also want to know exactly what time your symptoms started. And they might check your blood sugar level.
If everything points to a stroke, they send what’s called a CODE STROKE to the hospital. All of this happens within minutes. Then you’re speeding off in the ambulance. If there’s a stroke center in your area, they’ll take you there, even if it’s a little farther. If not, you’ll go to the nearest hospital.
While you’re on the way, the emergency room gets things lined up. Everyone, from lab techs to doctors who specialize in strokes, gets ready to hit the ground running.
Score Your Stroke Risk For The Next 10 Years
Key: SBP = systolic blood pressure Diabetes = history of diabetes Cigarettes = smokes cigarettes CVD = history of heart disease AF = history of atrial fibrillation LVH = diagnosis of left ventricular hypertrophy
Interpretation:15 points carries a 16 percent, 10-year probability of having a stroke. If Martha quits smoking she can reduce her points to 12, which carries a 9 percent, 10-year probability of having a stroke.
Her current point total does not mean Martha will have a stroke, but serves as a wake-up call to ways she can lower her risk or even prevent a stroke. A lower percent score doesnt mean that Martha wont have a stroke, only that she is at a lower risk of having one.
No matter what your score is, it is important to work on reducing your risk factors as Martha did in this example by quitting smoking.
Source: DAgostino, R.B. Wolf, P.A. Belanger, A.J. & Kannel, W.B. Stroke Risk Profile: The Framingham Study. Stroke, Vol. 25, No. 1, pp. 40-43, January 1994.
Many risk factors for stroke can be managed, some very successfully. Although risk is never zero at any age, by starting early and controlling your risk factors you can lower your risk of death or disability from stroke. With good control, the risk of stroke in most age groups can be kept below that for accidental injury or death.
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Cerebral Haemorrhage Is A Type Of Stroke
A cerebral haemorrhage is a type of stroke caused by bleeding from a ruptured blood vessel in the brain. It is sometimes called a haemorrhagic stroke. Without prompt medical treatment, this can result in death. A person who survives is often left with permanent disabilities.Causes include weakened blood vessel walls, head trauma or congenital conditions . A cerebral haemorrhage is a life-threatening emergency. Approximately one in 10 strokes is caused by cerebral haemorrhage. This type of stroke is usually much more severe than ischaemic stroke, although symptoms are similar.The major risk factor for cerebral haemorrhage is long-standing high blood pressure that weakens the walls of blood vessels, which then may split under the pressure.
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Astroke is loss of blood flow to part of the brain. It happens when a blood clot blocks an artery in the brain or when a bleed from a blood vessel in the head creates pressure in the brain.
In either case, brain cells die, and the brain is damaged temporarily or permanently. Depending on the area of brain deprived of oxygen, a person may experience loss of memory, movement, or speech, or other disabilities. If blood flow is restored or pressure is relieved quickly through medical treatment, the brain may fully recover.
Neurointerventionalist John Terry, MD, explains what a stroke is.
Click play to watch the video or read video transcript.
What is a stroke?
Stroke is among the top five causes of death and a leading reason for disability in Americans, according to the American Stroke Association. Close to 800,000 people in the U.S. have a stroke each year, and there are more than seven million stroke survivors in the U.S.
If blood flow is restored or pressure is relieved quickly through medical treatment, the brain may fully recover.
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The Location Of The Stroke Impacts Recovery
If you are a stroke survivor, its important to talk to your neurologist. Ask him/her about the location of your stroke, as it may help you to identify and understand what secondary effects to expect.
Once you understand the location and effects of your stroke, rehabilitation can proceed with more efficiency.
The stroke recovery process is unique to each individual because every stroke is different. The most important thing to do is never give up hope.
Keep pursuing rehabilitation so that you can getas close to a full recovery from stroke as possible.
Recovering From A Stroke
People who survive a stroke are often left with long-term problems caused by injury to their brain.
Some people need a long period of rehabilitation before they can recover their former independence, while many never fully recover and need ongoing support after their stroke.
Local authorities should provide free reablement services for anyone assessed as needing them.
These services help the person recovering from a stroke learn or relearn the skills they need to live at home independently.
Some people will continue to need some form of care or help with their daily activities.
For example, a care worker may come to the person’s home to help with washing and dressing, or to provide companionship.
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When Does Heat Exhaustion Lead To Sudden Death
Unexpected death Moving to a cool area, relaxing clothes, and applying cold, wet washcloths to the body will help reverse heat exhaustion. When persons suffering from heat exhaustion are unable to get respite, they can swiftly progress to heat stroke. When a person’s core body temperature increases above 104 degrees Fahrenheit, they get this condition . Without immediate medical attention, they could die.
The factors that determine whether someone will suffer from heat exhaustion or heat stroke are their body size, weight, age, physical activity level, diet, alcohol use, medications, genetics, and environment. Heavily obese people are at greater risk of developing heat-related illness. The same is true for older adults and individuals who are not in good physical shape. Active people who exercise vigorously in hot temperatures are at greater risk of injury than those who are not active. Obese people who eat a poor quality diet containing many empty calories and few fruits and vegetables are at greater risk of developing obesity-related illnesses such as heart disease, diabetes, and cancer. The same is true for persons with a history of smoking or drinking alcohol excessively or drugs that affect the immune system.
Why Does Oxygen Matter So Much
Your cells use oxygen to make energy. If they don’t get it, they die. It’s your blood’s job to deliver oxygen throughout your body.
Your brain is at the center of everything you do. Your ability to think, talk, feel, sing, and dance all goes back to your brain, and those brain cells need oxygen, too.
Your brain’s a real oxygen hog. It’s a small part of your body weight, but it uses 20% of your oxygen. It can’t store the oxygen, so it needs a steady flow of blood to work well. Brain cells start to die if they go without oxygen for just 3-4 minutes — and that’s exactly what happens during a stroke.
With each minute that passes, you lose about 2 million brain cells. The longer you go without oxygen, the greater your chance for brain damage that can’t be undone. After about 10 minutes, the damage can be severe.
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What Is A Stroke
A stroke occurs when the supply of blood in the brain becomes compromised. This can happen by either a blood clot obstructing an artery and stopping blood flow to an area of the brain or an artery in the brain bursting and leading to bleeding inside the brain .
During a stroke, the affected areas of the brain do not receive enough oxygen-rich blood. As a result, brain tissue begins to die. Depending on the area of the brain affected by stroke, this damage will cause changes in certain sensory, motor, or cognitive functions.
Although its impossible to revive dead brain cells, recoveryis possible through neuroplasticity.This process allows healthy parts of the brain to take over the functionsdamaged by stroke.
The goal of stroke rehabilitation is to restore or compensate for the secondary effects sustained to your highest potential. These effects vary from person to person based on the size and location of the stroke.
Next, we will discuss the different areas of the brainaffected by stroke so that you can better understand what to expect.
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Cigarette smoking as well as exposure to it can lead to a stroke too.
People who are under stress or constant depression are prime candidates of suffering from stroke.
People having family history of stroke or heart attack are more likely to suffer from stroke than others.
High blood pressure
People having a high blood pressure are at greater risk of having a stroke.
Overweight and obese people are far more likely to suffer from stroke than average weight people.
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What Happens During A Stroke
If something happens to block the flow of blood, brain cells start to die within minutes because they cant get oxygen. This causes a stroke.
There are two types of stroke:
- An ischemic stroke occurs when blood clots or other particles block the blood vessels to the brain. Fatty deposits called plaque can also cause blockages by building up in the blood vessels.
- A hemorrhagic stroke occurs when a blood vessel bursts in the brain. Blood builds up and damages surrounding brain tissue.
Both types of stroke damage brain cells. Symptoms of that damage start to show in the parts of the body controlled by those brain cells.
What Are The Symptoms Of Brain Stroke
Compared to men, women are more prone to get a brain stroke. Some of the common symptoms in men and women include:
- Blurred, blackened or double vision in one or both eyes
- Difficulty in speaking, slurring of speech and confusion
- Difficulty in walking and balancing
- Sudden severe headache with vomiting or unconsciousness
- Sudden, one-sided paralysis or numbness of an arm or leg and face, drooping of lips to one side on smiling
- Sudden headache
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Two Types Of Stroke: Ischemic And Hemorrhagic
Ischemic stroke. This type of stroke occurs when a blood clot blocks the flow of blood to the brain. The clot may have traveled from another part of the body or formed inside an artery that supplies blood to the brain .
Strokes that result from a blood clot make up about 87 percent of all strokes, according to the American Stroke Association. Medications that dissolve a clot can prevent severe damage if given quickly after stroke symptoms appear.
Hemorrhagic stroke. When a blood vessel in the brain breaks or leaks due to weakness in the vessel wall, blood flows into or around the brain and creates swelling and pressure. This bleeding damages brain cells and tissue.
Strokes from bleeding make up about 13 percent of all strokes, says the American Stroke Association, but they are the most deadly, causing about 40 percent of stroke deaths.
When a loved one or a family member has a stroke, knowing which type is really important for the physician because the treatment and the care is really different, says neurointerventionalist Bryan Ludwig, MD. Dr. Ludwig describes the two kinds of strokes.
How Can Stroke Be Prevented
If you want to prevent a stroke, you must understand the risk factors that lead to stroke as well as the strategies that are used to reduce stroke. Make sure that you know the warning signs. If you see stroke warning signs, call 9-1-1! Most of the stroke warning signs are painless:
- Sudden numbness or weakness of the face, arm or leg, particularly on one side of the body.
- Sudden difficulty understanding or speaking. May have either slurred speech or confused speech.
- Sudden difficulty seeing in one eye or both eyes.
- Severe dizziness and/or sudden loss of balance, coordination, or ability to walk
- Sudden and severe headache for no reason
Last reviewed by a Cleveland Clinic medical professional on 07/11/2018.
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Stroke Signs And Symptoms To Look For
When someone has a stroke, get medical help as soon as possible to restore blood flow to the brain or stop the bleeding. These symptoms signal that someone may be having a stroke:
- Sudden weakness or numbness in your face, arm or leg on one side of your body
- Speech difficulty or inability to understand speech
- Sudden loss of balance or coordination
- Vision loss or dimness in one eye
- Trouble swallowing
- Sudden and severe headache with no cause
You can also use the the acronym BE FAST to remember the signs:
- Balance difficulties
Diagnosis Of Stroke Emergency
The FAST testis aneasy way to recognise and remember the most common signs of stroke.Using the FAST test involves asking three simple questions. If the person has a problem with any of these functions, dial triple zero for an ambulance immediately.FAST stands for:
- Facial weakness check their face. Has their mouth drooped?
- Arm weakness can they lift both arms?
- Speech difficulty is their speech slurred? Do they understand you?
- Time is critical. If you see any of these signs, call 000 straight away.
If you suddenly experience any of these symptoms, get to a hospital immediately. Remember, a stroke is a life-threatening emergency.
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Emergency Surgical Stroke Treatment: Neurointerventional Procedures
Microcatheter-based surgical interventions for stroke may include the use of a small microcatheter, delivered through a larger guiding catheter inserted at the groin through a small incision. A microguidewire is used to navigate the microcatheter to the site of obstruction in the brain. Thrombolytic medication, such as tPA, can then be administered directly to the occluding thrombus. This kind of treatment, which delivers thrombolytic medication intraarterially, is more specific than IV tPA and consequently may require significantly lesser dosages of medication. The time limit to implement this type of intervention is also significantly longer than that for IV TPA. Generally, only Comprehensive Stroke Care Centers offer this type of treatment.
Ischemic Stroke Vs Hemorrhagic Stroke
During an ischemic stroke, arteries to your brain get blocked or become narrowed by a blood clot. Ischemic strokes can be classified as either thrombotic or embolic, depending on where the blood clot forms.
In a thrombotic stroke, a blood clot forms in an artery that carries blood to your brain. A clot usually forms in an artery that is already narrowed by plaque buildup.
In an embolic stroke, a blood clot forms in another part of your body, breaks away and is swept toward your brain. Often, these blood clots form in the heart.
During a hemorrhagic stroke, an artery in the brain bursts open or leaks blood into the brain due to high blood pressure, too much blood thinning medication or an outpouching of a blood vessel wall , which are weak spots in blood vessels.
The effects of a stroke can vary depending on where in the brain the stroke occurs and how many brain cells die. A stroke can cause paralysis, difficulty swallowing or talking, memory loss, pain, emotional changes and behavior issues.
Seeking medical care right away can help you avoid the long-term effects of a stroke, adds Dr. Ermak.
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Supplying The Brain With Blood
Worldwide, stroke is the second most common cause of death. In the United States, strokes are the fifth most common cause of death and the most common cause of disabling nervous system damage in adults. In the United States, about 795,000 people have a stroke, and about 130,000 die of stroke each year.
Strokes are much more common among older people than among younger adults, usually because the disorders that lead to strokes progress over time. Over two thirds of all strokes occur in people older than 65. Stroke is more common among women than among men, and nearly 60% of deaths due to stroke occur in women, possibly because women are on average older when the stroke occurs.
Blacks, Hispanics, American Indians, and Alaska Natives are more likely than non-Hispanic whites or Asians to have a stroke. The risk of having a first stroke is nearly twice as high for blacks as for whites. Blacks are also more likely to die of a stroke than whites.