Stroke, Part One: A Patient Guide

By Jacqui O'Connell, RN

At 3 a.m. the phone rings – it's the hospital calling to say that your brother has had a stroke. "Come quickly, it's serious". How can that be, you ask? Your brother is only 40 years old. But statistics show that your brother is not alone.

The numbers are staggering: According to the American Heart Association (AHA), stroke is the third-leading cause of death and one of the primary causes of long-term disability in the United States. Four out of every 1,000 people are affected by strokes each year, and there are over 4,000,000 stroke survivors alive at this time. Not just a disease for the elderly, 28 percent of stroke victims are under the age of 65, according to the Framingham Heart Study.

What is a stroke?

What does it mean to have a stroke? Let's first find out what happens in the brain:

Without a constant flow of oxygen-enriched blood, brain cells can become injured or destroyed (infarcted). A stroke, also known as a cerebrovascular attack (CVA) or brain attack, is an incident that occurs to any part of the brain when the blood supply is impeded. It can be gradual or sudden. Normal, everyday functioning of the body can be diminished or permanently lost after a stroke, and the symptoms will vary depending on the location and amount of brain tissue that is affected. Strokes are categorized as one of two types -- ischemic or hemorrhagic.

Ischemic stroke

According to the National Stroke Association (NSA), 85 percent of all "brain attacks" are ischemic. Ischemia is a decrease in the blood supply to any body organ, caused by the obstruction or constriction of blood vessels. During an ischemic stroke, a cerebral artery or blood vessel in the brain is blocked. The blockage causes the death of brain tissue, and the resulting death of tissue is called an infarction. Ischemic strokes are subdivided into two types – embolic and thrombotic.

Embolic stroke

A clot that travels through the blood stream toward or within the brain is called an embolus, and the resulting blockage causes a stroke. An embolus usually originates in the heart or neck and travels to the brain. The blockage occurs suddenly and without warning, and the symptoms of an embolic stroke can occur within seconds to minutes of the actual infarct.

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