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A stroke is a brain, spinal cord, or retinal injury related to dysfunction of the blood vessels supplying these parts of the central nervous system, resulting in permanent damage. When cells (neurons) or nerve fibers (axons) are injured, specific functions of the nervous system are impaired or lost: the ability to speak or comprehend others, the ability to move the face or limbs, the ability to see throughout one’s vision, and more.
A stroke is typically classified in one of two ways:
Ischemic strokes typically have a single cause, but the cause can differ greatly from one person to the next.
For older adults, the causes of stroke may be related to common “risk factors” for stroke and heart disease. Stroke is a brain disease, not a heart disease, but both the brain and the heart can be injured by the same medical problems.
For younger adults, the causes of stroke are often less connected to prior medical problems. Some of these include:
Intracerebral hemorrhages may have multiple contributing causes. These include:
Stroke is the leading cause of disability and the third leading cause of death in the United States. Stroke can affect people of any age, including babies, children, young adults, middle-aged adults, and elderly adults.
According to the Centers for Disease Control and Prevention, stroke affects more than 795,000 adults in the U.S. each year. However, many strokes remain undiagnosed when individuals do not receive medical attention for their symptoms, or if their symptoms are not recognized as stroke symptoms.
Common symptoms of a stroke relate to loss of function for the brain, spinal cord, or the retina of the eye. These include:
Most symptoms of stroke develop suddenly, but they can sometimes be gradual or fluctuating (come-and-go). The symptoms may be mild or severe.
The diagnosis of stroke is usually directed by a neurologist with the help of a team of resident physicians, Emergency Medicine physicians, nurses, emergency medical technicians, and others. The most important information for securing the diagnosis are your symptoms and your neurologic examination. Many physicians and nurses will ask you questions about your symptoms, usually repeatedly over the course of several evaluations, to confirm and glean additional details from your memory of your experience. Physicians and nurses will also repeatedly examine you to monitor your symptoms and deficits: this helps guide treatment decisions as they work to stabilize your condition.
In most cases, several tests will occur during and after the hospitalization. You may not undergo all of these tests, but your doctors will specifically tailor these tests to you. These include the following:
Risk factors are conditions that contribute to specific causes (or mechanisms) of stroke. Some of these contribute to both ischemic stroke and intracerebral hemorrhage. Risk factors are important to identify and address in order to reduce the chances of having another stroke in the future. Stroke can be prevented!
For ischemic stroke in older adults, the most common risk factors are:
For ischemic stroke in younger adults, the most common risk factors are:
For intracerebral hemorrhage, the most common risk factors are: