On a previous blog post we laid out one of the main types of dementia, Vascular Dementia, caused by stroke, current estimates claim that 15 to 20% of all dementia cases are in the vascular dementia category. With that in mind, we thought it was a good idea to explore exactly what a stroke is, the causes and symptoms. In a future post, we will explore risk factors, prevention and treatment.   

QUICK STROKE FACTS 

  • Every year, close to 80,000 people experience a new or recurrent stroke. 
  • A stroke happens every 40 seconds. 
  • Stoke is the leading cause of death in the U.S. 
  • Every four minutes someone dies from a stroke.  
  • Up to 80 percent of strokes can be prevented.  
  • Stroke is the leading cause of disability in the U.S.  

WHAT IS STROKE? 

A stroke is a “brain attack” and it can happen to anyone at any time. It occurs when the blood flow to an area of the brain is interrupted or reduced. Within minutes of this occurring, brain cells start to die because they are deprived of necessary oxygen to survive. When brain cells die during a stroke, abilities controlled by that area of the brain, such as memory and muscle control, are lost.   

How a person is affected by their stroke depends on where the stroke occurs in the brain and how much the brain is damaged. Someone who had a small stroke may only have minor problems, such as temporary weakness of an arm or leg. People who have larger strokes may be permanently paralyzed on one side of their body or lose their ability to speak. Some will recover completely from strokes, but more than two-thirds of survivors will have some type of permanent disability.   

CAUSES 

A stroke may be caused by a blocked artery (ischemic stroke) or the leaking or bursting of a blood vessel (hemorrhagic stroke). Some people may experience only a temporary disruption of blood flow to the brain (transient ischemic attack, or TIA) that doesn’t cause permanent damage. 

Hemorrhagic 

Hemorrhagic stroke occurs when a blood vessel in your brain leaks or ruptures. Brain hemorrhages can result from many conditions that affect your blood vessels. These include: 

  • Uncontrolled high blood pressure (hypertension) 
  • Overtreatment with anticoagulants (blood thinners) 
  • Weak spots in your blood vessel walls (aneurysms) 

A less common cause of hemorrhage is the rupture of an abnormal tangle of thin-walled blood vessels (arteriovenous malformation). Types of hemorrhagic stroke include: 

  • Intracerebral hemorrhage. In an intracerebral hemorrhage, a blood vessel in the brain bursts and spills into the surrounding brain tissue, damaging brain cells. Brain cells beyond the leak are deprived of blood and are also damaged. 
  • High blood pressure, trauma, vascular malformations, use of blood-thinning medications and other conditions may cause an intracerebral hemorrhage. 
  • Subarachnoid hemorrhage. In a subarachnoid hemorrhage, an artery on or near the surface of your brain bursts and spills into the space between the surface of your brain and your skull. This bleeding is often signaled by a sudden, severe headache. 
  • A subarachnoid hemorrhage is commonly caused by the bursting of a small sack-shaped or berry-shaped aneurysm. After the hemorrhage, the blood vessels in your brain may widen and narrow erratically (vasospasm), causing brain cell damage by further limiting blood flow. 

Ischemic  

About 80 percent of strokes are ischemic strokes. Ischemic strokes occur when the arteries to your brain become narrowed or blocked, causing severely reduced blood flow (ischemia). The most common ischemic strokes include: 

  • Thrombotic stroke. A thrombotic stroke occurs when a blood clot (thrombus) forms in one of the arteries that supply blood to your brain. A clot may be caused by fatty deposits (plaque) that build up in arteries and cause reduced blood flow (atherosclerosis) or other artery conditions. 
  • Embolic stroke. An embolic stroke occurs when a blood clot or other debris forms away from your brain — commonly in your heart — and is swept through your bloodstream to lodge in narrower brain arteries. This type of blood clot is called an embolus. 

Transient ischemic attack (TIA) 

A transient ischemic attack (TIA) — sometimes known as a ministroke — is a temporary period of symptoms similar to those you’d have in a stroke. A temporary decrease in blood supply to part of your brain causes TIAs, which may last as little as five minutes. 

Like an ischemic stroke, a TIA occurs when a clot or debris blocks blood flow to part of your nervous system — but there is no permanent tissue damage and no lasting symptoms. 

Seek emergency care even if your symptoms seem to clear up. Having a TIA puts you at greater risk of having a full-blown stroke, causing permanent damage later. If you’ve had a TIA, it means there’s likely a partially blocked or narrowed artery leading to your brain or a clot source in the heart. 

It’s not possible to tell if you’re having a stroke or a TIA based only on your symptoms. Even when symptoms last for under an hour, there is still a risk of permanent tissue damage. 

STROKE SYMPTOMS 

The key to positive outcomes with stroke are identifying the symptoms early and getting immediate treatment. Pay close attention to when the signs and symptoms begin as the length of time they have been present can affect treatment options. Some of these include:  

  • Trouble with speaking and understanding. You may experience confusion. You may slur your words or have difficulty understanding speech. 
  • Paralysis or numbness of the face, arm or leg. You may develop sudden numbness, weakness or paralysis in your face, arm or leg. This often happens just on one side of your body. Try to raise both your arms over your head at the same time. If one arm begins to fall, you may be having a stroke. Also, one side of your mouth may droop when you try to smile. 
  • Trouble with seeing in one or both eyes. You may suddenly have blurred or blackened vision in one or both eyes, or you may see double. 
  • Headache. A sudden, severe headache, which may be accompanied by vomiting, dizziness or altered consciousness, may indicate you’re having a stroke. 
  • Trouble with walking. You may stumble or experience sudden dizziness, loss of balance or loss of coordination. 

When to see a doctor 

Seek immediate medical attention if you notice any signs or symptoms of a stroke, even if they seem to fluctuate or disappear. Think “FAST” and do the following: 

  • Face. Ask the person to smile. Does one side of the face droop? 
  • Arms. Ask the person to raise both arms. Does one arm drift downward? Or is one arm unable to rise up? 
  • Speech. Ask the person to repeat a simple phrase. Is his or her speech slurred or strange? 
  • Time. If you observe any of these signs, call 911 immediately. 

Call 911 and don’t wait to see if symptoms stop. Every minute counts. The longer a stroke goes untreated, the greater the potential for brain damage and disability. 

 

Sources 

https://www.mayoclinic.org/diseases-conditions/stroke/symptoms-causes/syc-20350113 

http://www.stroke.org/understand-stroke/what-stroke 

 

 

Vascular Dementia
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