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Health Bulletin - April 2024

Acute Ischemic Stroke (Acute Stroke)

What is stroke?

Acute Ischemic stroke is commonly called Acute Stroke. It is caused by lack of blood flow or oxygen to the brain resulting in damage to the brain tissue. This results in sudden onset long-term neurologic problems.

Transient Ischemic Attack (TIA) is commonly called “mini-stroke”. It is caused by lack of blood flow to the brain for only a brief period. Symptoms improve in minutes to hours, and long term neurologic problems do not occur.

How common is this?

About 800,000 people have a stroke in the United States every year.

More common in Southeastern states like Mississippi, Alabama and Louisiana.

What are the causes of stroke?

  • Build up of fatty tissue in the neck or brain blood vessels
  • Blood clot that blocks an artery in the brain
  • Less commonly, brain infection or inflammation

What increases the risk?

  • High blood pressure (hypertension)
  • Diabetes.
  • High cholesterol.
  • Heart disease: Abnormal heart rhythms like atrial fibrillation or heart attacks.
  • Obesity
  • Tobacco Use
  • Drugs like cocaine and methamphetamine.
  • Taking birth control pills, especially if you also use tobacco.

What are the symptoms?

Symptoms usually develop very SUDDENLY or AFTER WAKING from sleep.

These include:

  • Weakness of your face, arm, or leg, on one side of the body.
  • Numbness of face, arm or leg especially on one side of the body
  • Loss of balance or coordination.
  • Trouble speaking, trouble understanding speech, or a combination of these.
  • Vision changes like double vision, blurred vision, or loss of vision.
  • Difficulty swallowing

What should I do?

RECOGNIZE STROKE SYMPTOMS AND CALL 911 IMMEDIATELY as early treatment can be lifesaving.

“BE FAST” is an easy way to remember the main warning signs of a stroke:

How is this diagnosed?

MRI scanner

  • Medical history and physical exam by an Emergency Room physician or a Neurologist.
  • Tests to look at the brain: CT scan or MRI scan of the brain.
  • Tests that scan blood flow in the brain and neck: CT angiogram, MRI angiogram, carotid ultrasound.
  • Tests for heart function: Electrocardiogram (ECG), Continuous heart monitor, Transthoracic echocardiogram (commonly called Echo).

MRI scanner

MRI brain cross-sectional image

Bright area shows acute stroke

How is this treated?

Some treatments work best if they are given within 3 hours of the start of symptoms.

  • Emergency treatments include:
    1. Tissue plasminogen activator – Medicine that is injected into the veins to dissolve the blood clot.
    2. Mechanical thrombectomy – Blood clot in the brain is dissolved or removed with a catheter inserted in the groin
  • Medications to prevent another stroke include:
    1. Aspirin, clopidogrel or related medications reduce chances of blockage of blood vessels
    2. Blood thinners like xarelto or eliquis prevent blood clot formation if there is abnormal heart rhythm like atrial fibrillation.
    3. Medications to control diabetes, high blood cholesterol and high blood pressure.
  • Rehabilitation:
    1. Physical therapy helps strengthen arms and legs. Also helps regain balance.
    2. Occupational therapy helps regain independence with daily activities like bathing, dressing
    3. Speech therapy for swallowing or speech problems

How can I prevent a stroke?

  • Adequate treatment of diabetes, hypertension and high blood cholesterol.
  • Eat a healthy low salt, low fat diet
  • Do not use any products that contain nicotine or tobacco. These include cigarettes, chewing tobacco, and vaping devices, such as e-cigarettes.
  • Maintain a healthy body weight.
  • Exercise at least 30 minutes a day

Kartheek Ganta, MD Neurology
Board Certified In Neurology and Clinical Neurophysiology
Cumberland Neurology
Oak Ridge , TN

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