All about Stroke

By Dr. Sonia Lal Gupta in Neurology

Jan 25, 2023

All About Stroke – Causes, Symptoms, Diagnosis & Treatment

A stroke, often called a brain attack, is a life-threatening medical emergency that occurs when the blood supply to a part of the brain is suddenly interrupted— due to a blockage in a blood vessel or the bursting of a vessel in the brain. When oxygen-rich blood cannot reach the brain, brain cells begin to die within minutes, leading to permanent damage to the body functions controlled by that area.

Stroke is one of the leading causes of death and long-term disability in India, with an estimated occurrence of 105–152 cases per 1,00,000 population. Early recognition and immediate treatment are crucial for survival and recovery.

Causes of Stroke

Stroke risk increases due to lifestyle factors, age, and underlying medical conditions. Common causes include:

• Obesity
• Age above 55 years
• Previous history of stroke or TIA
• High blood pressure
• Diabetes
• High cholesterol
• Heart diseases
• Sedentary lifestyle
• Smoking or tobacco use
• Excessive alcohol consumption

Types of Stroke

1. Ischemic Stroke (Most Common)

Ischemic strokes occur when blood flow to the brain is blocked—either due to a blood clot or narrowing of the brain arteries. It leads to oxygen deprivation and brain cell death.

Two subtypes include:

• Cerebral Embolism – A clot forms elsewhere (heart, neck, chest) and travels to the brain, blocking a narrow artery.
• Cerebral Thrombosis – Fatty plaque buildup inside brain vessels leads to clot formation within the vessel.

2. Transient Ischemic Attack (TIA) – “Warning Stroke”

A TIA happens when the brain experiences a brief, temporary disruption in its blood supply. Symptoms are similar to a full stroke but last only minutes to a few hours and resolve once the clot moves.

TIAs are significant warning signs—studies show a high chance of a major stroke within a year if untreated.

3. Hemorrhagic Stroke

This stroke occurs when a blood vessel in the brain ruptures, causing bleeding inside or around the brain. Factors include uncontrolled blood pressure or blood-thinning medications.

While less common, hemorrhagic strokes are extremely dangerous because leaked blood can cause the brain to swell and increase pressure inside the skull.

Symptoms of Stroke

Recognizing symptoms early can save a life. Call emergency medical services immediately if any of these signs appear:

• Difficulty Speaking or Understanding – Slurred speech or confusion
• Sudden Paralysis or Numbness – Especially on one side of the body; dropping of arm or facial droop
• Blurred Vision – Trouble seeing from one or both eyes
• Severe Headache – Often sudden, with dizziness or vomiting
• Loss of Balance or Coordination – Trouble walking or maintaining balance

Diagnosis

Stroke is a medical emergency—treatment should ideally begin within 4 hours of symptom onset. Diagnostic tests include:

• Physical Examination – Neurological assessment and examination of blood vessels
• Blood Tests – To check clotting factors and risk markers
• CT Scan – Detects bleeding, blockages, or stroke damage
• MRI Scan – Creates detailed images of brain tissue
• Carotid Doppler Ultrasound – Checks for blockages or plaque in the carotid arteries
• Cerebral Angiography – Dye-based imaging to locate vessel blockages or aneurysms
• Echocardiogram – Helps identify heart-based clots that may have travelled to the brain

Treatment

Treatment depends on the type & severity of the stroke:

1. Medications

• Ischemic Stroke – Clot-dissolving drug tPA (tissue plasminogen activator) must be given within 4–4.5 hours.
• Hemorrhagic Stroke – Requires stopping bleeding, managing pressure, and sometimes emergency clot evacuation.

2. Surgery

Surgical options include:

• Removal of blood clot
• Repair or clipping of aneurysms

3. Stenting / Coiling / Clamping

These minimally invasive procedures help open blocked arteries or seal ruptured vessels.

Conclusion

A stroke is a medical emergency that can cause permanent disability or even death if not treated quickly. Recognizing early symptoms and seeking immediate medical care can dramatically improve outcomes.

Preventive measures—such as maintaining a healthy lifestyle, regular monitoring of blood pressure, diabetes, and cholesterol—can significantly reduce the risk of stroke.

Most leading hospitals offer 24/7 emergency care, stroke units, and ambulance services, ensuring timely treatment and improved survival rates.