What is a stroke?
A stroke occurs when the blood circulation to the brain is suddenly interrupted, typically because of a blocked artery or ruptured blood vessel. Because the interruption prevents blood and oxygen from reaching the brain, a stroke is a medical emergency and requires immediate treatment. Brain cells and tissues can begin to die within minutes.
Nearly 800,000 Americans a year suffer from strokes, with the vast majority being ischemic strokes from blocked arteries. Less than 20 percent are hemorrhagic strokes, which are caused when blood vessels in the brain rupture. While strokes remain a leading cause of death, the ability to quickly identify and effectively treat a stroke dramatically improves a patient’s health outcomes.
What You Can Expect at UTHealth Neurosciences
At UTHealth Neurosciences, our dedicated stroke team uses advanced technology to accurately diagnose a stroke, to determine its cause, and to develop a comprehensive treatment plan. Our vascular neurosurgeons use minimally invasive techniques to deploy possibly life-saving therapies.
We work in multidisciplinary teams of specialists and therapists that share insights, leading to better treatment decision-making and outcomes, as well as lower costs and time savings. Throughout the treatment process, we will work closely with the doctor who referred you to ensure a smooth transition back to your regular care. While you are with us, you will receive expert care, excellent communication, and genuine compassion.
Causes of a stroke
The majority of strokes are considered preventable and most of the risk factors can be managed. People who are overweight, inactive, or heavy drinkers or smokers are at a higher risk for having a stroke. People with diabetes, high blood pressure, high cholesterol, obstructive sleep apnea, or cardiovascular disease are at higher risk. People with atrial fibrillation are at increased risk.
African Americans and people older than 65 are more prone to strokes. While men are more likely to suffer strokes in young and middle age, women have a higher lifetime risk of stroke and are more likely to die from a stroke than men.
Signs of a stroke
Recognizing the signs of a stroke is critical, as minutes count in making treatment decisions. Doctors will want to know, as precisely as possible, when the symptoms began.
The most noticeable symptoms of a stroke include a sudden, severe headache; vision problems; difficulty speaking; and sudden paralysis or numbness of the face, arms or legs on one side. Coordination problems are also common. Someone who has suffered a stroke might have confusion, memory loss, and difficulty reading or writing. If you suspect a stroke, see if the patient has trouble smiling, raising both arms out to their side, or repeating a simple phrase. Facial drooping, arm weakness, and speech difficulties are signs that you should call 911.
Medical experts offer the F.A.S.T. acronym to help people remember what to check for: FACE, ARMS, SPEECH, and TIME.
- Check whether the person’s FACE can smile. Is the face drooping?
- Check whether the person can raise both ARMS out. Does one drift downward because of weakness?
- Check the person’s SPEECH by asking them to repeat a simple phrase.
- Act in a short TIME by calling 911 fast. Some stroke treatments only work in the first three hours.
An important part of diagnosis is determining the type of stroke a patient suffered. Ischemic strokes, the most common type, are caused by a blocked artery and often can be treated with a clot-busting medicine, called tissue plasminogen activator (tPA), if diagnosed within the first few hours. A hemorrhagic stroke happens when a blood vessel ruptures and bleeds into the brain, causing damage.
A medical team offering emergency stroke care will ask about symptoms, collect a medical history, conduct a physical and neurological exam, order blood tests, and do a Computer Tomography (CT) scan or Magnetic Resonance Imaging (MRI). A CT scan uses radiation to create a picture of the brain. It can help determine the cause, location, and extent of brain injury. An MRI might be used for a more detailed image. Other diagnostic tools that might be used include carotid ultrasound, cerebral angiogram, echocardiogram, or a blood flow test.
Doctors might determine that a patient suffered a transient ischemic attack, which is sometimes called a mini-stroke. The main difference is that the blood supply is blocked for a short time, usually less than five minutes, but TIAs should still be treated as medical emergencies. They are warnings of a future stroke.
Advanced Treatment of Stroke
UTHealth Neurosciences uses pioneering and proven procedures to treat, prevent, and rehabilitate stroke patients.
When a tPA (tissue plasminogen activator) can be administered shortly after an ischemic stroke, patients see improved recovery outcomes. The IV injection helps to quickly break down the blood clot. UTHealth — in an attempt to bring this gold standard care to the patient as quickly as possible — introduced the nation’s first Mobile Stroke Unit. The unit is a specially equipped and staffed ambulance that can help treat strokes on site and on the way to the emergency room.
Doctors also might opt to treat an ischemic stroke with an emergency endovascular procedure. A long tube can be inserted through an artery in the groin to deliver tPA directly to where the stroke is happening. A doctor might also use a device attached to a catheter to remove a large clot from the blocked blood vessel in the brain.
Doctors may decide to perform a procedure to reduce the risk of future strokes, such as removing plaque blocking a carotid artery. An angioplasty might also be used to insert a stent to support an opened artery.
During a hemorrhagic stroke, doctors will focus on controlling the bleeding and reducing pressure in the brain. They may perform surgery or surgical clipping to stop the blood flow. Medication or a transfusion might be used to stop the bleeding, control blood pressure, and reduce brain swelling. Aspirin, antiplatelet drugs, statins, and blood pressure medication might be part of treatment.
After the emergency treatment, your medical team will focus on recovery and rehabilitation. Depending on the condition, a program could include working with a dietitian, physical therapist, occupational therapist, speech pathologist, psychologist, and social worker. Risk factors for future stokes should be mitigated through lifestyle and diet changes.
At UTHealth Neurosciences, we offer patients access to specialized neurological care at clinics across the greater Houston area. To ask us a question, schedule an appointment, or learn more about us, please call (713) 486-8000, or click below to send us a message. In the event of an emergency, call 911 or go to the nearest Emergency Room.