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Functional electrical stimulation is used to help treat the effects of strokes.
In functional electrical stimulation, electricity is applied to weakened muscles, causing them to contract. The electrical stimulation may help reeducate your muscles which is a treatment and form of rehabilitation for stroke patients. The risks include irritation or infection at the site of electrode placement (internal and external systems), scar tissue that forms around the electrode (called encapsulation), broken wires, and electrodes that move after placement.

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For patients that are stroke prone, or have a history of strokes, there are wearable devices that can monitor the heart rate and muscle flexion of the patient. If the device determines the patient may be undergoing a stroke, it will prompt an interactive pop up. If this is not reacted to, the device can contact healthcare workers or 911 for the patient. These devices can malfunction, which can result in improper readings or inappropriate contact of authorities.

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To avoid Strokes, especially in the elderly, exercise is crucial to keep blood pressures low and to clear the build up of cholesterol in the blood stream. Even light jogging for half an hour a day can go a long way in improving cardio health and blood pressure health. Beginning exercise can be difficult for many who have not done it before, or are out of shape. Clearing the initial effort may require meetings with dietitians and PT's.

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Regular physical activity can reduce the risk of a stroke by strengthening neurological pathways and increasing bone density and muscle mass thus lowering injury risk. This can include leisurely low intensity state state cardio like walking which is recommended for stroke patients to prevent a future stroke and can gradually build up to resistance training. However, regular physical activity differs from training exercises in that it is consistent and unplanned and a part of daily life. This decreases the susceptibility to quitting due to lifestyle or other changes. The consistency of regular physical activity also helps blood flow which is important to preventing a stroke caused by blood clotting.

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One preventative measure that could reduce the risk of a person having a stroke is eating a healthy, balanced diet. A healthy diet includes plenty of fresh fruits and vegetables. Eating foods low in saturated fats, trans fat, and cholesterol and high in fiber can help prevent high cholesterol. Limiting salt (sodium) in your diet can also lower your blood pressure. Some challenges people would face are healthy food is often more expensive than unhealthy food. Some people might not have access to healthy foods.

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The elderly are more affected by a stroke primarily because they have high blood pressure and diabetes. In addition to this, the elderly have to manage multiple conditions, making healthcare more difficult to receive.

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Obesity can lead to multiple complications after experiencing a stroke, ranging from more difficult surgeries and certain medicines/physical therapies that cannot be administered due to their higher BMI and blood pressure, or lack of physical ability.

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One lifestyle change after a stroke that a patient would have to adapt to is to stop smoking. Smoking damages and tightens blood vessels increasing the risk of a stroke, so quitting would be necessary for some stroke patients. On a scale of 1-10, it would be a difficulty of 9 because it is addictive. The professional that would help with this would be a smoking cessation advisor.

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Stroke attacks can leave a victim with multiple disabilities, including losing the ability to walk, and the ability to speak. To recover and adapt to these lifestyle changes, stroke victims will meet with a range of staff to help them with rehabilitations into society, ranging from physical therapists, personal therapists, speech therapists, psychologists, and pharmacists. These changes range in difficulty, but many would be high, around 8-10/10.

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Mirror therapy is when a mirror is used to create a reflective illusion of an affected limb in order to trick the brain into thinking movement has occurred without pain, or to create positive visual feedback of a limb movement. It involves placing the affected limb behind a mirror. The mirror is positioned so the reflection of the opposing limb appears in place of the hidden limb. The short-term and long-term effects of a stroke mirror therapy treat are limb coordination and more long-term nerve damage. The type of professional that does mirror therapy is a physical therapist.

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Speech therapy is used to help aphasia. This can help with pronunciation, grammar, voice quality, fluency, and articulation. The professional who gives this type of therapy is a speech and language pathologist.

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CBT focuses on identifying and modifying negative thoughts, beliefs, and behaviors. It helps individuals develop healthier coping strategies and adapt to the emotional and behavioral changes after a stroke. This helps with the short-term effects as the patients learn how to control the new behaviors they have, as well as the long-term effects because the effects of stroke can be life-long. This can be delivered by psychiatrists, psychologists, mental health nurses, and general practitioners.

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Psychotherapy is the quintessential form of therapy that involves talking with a licensed therapist. This helps via talking about emotional issues. Psychotherapy can be useful to help stroke patients with post-stroke depression and other depressive symptoms or anxiety. The professionals that are licensed for psychotherapy include psychologists, psychiatrists, social workers, licensed professional clinical counselors, licensed marriage and family therapists, pastoral counselors, and psychiatric nurse practitioners.

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For patients not covered by health insurance, occupational therapy typically costs about $150-$200 for an initial evaluation, then $50-$400 per hour, depending on the type of service and the provider. Occupational therapy typically is covered by health insurance in certain cases. For example, Aetna considers short-term occupational therapy medically necessary to help regain daily living functions lost as a result of an injury or illness, but typically does not cover it when the primary diagnosis is mental retardation or developmental delay. Some policies limit the total number of sessions. For patients covered by health insurance, typical out-of-pocket costs consist of coinsurance of 10%-50% and copays for any required medical devices. The American Occupational Therapy Association states that stroke patients who receive occupational therapy are “significantly less likely to deteriorate and more likely to be independent in their ability to perform activities of daily living and the end of treatment.”

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Prozac is a medicine often prescribed to aid patients with aggression or behavioral disorders that are present after extreme cases of stroke. If the doctor deems it necessary to treatment, insurances will often cover it, but if the patients does not qualify for any reason, the medicines can range up to 500 dollars. If a patient does not receive Prozac when its prescribed, then can suffer from continual behavioral disorders- sometimes permanently.

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The first diagnostic evaluation for speech therapy usually costs between $150-400. Half an hour sessions cost $65-175, but this varies based on geographical location and instructor expertise. Many stroke patients have damage to their brain's speech center. This means that many stroke patients cannot speak yet, so speech therapy becomes medically necessary. Speech therapy is not covered on many insurance plans, so many suggest going to a low-cost clinic instead. However, because stroke is considered a critical condition, insurance companies may deem speech therapy medically necessary.

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A common long-term effect of strokes is aphasia. There are many different types of aphasia like Broca's aphasia and Wernicke’s aphasia. Broca's aphasia is characterized by the inability to produce speech, but comprehension remains intact. Wernicke's aphasia is when individuals are able to say words, but the meaning is unclear even though their hearing remains intact. Both are common long-term consequences of stroke.

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Paralysis is the loss of voluntary muscle movement. It usually occurs on the side of the body opposite to the side of the brain that the stroke has damaged.

A severe example is the locked-in syndrome which occurs when there is severe damage to the brain stem which can occur after a  stroke.

People with locked-in syndrome are usually aware of what is happening around them but cannot speak, move, or show facial expressions. They can only communicate through eye movements or blinking.

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Insomnia is common in stroke patients and affects 20–56% of them. About 18% of the people reported new-onset insomnia after their stroke. Insomnia typically occurs in the setting of the acute phase of the stroke.

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After experiencing a stroke, many people report a loss of memory from around the time of the event and onward. This occurs because of damage to the hippocampus, the portion of your brain responsible for creating and encoding long term memories.

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Computed tomography (CT) uses X-rays to take clear, detailed pictures of your brain. It is often done right after a suspected stroke. A brain CT scan can show whether there is bleeding in the brain or damage to the brain cells from a stroke.

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An MRI is typically done to diagnose a stroke because it can detect damage done by an ischemic stroke and brain hemorrhages. Also, the doctor can specify a dye into the blood vessel which can let the doctor see the blood flow through the arteries to see where the blood clot is.

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Another warning sign or symptom of a stroke is sudden confusion. This can be detected by trouble speaking, understanding, disorientation, etc.

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Carotid endarterectomy is surgery to treat carotid artery disease. The carotid arteries are the main blood vessels that carry oxygen and blood to the brain. In carotid artery disease, these arteries become narrowed. This reduces blood flow to the brain and could cause a stroke.

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What is a carotid endarterectomy?

Carotid endarterectomy (CEA) is surgery to treat carotid artery disease. The carotid arteries are the main blood vessels that carry oxygen and blood to the brain. In carotid artery disease, these arteries become narrowed. This reduces blood flow to the brain and could cause a stroke.

During a carotid endarterectomy, your healthcare provider will surgically remove plaque that builds up inside the carotid artery. He or she will make a cut (incision) on the side of the neck over the affected carotid artery. The artery is opened and the plaque removed. Your healthcare provider will stitch the artery back together. This restores normal blood flow to the brain. You may have this procedure while you are awake under local anesthesia or while you are asleep under general anesthesia.

Why might I need a carotid endarterectomy?

Narrowing of the carotid arteries is most often caused by atherosclerosis. This is a buildup of plaque in the inner lining of the artery. Plaque is made up of fatty substances, cholesterol, cellular waste products, calcium, and fibrin. Atherosclerosis is also called "hardening of the arteries." It can affect arteries throughout the body. Carotid artery disease is similar to coronary artery disease. In coronary artery disease, blockages form in the arteries of the heart and may cause a heart attack. In the brain, it can lead to stroke.

The brain needs a constant supply of oxygen and nutrients to work correctly. Even a brief break in blood supply can cause problems. Brain cells start to die after just a few minutes without blood or oxygen. If the narrowing of the carotid arteries becomes severe enough to block blood flow, or a piece of plaque breaks off and blocks blood flow to the brain, a stroke may happen. A mini-stroke (transient ischemic attack or TIA) is stroke like-symptoms that last only a few minutes to a few hours. A TIA may be the first sign of the disease.

You may not have symptoms if you have carotid artery disease. Plaque buildup may not be blocking enough blood flow to cause symptoms. An artery that is blocked only halfway or less often does not cause any symptoms.

Your healthcare provider may have other reasons to advise a carotid endarterectomy.

What are the risks of a carotid endarterectomy?

Some possible complications of carotid endarterectomy include:

Stroke or TIA

Heart attack

Pooling of blood into tissue around the incision site causing swelling

Nerve problems with certain functions of the eyes, nose, tongue, or ears

Bleeding into the brain (intracerebral hemorrhage)

Seizures (uncommon)

Repeated blockage of the carotid artery. Or new blockage that develops in the artery on the other side of your neck.

Bleeding at the incision site in the neck

Infection

High blood pressure

Irregular heart beat

Blocked airway from swelling or from bleeding in the neck

If you are allergic to or sensitive to medicines, contrast dye, iodine, or latex, tell your healthcare provider. Also tell your healthcare provider if you have kidney failure or other kidney problems.

There may be other risks based on your condition. Discuss any concerns with your healthcare provider before the procedure.

How do I get ready for a carotid endarterectomy?

Your healthcare provider will explain the procedure to you and you can ask questions.

You will be asked to sign a consent form that gives your permission to do the procedure. Read the form carefully and ask questions if something is not clear.

Your healthcare provider will review your health history and do a physical exam to make sure you are in otherwise good health before having the procedure. You may have blood tests or other diagnostic tests.

Tell your healthcare provider if you are sensitive to or are allergic to any medicines, iodine, latex, tape, contrast dye, or anesthesia.

Tell your healthcare provider of all prescription and over-the-counter medicines and herbal supplements that you are taking.

Tell your healthcare provider if you have a history of bleeding disorders. Also tell your provider if you are taking any blood-thinning medicines (anticoagulants), aspirin, or other medicines that affect blood clotting. You may be told to stop some of these medicines before the procedure.

If you are pregnant or think you could be, tell your healthcare provider.

Follow any directions you are given for not eating or drinking before surgery.

Your healthcare provider may request a blood test before the procedure to find out how long it takes your blood to clot.

You may get medicine (sedative) before the procedure to help you relax.

Tell your healthcare provider if you have a pacemaker.

If you smoke, stop smoking as soon as possible before the procedure. This may help you recover faster. It may also improve your overall health status. Smoking raises the risk for blood clots..

Based on your condition, your healthcare provider may give you other directions for getting ready.

What happens during a carotid endarterectomy?

Carotid endarterectomy requires a stay in hospital. Procedures may vary based on your condition and your healthcare provider's practices.

Generally, carotid endarterectomy (CEA) follows this process:

1. You will be asked to remove any jewelry or other objects that may interfere with the procedure.

2. You will remove your clothing and put on a hospital gown.

3. You will be asked to empty your bladder before the procedure.

4. An IV (intravenous) line will be started in your arm or hand. Another catheter will be put in your wrist to monitor your blood pressure and to take blood samples. One or more extra catheters may be put in into your neck, opposite the surgery site, to monitor your heart. Other sites for the catheter include the under the collarbone area and the groin.

5. If there is too much hair at the surgical site, the healthcare team may shave it off.

6. You will be placed on the operating table, lying on your back. Your head will be raised slightly and turned away from the side to be operated on.

7. A catheter will be put in into your bladder to drain urine.

8. The anesthesiologist will check your heart rate, blood pressure, breathing, and blood oxygen level during the surgery.

9. CEA may be done under local anesthesia. You will be sleepy, but will not feel the area being operated on. You will get a sedative in your IV before the procedure to help you relax. This lets the healthcare provider monitor how you are doing during the procedure by asking you questions and testing your hand grip strength.

10. If the CEA is done under local anesthesia, the healthcare provider will give you constant support and keep you comfortable during the procedure. You will get pain medicine as needed.

11. Under local anesthesia, you will get oxygen through a tube that fits in your nose.

12. A CEA may also be done under general anesthesia. This means you will be asleep. Once you are sedated, the provider will put a breathing tube into your throat and into your windpipe to provide air to your lungs. You will be connected to a ventilator. This machine will breathe for you during the surgery.

13. You will be given a dose of antibiotics through your IV to help prevent infection.

14. The healthcare team will clean the skin over the surgery site with an antiseptic solution.

15. The healthcare provider will make a cut (incision) down the side of the neck over the diseased artery. Once the artery is exposed, the provider will make a cut into the artery.

16. The healthcare provider may use a device called a shunt to divert blood flow around the surgery area. This will keep blood flowing to the brain. A shunt is a small tube that is put into the carotid artery to send blood flow around the area being operated on.

17. With the blood flow diverted, the healthcare provider will remove the plaque from the artery.

18. The provider will then remove the shunt and carefully close the artery. The incision in the neck will be stitched together.

19. A small tube (drain) may be placed in your neck. This will drain any blood into a small palm-size suction bulb. It is generally removed the morning after the procedure.

20. You may get blood pressure medicine through your IV during and after the procedure to keep your blood pressure within a certain range.

21. If you had general anesthesia, the healthcare provider will wake you up in the operating room to be sure you can respond to questions.

22. A sterile bandage or dressing will be put on the surgery site.

What happens after a carotid endarterectomy?

In the hospital

After the procedure you will be taken to the recovery room. Once your blood pressure, pulse, and breathing are stable and you are alert, you may be taken to the intensive care unit (ICU) or your hospital room.

At the appropriate time, you will be helped out of bed to walk around as you can handle it.

If a drainage tube was placed in the incision during the procedure, your healthcare provider will likely remove it the next morning.

You will be offered solid foods as you can handle them.

Take a pain reliever as recommended by your healthcare provider. Aspirin or certain other pain medicines may increase the chance of bleeding. Be sure to take only recommended medicines.

Your healthcare provider may schedule you for follow-up duplex ultrasound procedures to monitor the carotid arteries in your neck.

Generally, you can go home within 1 to 2 days after a carotid endarterectomy.

At home

Once you are home, it is important to keep the incision area clean and dry. Your healthcare provider will give you specific bathing instructions. If stitches are used, they will be removed during a follow-up office visit. If adhesive strips are used, keep them dry and they will fall off within a few days.

You may go back to your normal diet unless your healthcare provider tells you otherwise. It is generally advised to follow a diet that is low in fat and cholesterol. You should eat vegetables, fruits, low-fat or non-fat dairy products, and lean meats. Avoid foods that are processed or packaged.

Tell your healthcare provider to report any of the following:

Fever or chills

Redness, swelling, or bleeding or other drainage from the incision site

Increased pain around the incision site

Call 911

Call 911 if any of the following occur:

Weakness, tingling, or loss of feeling on one side of your face or body

Sudden double vision or trouble seeing in one or both eyes

Sudden trouble talking or slurred speech

Sudden severe headache

F.A.S.T. is an easy way to remember the signs of stroke. When you see the signs, you k now you need to call 911 fast. F.A.S.T. stands for:

F is for face drooping. One side of the face is drooping or numb.

A is for arm weakness. One arm is weak or numb. When the person lifts both arms at the same time, one arm may drift downward.

S is for speech difficulty. You may notice slurred speech or trouble speaking. The person can't repeat a simple sentence correctly when asked.

T is for time to call 911. If someone shows any of these symptoms, even if they go away, call 911 right away. Make note of the time the symptoms first appeared.

Your healthcare provider may give you other instructions after the procedure, based on your situation.

Next steps

Before you agree to the test or the procedure make sure you know:

The name of the test or procedure

The reason you are having the test or procedure

What results to expect and what they mean

The risks and benefits of the test or procedure

What the possible side effects or complications are

When and where you are to have the test or procedure

Who will do the test or procedure and what that person's qualifications are

What would happen if you did not have the test or procedure

Any alternative tests or procedures to think about

When and how will you get the results

Who to call after the test or procedure if you have questions or problems

How much will you have to pay for the test or procedure

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Carotid endarterectomy (CEA) is surgery to treat carotid artery disease. The carotid arteries are the main blood vessels that carry oxygen and blood to the brain. In carotid artery disease, these arteries become narrowed. This reduces blood flow to the brain and could cause a stroke.

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Thrombolysis is a medicine that clears blood clots and vesicles, especially in the region around the brain and heart. It is administered to stroke patients with the intent of returning blood flow to the brain, hopefully healing the impacted area before cell death and degradation.

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A common symptom of stroke is sudden numbness/weakness in the face, arm, or leg. This is usually limited to one side of the body

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One symptom of a stroke can be having trouble seeing in one or both eyes

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The beginning of a stroke may entail a sudden difficulty of  walking, dizziness, loss of balance, or lack of coordination

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A sudden increase in blood pressure increases the risk of an ischemic stroke. This is because high blood pressure can damage blood vessels, making them less flexible and more vulnerable to blood clot formation. These blood clots (thrombus) cause blocked arteries. Because of this, the brain tissue is prevented from getting oxygen and nutrients. Within minutes the brain cells begin to die, and the neurons are unable to send messages down the axons to one another.

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Hemorrhages occur after the blood vessels weaken and eventually rupture. Blood seeps into the surrounding brain tissue which clots, accumulates, and compresses from the displaced volume. This causes enlargement. Vasospasms come when the contraction of these blood vessels causes a narrowing of the arteries.

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In some cases the brain doesn't receive enough oxygen causing brain leaks and ruptures of the vessels.

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Overview

What is a stroke? A Mayo Clinic expert explains

Learn more from neurologist Robert D. Brown, Jr. M.D., M.P.H.

I'm Dr. Robert Brown, neurologist at Mayo Clinic. In this video, we'll cover the basics of a stroke. What is it, who it happens to, the symptoms, diagnosis, and treatment. Whether you're looking for answers for yourself or someone you love, we're here to give you the best information available. You've likely heard the term stroke before. They affect about 800,000 people in the United States each year. Strokes happen in two ways. In the first, a blocked artery can cut off blood to an area of the brain. And this is known as an ischemic stroke. 85% of strokes are of this type. The second type of stroke happens when a blood vessel can leak or burst. So the blood spills into the brain tissue or surrounding the brain. And this is called a hemorrhagic stroke. Prompt treatment can reduce brain damage and the likelihood of death or disability. So if you or someone you know is experiencing a stroke, you should call 911 and seek emergency medical care right away.

Anyone can have a stroke, but some things put you at higher risk. And some things can lower your risk. If you're 55 and older, if you're African-American, if you're a man, or if you have a family history of strokes or heart attacks, your chances of having a stroke are higher. Being overweight, physically inactive, drinking alcohol heavily, recreational drug use. Those who smoke, have high blood pressure or high cholesterol, have poorly controlled diabetes, suffer from obstructive sleep apnea, or have certain forms of heart disease are at greater risk as well.

Look for these signs and symptoms if you think you or someone you know is having a stroke: Sudden trouble speaking and understanding what others are saying. Paralysis or numbness of the face, arm or leg on one side of the body. Problems seeing in one or both eyes, trouble walking, and a loss of balance. Now many strokes are not associated with headache, but a sudden and severe headache can sometimes occur with some types of stroke. If you notice any of these, even if they come and go or disappear completely, seek emergency medical attention or call 911. Don't wait to see if symptoms stop, for every minute counts.

Once you get to the hospital, your emergency team will review your symptoms and complete a physical exam. They will use several tests to help them figure out what type of stroke you're having and determine the best treatment for the stroke. This could include a CT scan or MRI scan, which are pictures of the brain and arteries, a carotid ultrasound, which is a soundwave test of the carotid arteries which provide blood flow to the front parts of the brain, and blood tests.

Once your doctors can determine if you're having an ischemic or hemorrhagic stroke, they'll be able to figure out the best treatment. If you're suffering an ischemic stroke, it's important to restore blood flow to your brain as quickly as possible, providing the oxygen and other nutrients your brain cells need to survive. To do this, doctors may use an intravenous clot buster medicine, dissolving the clot that is obstructing the blood flow or they may perform an emergency endovascular procedure. This involves advancing a tiny plastic tube called a catheter up into the brain arteries, allowing the blockage in the artery to be removed directly. Unlike ischemic strokes, the goal for treating a hemorrhagic stroke is to control the bleeding and reduce pressure in the brain. Doctors may use emergency medicines to lower the blood pressure, prevent blood vessel spasms, encourage clotting and prevent seizures. Or, if the bleeding is severe, surgery may be performed to remove the blood that is in the brain.

Every stroke is different, and so every person's road to recovery is different. Management of a stroke often involves a care team with several specialties. This may include a neurologist and a physical medicine and rehabilitation physician, among others. Now, in the end, our goal is to help you recover as much function as possible so that you can live independently. A stroke is a life-changing event that can affect you emotionally as much as it can physically. You may feel helpless, frustrated, or depressed. So look for help and support from friends and family. Accept that recovery will take hard work and most of all time. Strive for a new normal and remember to celebrate your progress. If you'd like to learn even more about strokes, watch our other related videos or visit mayoclinic.org. We wish you all the best.

An ischemic stroke occurs when the blood supply to part of the brain is blocked or reduced. This prevents brain tissue from getting oxygen and nutrients. Brain cells begin to die in minutes. Another type of stroke is a hemorrhagic stroke. It occurs when a blood vessel in the brain leaks or bursts and causes bleeding in the brain. The blood increases pressure on brain cells and damages them.

A stroke is a medical emergency. It's crucial to get medical treatment right away. Getting emergency medical help quickly can reduce brain damage and other stroke complications.

The good news is that fewer Americans die of stroke now than in the past. Effective treatments also can help prevent disability from stroke.

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Symptoms

If you or someone you're with may be having a stroke, pay attention to the time the symptoms began. Some treatments are most effective when given soon after a stroke begins.

Symptoms of stroke include:

Trouble speaking and understanding what others are saying. A person having a stroke may be confused, slur words or may not be able to understand speech.

Numbness, weakness or paralysis in the face, arm or leg. This often affects just one side of the body. The person can try to raise both arms over the head. If one arm begins to fall, it may be a sign of a stroke. Also, one side of the mouth may droop when trying to smile.

Problems seeing in one or both eyes. The person may suddenly have blurred or blackened vision in one or both eyes. Or the person may see double.

Headache. A sudden, severe headache may be a symptom of a stroke. Vomiting, dizziness and a change in consciousness may occur with the headache.

Trouble walking. Someone having a stroke may stumble or lose balance or coordination.

When to see a doctor

Seek immediate medical attention if you notice any symptoms of a stroke, even if they seem to come and go or they disappear completely. 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?

Speech. Ask the person to repeat a simple phrase. Is the person's speech slurred or different from usual?

Time. If you see any of these signs, call 911 or emergency medical help right away.

Call 911 or your local emergency number immediately. 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.

If you're with someone you suspect is having a stroke, watch the person carefully while waiting for emergency assistance.

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Causes

There are two main causes of stroke. An ischemic stroke is caused by a blocked artery in the brain. A hemorrhagic stroke is caused by leaking or bursting of a blood vessel in the brain. Some people may have only a temporary disruption of blood flow to the brain, known as a transient ischemic attack (TIA). A TIA doesn't cause lasting symptoms.

Ischemic stroke

This is the most common type of stroke. It happens when the brain's blood vessels become narrowed or blocked. This causes reduced blood flow, known as ischemia. Blocked or narrowed blood vessels can be caused by fatty deposits that build up in blood vessels. Or they can be caused by blood clots or other debris that travel through the bloodstream, most often from the heart. An ischemic stroke occurs when fatty deposits, blood clots or other debris become lodged in the blood vessels in the brain.

Some early research shows that COVID-19 infection may increase the risk of ischemic stroke, but more study is needed.

Hemorrhagic stroke

Hemorrhagic stroke occurs when a blood vessel in the brain leaks or ruptures. Bleeding inside the brain, known as a brain hemorrhage, can result from many conditions that affect the blood vessels. Factors related to hemorrhagic stroke include:

High blood pressure that's not under control.

Overtreatment with blood thinners, also known as anticoagulants.

Bulges at weak spots in the blood vessel walls, known as aneurysms.

Head trauma, such as from a car accident.

Protein deposits in blood vessel walls that lead to weakness in the vessel wall. This is known as cerebral amyloid angiopathy.

Ischemic stroke that leads to a brain hemorrhage.

A less common cause of bleeding in the brain is the rupture of an arteriovenous malformation (AVM). An AVM is an irregular tangle of thin-walled blood vessels.

Transient ischemic attack

A transient ischemic attack (TIA) is a temporary period of symptoms similar to those of a stroke. But a TIA doesn't cause permanent damage. A TIA is caused by a temporary decrease in blood supply to part of the brain. The decrease may last as little as five minutes. A transient ischemic attack is sometimes known as a ministroke.

A TIA occurs when a blood clot or fatty deposit reduces or blocks blood flow to part of the nervous system.

Seek emergency care even if you think you've had a TIA. It's not possible to tell if you're having a stroke or TIA based only on the symptoms. If you've had a TIA, it means you may have a partially blocked or narrowed artery leading to the brain. Having a TIA increases your risk of having a stroke later.

Risk factors

Many factors can increase the risk of stroke. Potentially treatable stroke risk factors include:

Lifestyle risk factors

Being overweight or obese.

Physical inactivity.

Heavy or binge drinking.

Use of illegal drugs such as cocaine and methamphetamine.

Medical risk factors

High blood pressure.

Cigarette smoking or secondhand smoke exposure.

High cholesterol.

Diabetes.

Obstructive sleep apnea.

Cardiovascular disease, including heart failure, heart defects, heart infection or irregular heart rhythm, such as atrial fibrillation.

Personal or family history of stroke, heart attack or transient ischemic attack.

COVID-19 infection.

Other factors associated with a higher risk of stroke include:

Age - People age 55 or older have a higher risk of stroke than do younger people.

Race or ethnicity - African American and Hispanic people have a higher risk of stroke than do people of other races or ethnicities.

Sex - Men have a higher risk of stroke than do women. Women are usually older when they have strokes, and they're more likely to die of strokes than are men.

Hormones - Taking birth control pills or hormone therapies that include estrogen can increase risk.

Complications

A stroke can sometimes cause temporary or permanent disabilities. Complications depend on how long the brain lacks blood flow and which part is affected. Complications may include:

Loss of muscle movement, known as paralysis. You may become paralyzed on one side of the body. Or you may lose control of certain muscles, such as those on one side of the face or one arm.

Trouble talking or swallowing. A stroke might affect the muscles in the mouth and throat. This can make it hard to talk clearly, swallow or eat. You also may have trouble with language, including speaking or understanding speech, reading or writing.

Memory loss or trouble thinking. Many people who have had strokes experience some memory loss. Others may have trouble thinking, reasoning, making judgments and understanding concepts.

Emotional symptoms. People who have had strokes may have more trouble controlling their emotions. Or they may develop depression.

Pain. Pain, numbness or other feelings may occur in the parts of the body affected by stroke. If a stroke causes you to lose feeling in the left arm, you may develop a tingling sensation in that arm.

Changes in behavior and self-care. People who have had strokes may become more withdrawn. They also may need help with grooming and daily chores.

Prevention

You can take steps to prevent a stroke. It's important to know your stroke risk factors and follow the advice of your healthcare professional about healthy lifestyle strategies. If you've had a stroke, these measures might help prevent another stroke. If you have had a transient ischemic attack (TIA), these steps can help lower your risk of a stroke. The follow-up care you receive in the hospital and afterward also may play a role.

Many stroke prevention strategies are the same as strategies to prevent heart disease. In general, healthy lifestyle recommendations include:

Control high blood pressure, known as hypertension. This is one of the most important things you can do to reduce your stroke risk. If you've had a stroke, lowering your blood pressure can help prevent a TIA or stroke in the future. Healthy lifestyle changes and medicines often are used to treat high blood pressure.

Lower the amount of cholesterol and saturated fat in your diet. Eating less cholesterol and fat, especially saturated fats and trans fats, may reduce buildup in the arteries. If you can't control your cholesterol through dietary changes alone, you may need a cholesterol-lowering medicine.

Quit tobacco use. Smoking raises the risk of stroke for smokers and nonsmokers exposed to secondhand smoke. Quitting lowers your risk of stroke.

Manage diabetes. Diet, exercise and losing weight can help you keep your blood sugar in a healthy range. If lifestyle factors aren't enough to control blood sugar, you may be prescribed diabetes medicine.

Maintain a healthy weight. Being overweight contributes to other stroke risk factors, such as high blood pressure, cardiovascular disease and diabetes.

Eat a diet rich in fruits and vegetables. Eating five or more servings of fruits or vegetables every day may reduce the risk of stroke. The Mediterranean diet, which emphasizes olive oil, fruit, nuts, vegetables and whole grains, may be helpful.

Exercise regularly. Aerobic exercise reduces the risk of stroke in many ways. Exercise can lower blood pressure, increase the levels of good cholesterol, and improve the overall health of the blood vessels and heart. It also helps you lose weight, control diabetes and reduce stress. Gradually work up to at least 30 minutes of moderate physical activity on most or all days of the week. The American Heart association recommends getting 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous aerobic activity a week. Moderate intensity activities can include walking, jogging, swimming and bicycling.

Drink alcohol in moderation, if at all. Drinking large amounts of alcohol increases the risk of high blood pressure, ischemic strokes and hemorrhagic strokes. Alcohol also may interact with other medicines you're taking. However, drinking small to moderate amounts of alcohol may help prevent ischemic stroke and decrease the blood's clotting tendency. A small to moderate amount is about one drink a day. Talk to your healthcare professional about what's appropriate for you.

Treat obstructive sleep apnea (OSA). OSA is a sleep disorder that causes you to stop breathing for short periods several times during sleep. Your healthcare professional may recommend a sleep study if you have symptoms of OSA. Treatment includes a device that delivers positive airway pressure through a mask to keep the airway open while you sleep.

Don't use illicit drugs. Certain illicit drugs such as cocaine and methamphetamine are established risk factors for a TIA or a stroke.

Preventive medicines

If you have had an ischemic stroke, you may need medicines to help lower your risk of having another stroke. If you have had a TIA, medicines can lower your risk of having a stroke in the future. These medicines may include:

Anti-platelet drugs. Platelets are cells in the blood that form clots. Anti-platelet medicines make these cells less sticky and less likely to clot. The most commonly used anti-platelet medicine is aspirin. Your healthcare professional can recommend the right dose of aspirin for you.

If you've had a TIA or minor stroke, you may take both an aspirin and an anti-platelet medicine such as clopidogrel (Plavix). These medicines may be prescribed for a period of time to reduce the risk of another stroke. If you can't take aspirin, you may be prescribed clopidogrel alone. Ticagrelor (Brilinta) is another anti-platelet medicine that can be used for stroke prevention.

Blooding-thinning medicines, known as anticoagulants. These medicines reduce blood clotting. Heparin is a fast-acting anticoagulant that may be used short-term in the hospital.

Slower acting warfarin (Jantoven) may be used over a longer term. Warfarin is a powerful blood-thinning medicine, so you need to take it exactly as directed and watch for side effects. You also need regular blood tests to monitor warfarin's effects.

Several newer blood-thinning medicines are available to prevent strokes in people who have a high risk. These medicines include dabigatran (Pradaxa), rivaroxaban (Xarelto), apixaban (Eliquis) and edoxaban (Savaysa). They work faster than warfarin and usually don't require regular blood tests or monitoring by your healthcare professional. These medicines also are associated with a lower risk of bleeding complications compared to warfarin.

Stroke care at Mayo Clinic

Show references

1. Walls RM, et al., eds. Stroke. In: Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Elsevier; 2023. https://www.clinicalkey.com. Accessed Sept. 13, 2023.

2. Ferri FF. Ferri's Clinical Advisor 2024. Elsevier; 2024. https://www.clinicalkey.com. Accessed Sept. 13, 2023.

3. Patients and caregivers. National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/health-information/public-education/know-stroke/patients-and-caregivers#. Accessed Sept. 13, 2023.

4. Stroke. National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health-topics/stroke. Accessed Sept. 13, 2023.

5. Oliveira-Filho J, et al. Initial assessment and management of acute stroke. https://www.uptodate.com/contents/search. Accessed Sept. 13, 2023.

6. About stroke. Centers for Disease Control and Prevention. https://www.cdc.gov/stroke/healthy_living.htm. Accessed Sept. 13, 2023.

7. Effects of stroke. American Stroke Association. https://www.stroke.org/en/about-stroke/effects-of-stroke. Accessed Sept. 13, 2023.

8. Rehab therapy after a stroke. American Stroke Association. https://www.stroke.org/en/life-after-stroke/stroke-rehab/rehab-therapy-after-a-stroke. Accessed Sept. 13, 2023.

9. Arteriovenous malformations (AVMs). National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/health-information/disorders/arteriovenous-malformations-avms?search-term=arterial#. Accessed Oct. 2, 2023.

10. Cerebral aneurysms. National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/disorders/patient-caregiver-education/fact-sheets/cerebral-aneurysms-fact-sheet. Accessed Sept. 13, 2023.

11. Transient ischemic attack. Merck Manual Professional Version. https://www.merckmanuals.com/professional/neurologic-disorders/stroke/transient-ischemic-attack-tia?query=transient%20ischemic%20attack#. Accessed Sept. 13, 2023.

12. Stroke. National Institute of Neurological Disorders and Stroke. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Post-Stroke-Rehabilitation-Fact-Sheet. Accessed Sept. 13, 2023.

13. Rose NS, et al. Overview of secondary prevention of ischemic stroke. https://www.uptodate.com/contents/search. Accessed Sept. 13, 2023.

14. Prevent stroke: What you can do. Centers for Disease Control and Prevention. https://www.cdc.gov/stroke/prevention.htm#print. Accessed Sept. 13, 2023.

15. Know your risk for stroke. Centers for Disease Control and Prevention. https://www.cdc.gov/stroke/risk_factors.htm#. Accessed Oct. 2, 2023.

16. Powers WJ, et al. Guidelines for the early management of patients with acute ischemic stroke: 2019 update to the 2018 guidelines for the early management of acute ischemic stroke - A guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2019; doi:10.1161/STR.0000000000000211.

17. Papadakis MA, et al., eds. Quick Medical Diagnosis & Treatment 2023. McGraw Hill; 2023. https://accessmedicine.mhmedical.com. Accessed Sept. 13, 2023.

18. Tsao CW, et al. Heart disease and stroke statistics - 2023 update: A report from the American Heart Association. Circulation. 2023; doi:10.1161/CIR.0000000000001123.

19. Grotta JC, et al., eds. Stroke: Pathophysiology, Diagnosis, and Management. 7th ed. Elsevier, 2022. https://www.clinicalkey.com. Accessed Sept. 15, 2023.

20. Suppah M, et al. An evidence-based approach to anticoagulation therapy comparing direct oral anticoagulants and vitamin K antagonists in patients with atrial fibrillation and bioprosthetic valves: A systematic review, meta-analysis and network meta-analysis. American Journal of Cardiology. 2023; doi:10.1016/j.amjcard.2023.07.141.

21. Tyagi K, et al. Neurological manifestations of SARS-CoV-2: Complexity, mechanism and associated disorders. European Journal of Medical Research. 2023; doi:10.1186/s40001-023-01293-2.

22. Siegler JE, et al. Cerebrovascular disease in COVID-19. Viruses. 2023; doi:10.3390/v15071598.

23. Lombardo M, et al. Health effects of red wine consumption: A narrative review of an issue that still deserves debate. Nutrients. 2023; doi:10.3390/nu15081921.

24. Jim J. Complications of carotid endarterectomy. https://www.uptodate.com/contents/search. Accessed Oct. 2, 2023.

25. Van Nimwegan D, et al. Interventions for improving psychosocial well-being after stroke: A systematic review. International Journal of Nursing Studies. 2023; doi:10.1016/j.ijnurstu.2023.104492.

26. Hasan TF, et al. Diagnosis and management of acute ischemic stroke. Mayo Clinic Proceedings. 2018; doi:10.1016/j.mayocp.2018.02.013.

27. Ami TR. Allscripts EPSi. Mayo Clinic. Sept. 4, 2023.

28. Barrett KM, et al. Ambulance-based assessment of NIH stroke scale with telemedicine: A feasibility pilot study. Journal of Telemedicine and Telecare. 2017; doi:10.1177/1357633X16648490.

29. Sener U, et al. Ischemic stroke in patients with malignancy. Mayo Clinic Proceedings. 2022; doi:10.1016/j.mayocp.2022.09.003.

30. Quality check. The Joint Commission. https://www.qualitycheck.org/search/?keyword=mayo%20clinic. Accessed Oct. 4, 2023.

31. Quality care you can trust. American Heart Association. https://www.heart.org/en/professional/quality-improvement/hospital-maps. Accessed Oct. 4, 2023.

32. Attig JM. Allscripts EPSi. Mayo Clinic. Oct. 9, 2023.

33. How much physical activity do you need? American Heart Association. https://www.heart.org/en/healthy-living/fitness/fitness-basics/aha-recs-for-physical-activity-infographic. Accessed Oct. 12, 2023.

34. Graff-Radford J (expert opinion). Mayo Clinic. Oct. 11, 2023.

35. Healthcare. DNV Healthcare USA, Inc. https://www.dnvhealthcareportal.com/hospitals?search_type=and&q=mayo+clinic&c=&c=20806&c=&c=&prSubmit=Search. Accessed Nov. 1, 2023.

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Promptly spotting stroke symptoms leads to faster treatment and less damage to the brain.

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Commonly referred to as “hardening of the arteries,” is a pathological process in which calcified lipid or fatty deposits from the flowing blood accumulate circumferentially. The plaques form, the walls become thick, fibrotic, and calcified, and the lumen narrows, reducing the flow of blood to the tissues the artery supplies.

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Commonly in a stroke, the middle cerebral artery becomes blocked. Clots form in the brain slowly over time-caused by fatty plaques in a process called atherosclerosis- eventually clogging arteries or causing blood vessels to break, leading to damage in the brain.

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We chose to study strokes because it is the number 5 cause of death in America. Many people have family members, close friends, or relatives who have suffered from a stroke, so it is important to learn more about them. This allows us to be more prepared, proactive, and aware of strokes and about who is most at risk.

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Stroke is a disease that affects the arteries leading to and within the brain. It is the No. 5 cause of death and a leading cause of disability in the United States.

A stroke occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot or bursts (or ruptures). When that happens, part of the brain cannot get the blood (and oxygen) it needs, so it and brain cells die.

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Stroke is a disease that affects the arteries leading to and within the brain. It is the No. 5 cause of death and a leading cause of disability in the United States.

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Strokes can have an increased likelihood due to smoking, high blood pressure, diabetes, and cardio vascular disease. To avoid strokes, doctors encourage a healthy diet and consistent exercise.

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1. blocked artery (ischemic stroke)
- It happens when the brain's blood vessels become narrowed or blocked, causing severely reduced blood flow. This is  caused by fatty deposits that build up in blood vessels or by blood clots or other debris that travel through the bloodstream, most often from the heart, and lodge in the blood vessels in the brain.
2. leaking or bursting of a blood vessel (hemorrhagic stroke)
- Hemorrhagic stroke occurs when a blood vessel in the brain leaks or ruptures. Brain hemorrhages can result from many conditions that affect the blood vessels.
Some common reasons:

Uncontrolled high blood pressure

Over-treatment with blood thinners (anticoagulants)

Bulges at weak spots in your blood vessel walls (aneurysms)

Trauma (such as a car accident)

Protein deposits in blood vessel walls that lead to weakness in the vessel wall (cerebral amyloid angiopathy)

Ischemic stroke leading to hemorrhage

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African Americans and Hispanics have the highest rate of stroke than any other race or ethnicity. Per 100,000 population, 223 African Americans, 196 Hispanic Americans, and 93 white Americans had strokes when adjusted for age. African American adults are also 45% more likely to die, the highest rate of death, followed by Hispanic Americans.

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Genetic factors also play a role in strokes. Genetic disorders like sickle cell disease can increase the chances of having a stroke. People with a family history of strokes are also more at risk because they may share common environments and other potentially similar factors that may increase their risk. When genetics combines with unhealthy lifestyle choices, like smoking and having a poor diet, chances for stroke also increase.

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Who is most likely affected by a stroke?

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Who is most likely affected by a stroke?

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People 55 or older are most at risk than younger people.

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Although stroke risk increases after 55, many factors play a role in who has one. Learn about risks and prevention to reduce stroke risk.