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Not All Strokes Are the Same: Easy Guide to Strokes

By Alyssa Ball

Whatever your age, you're probably aware that a stroke is a dangerous medical event with life-changing consequences. Many seniors and their loved ones are aware of some of the serious warning signs of a stroke, like arm weakness, difficulty speaking, and face drooping. But did you know that this medical emergency — which affects around 800,000 Americans every year — comes in different forms?

Not only do strokes affect you differently based on where they occur in the brain, but strokes can be broken down into three distinct types. Ischemic strokes, hemorrhagic strokes, and transient ischemic attacks (TIA) are all caused by different factors in your brain, body, and cardiovascular system. By understanding the different types of strokes — and what contributes to each — you and your loved one can stay educated in the fight against strokes.

Strokes: The Basics

Throughout your body, your cardiovascular system pumps nutrient-rich, oxygen-rich to every organ, including your brain. 

Like heart attacks, strokes are associated with an interruption in that all-important blood flow. Whether this occurs as a result of a clot, a blockage, or a rupture, the results are dire. Without the influx of oxygen and nutrients supplied from blood, cells and tissues die very quickly in the affected parts of the brain.

How Strokes Damage Different Parts of the Brain

Brain cells can start to die just 5 minutes after losing their supply of oxygen-rich blood. Depending on which brain tissues are targeted, this affects everyone in a unique way:

  • Cerebrum: Your cerebrum takes up 2/3 of your brain's weight and is divided into left and right hemispheres. When a stroke damages blood cells in the cerebrum, you might experience changes in speech, movement, eating, reason, memory, perception, and emotional control.
  • Cerebellum: Located at the back of the skull, your cerebellum helps you with coordination and balance. If you have a stroke that impacts this part of your brain, you or a loved one might have trouble with walking, balance, and dizziness.
  • Brain Stem: Strokes that affect the brain stem can have serious consequences, including death. Situated right over your spinal cord, your brain stem helps control vital functions like breathing and heartbeat. Strokes in this part of the brain can impact heart and breathing function, and cause paralysis and coma.

3 Major Types of Stroke 

Every stroke comes with a unique set of challenges and issues. This has a lot to do with which parts of the brain are impacted, but also depends on the type of stroke you or a loved one experiences:

1. Ischemic Stroke

Let's talk about the most common type of stroke first. Ischemic events account for 87% of all strokes. The word ischemia means restriction of blood supply. In this type of stroke, one of the arteries that supplies the brain becomes blocked. Once this happens, cells and brain tissue rapidly die.

In some cases, doctors can administer a medication that helps dissolve the clot. In other cases, they might have to remove the clot through a mechanical treatment. Ischemic strokes are divided into 2 main types:

  • Thrombotic: In this type of ischemic stroke, a blood clot or blockage forms in a damaged blood vessel inside the brain itself. 
  • Embolic: Though embolic strokes are also caused by blood clots, they're distinct from thrombotic types because they originate somewhere else in the body. By traveling through the bloodstream, they eventually restrict blood flow to the brain.

Who's at risk for ischemic strokes? 

Unfortunately, the risk of ischemic strokes increases with age. Most people who suffer from these are 60 years or older, and women are more commonly affected by men.

Often, a thrombotic stroke is caused by atherosclerosis, a condition where the blood vessels become narrow or blocked due to the buildup of plaque. Embolic strokes are often caused by atrial fibrillation, which is associated with an irregular heartbeat that causes blood to pool in the upper chambers of the heart and leads to a clot.

How do you prevent ischemic strokes?

Well, doctors agree that controlling risk factors like high blood pressure, managing atherosclerosis, and keeping high cholesterol under control can make a huge difference in your risk for an ischemic stroke.

2. Hemorrhagic Stroke

While ischemia refers to restricted blood flow, the word hemorrhage refers to blood releasing from a ruptured blood vessel. So while ischemic strokes are caused by clots and blockages, hemorrhagic strokes stem from burst blood vessels.  When blood from a ruptured vessel spills into the brain, it damages brain tissue and cells through increased swelling and pressure. Often, hemorrhagic strokes require surgery to remove the blood, repair damaged blood vessels, and relieve the excess brain pressure.

There are 2 different kinds of hemorrhagic stroke:

  • Intracerebral: An intracerebral hemorrhage is caused by bleeding inside the brain itself. Associated with aneurysms — in which a weakened or damaged blood vessel bulges and bursts — an intracerebral hemorrhage floods the brain with blood. The leaked blood then causes massive swelling, increases pressure in the brain, and releases cell-damaging toxins. 
  • Subarachnoid: Also caused by a burst aneurysm, a subarachnoid stroke simply occurs in a different part of the brain. It targets the space between the brain and the tissue that covers the brain.

Who's at risk for hemorrhagic strokes?

As in all strokes, high blood pressure is a major risk factor for hemorrhagic strokes. To prevent the risk of hemorrhagic strokes, it's important to avoid smoking cigarettes and drinking excessive alcohol.

In some cases, it can be difficult to predict an aneurysm, since blood vessels can age along with the rest of the body and simply become more likely to rupture. In addition, some people are born with abnormally formed blood vessels that are prone to become weak and burst, while others may suffer from head trauma that makes them more prone to hemorrhagic strokes.

3. Transient Ischemic Attack

Also known as a TIA, a transient ischemic attack occurs when blood flow to the brain is briefly interrupted. Though they don't usually cause lasting brain damage or death, they serve as a warning sign that a person is at risk for strokes in the future. In fact, 40% of people who have a TIA will go on to have a stroke down the road.

There are a few different ways a TIA can happen. First, a small blood clot can break off from somewhere else in the body and temporarily block blood flow, like an embolism. In other cases, TIAs occur when plaque builds up in a small blood vessel in the brain, causing the vessel to narrow and temporarily block blood flow.

Though symptoms often resolve within 24 hours, transient ischemic attacks require immediate medical intervention. A physician will work with you to identify why the TIA occurred — and help you reduce your risk factors for a future stroke.

HOW DO YOU PREVENT ISCHEMIC STROKES?

Like the other types of stroke, the risk of TIA's rises as we age. Some of other risk factors include:

  • High blood pressure
  • Smoking cigarettes
  • Diabetes
  • Blood clots and atherosclerosis
  • Heart disease

For seniors and their loved ones, strokes can be life-changing and even life-threatening. Knowing about the different types of strokes can help you stay educated about this dangerous medical issue.

To learn more about strokes, including how to recognize symptoms, how to respond during an event, and what recovery looks like, check out our comprehensive guide to strokes or feel free to contact us at Caring Senior Service. 

Alyssa Ball Blog Author

Warning Signs of Stroke Promotion

Tags: Heart health, Stroke

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