Stroke Symptoms and Causes

Stroke is the fifth leading cause of death in the United States and a major cause of disability in American adults.

About 795,000 strokes are reported each year, according to the Centers for Disease Control and Prevention (CDC). (1)

Treatments are available that can reduce the damage of stroke. Getting treatment as soon as possible can help to prevent permanent disability.

Knowing the signs and symptoms of stroke can help save lives.

Because stroke injures the brain, people who are having a stroke may not be aware of it.

People suffering from stroke have the best chance of surviving if someone around them recognizes the signs and acts quickly by calling 911.

Common Signs of Stroke

The type and severity of stroke symptoms depend on the area of the brain that is affected.

Signs and symptoms of stroke in both men and women may include:

• Sudden numbness, weakness, or inability to move the face, arm, or leg (especially on one side of the body)
• Confusion
• Trouble speaking or understanding speech
• Trouble seeing in one or both eyes
• Dizziness, trouble walking, or loss of balance or coordination
• Sudden, severe headache (often described as “the worst headache of my life”)
• Trouble breathing
• Loss of consciousness

FAST!

Learning this simple acronym can help you remember the signs and symptoms of stroke.

If you think that you or someone around you is having a stroke, call 911 immediately.

• Face Drooping Ask the person to smile. Is the smile uneven?
• Arm Weakness Ask the person to raise both arms. Does one drift downward?
• Speech Difficulty Is speech slurred or hard to understand? Ask the person to repeat a simple sentence, like: “The sky is blue.” Is the sentence repeated correctly?
• Time to call 911 Call 911 if someone shows any of these symptoms, even if the symptoms go away. Check the time so you’ll know when symptoms first started. (2)

Symptoms in Women are Different

Stroke is the third leading cause of death in women and the fifth leading cause of death in men. Every year, 55,000 more women have a stroke than men, according to the National Stroke Association. (3)

The stroke symptoms women may experience can be different from those experienced by men. According to Northwestern Medicine, these might include:

• Difficulty breathing or shortness of breath
• Racing heartbeat
• Fatigue
• Chest pain
• Nausea
• Hiccups

Blood Tests and Scans Can Help Make A Diagnosis

Your doctor will diagnose stroke based on several factors, including symptoms, medical history, physical exam, and diagnostic tests.

The following brain and heart tests may be used to help diagnose stroke:

• Brain computerized tomography (brain CT scan) uses X-rays to take pictures of the brain.
• Magnetic resonance imaging (brain MRI) uses magnets and radio waves to show changes in brain tissue.
• Carotid ultrasound, or carotid angiography, shows the insides of the arteries that supply blood to the brain.
• Electrocardiogram (EKG) is a heart test to help detect heart problems that may have led to a stroke.
• Echocardiography creates a picture of the heart to show how well it’s working.

Blood tests may also be used to help diagnose a stroke. (4)

Types and Causes of Stroke

A stroke happens when blood that carries oxygen to the brain is blocked.There are two main types of stroke: ischemic and hemorrhagic.

Ischemic strokes are caused by blood clots that block blood flow to the brain. This type of stroke accounts for 87 percent of all cases.

Blockages can form when the arteries supplying blood to the brain become narrowed by a buildup of plaque.

Plaque is a combination of fat, cholesterol, and other substances that build up in the inner lining of the artery wall. This condition is often referred to as atherosclerosis, or “hardening of the arteries.” (5)

Hemorrhagic strokes are caused by bleeding in or around the brain. They make up about 13 percent of stroke cases.

Bleeding occurs when a weakened blood vessel in the brain ruptures and leaks into the surrounding brain tissue.

The bleeding can put too much pressure on the cells in the brain, causing damage.

Two types of weakened blood vessels can cause hemorrhagic stroke:

• Aneurysm, an abnormally shaped weak point in a blood vessel
• Arteriovenous malformations (AVMs), clusters of abnormally formed blood vessels (6)

Some Risk Factors Can Be Treated

Certain environmental factors, medical conditions, and lifestyle habits increase your risk of stroke.

Some risk factors can be treated or controlled, while other risk factors cannot.

Factors that can’t be changed include:

• Family History Stroke often runs in families. Your stroke risk may be higher if a grandparent, parent, or sibling has suffered a stroke in the past.
• Age Stroke is most common in adults over age 65. The chance of having a stroke doubles for each decade of life after 55, according to the American Stroke Association.
• Gender Women have more strokes than men, and strokes kill more women than men each year.
• Race African-Americans, Hispanics, American Indians, and Alaska Natives have a higher risk of stroke than non-Hispanic whites or Asians.
• Personal History Having had a previous stroke increases your chances of having another. (7,8)

Stroke risk factors that can be modified include:

• High Blood Pressure High blood pressure is the main risk factor for stroke. It can damage and weaken arteries throughout the body so that they burst or clog more easily.
• High Cholesterol Cholesterol is a fatty substance that contributes to plaques in the arteries that can block blood flow to the brain.
• Heart Disease Coronary artery disease, the buildup of plaque in the arteries, can increase your risk of stroke. So can other heart conditions, including heart valve defects and irregular heartbeat (atrial fibrillation).
• Diabetes Not only does diabetes increase the risk of stroke, many people with the condition also have high blood pressure, high cholesterol, and are overweight, which increases the risk further.
• Sickle Cell Anemia Sickle cell anemia is an inherited form of anemia typically diagnosed in infancy, in which there aren’t enough healthy red blood cells to carry an adequate amount of oxygen to the rest of the body. The condition heightens the risk of stroke if sickle cells block blood flow to the brain. Doctors can use a special, painless ultrasound machine to assess which children are at a greater risk of stroke. Regular blood transfusions can reduce the risk of a stroke. (9)

Other Risk Factors for Stroke

Certain lifestyle habits and conditions can also increase your risk of stroke.

These risk factors include:

• Smoking
• Poor diet
• Obesity
• Low physical activity
• Stress and depression
• Heavy alcohol use
• Use of illicit drugs, including cocaine and amphetamines (8)

Additional reporting by Ashley Welch.