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An inside look at a “brain attack”

A stroke is a scary event—it could have long-reaching effects on your movement, speech, emotional health, brain function and even how you swallow. And in some cases, a stroke could cause death.

There are two different types of stroke. Ischemic strokes account for about 87 percent of all stroke cases, while hemorrhagic strokes account for about 13 percent. 

“Most often, when people talk about stroke they’re describing an ischemic stroke, where blood flow to the brain is blocked,” said Geisinger vascular neurologist Ramin Zand, M.D. “Hemorrhagic strokes are less common and happen when a weak or ruptured artery leaks blood into the brain.”

During an ischemic stroke, arteries to your brain get blocked or become narrowed by a blood clot. 

Ischemic strokes can be classified as either thrombotic or embolic, depending on where the blood clot forms. In a thrombotic stroke, a blood clot forms in an artery that carries blood to your brain. A clot usually forms in an artery that is already narrowed by plaque buildup. In an embolic stroke, a blood clot forms in another part of your body, breaks away and is swept toward your brain. Often, these blood clots form in the heart. 

During a hemorrhagic stroke, an artery in the brain bursts open or leaks blood into the brain due to high blood pressure, too much blood thinning medication or an outpouching of a blood vessel wall (aneurysms), which are weak spots in blood vessels. Hemorrhagic strokes can further be classified depending on where, exactly, the brain bleed happens.

“Once blood flow is blocked or blood begins leaking into the brain, cells become damaged or die—and where these cells die could put you at risk for major disability or death,” said Dr. Zand. 

The effects of a stroke can vary depending on where in the brain the stroke occurs and how many brain cells die. A stroke can cause paralysis, difficulty swallowing or talking, memory loss, pain, emotional changes and behavior issues. 

TIAs – Warning signs of a more serious problem
Ischemic and hemorrhagic strokes can cause major complications and even death. But there’s a third health issue closely related to an ischemic stroke that is also a cause for concern. It’s called a transient ischemic attack (TIA), and it’s a result of temporarily blocked blood flow to part of the brain.

Though blood flow is usually blocked for fewer than five minutes, this event is just as serious as a major stroke. TIAs are usually caused by blood clots and are often precursors to ischemic strokes—over one-third of people have a stroke within a year of having a TIA. 

“Someone having a TIA or a major ischemic stroke might show the same symptoms, so it’s vital to get emergency medical help as soon as possible,” said Dr. Zand. “Though TIAs often don’t cause any damage, getting treatment for a TIA can help you work toward preventing a major stroke in the future.”

What causes a stroke
Strokes are serious health issues, but they’re often preventable. High blood pressure, smoking, diabetes, poor diet, obesity, high cholesterol, AFib (atrial fibrillation) and heart disease are all risk factors for stroke. 

“Making good lifestyle choices like eating a healthy diet, getting exercise and managing any current health issues you have can help you avoid a debilitating stroke,” said Dr. Zand. “The ways you protect your heart health can also help you avoid having a stroke.”

Signs and symptoms to look for
When someone has a stroke, it’s important to get medical help as soon as possible to restore blood flow to the brain or stop the bleeding. 

Here are the symptoms that signal someone may be having a stroke:

  • Sudden weakness or numbness in your face, arm or leg on one side of your body
  • Speech difficulty or inability to understand speech
  • Sudden loss of balance or coordination
  • Vision loss or dimness in one eye
  • Trouble swallowing
  • Sudden and severe headache with no cause

If you notice any of these signs in someone, call 9-1-1 immediately. 

Vascular neurologist Ramin Zand, M.D., is the northeastern regional stroke director for Geisinger Wyoming Valley Medical Center (GWV) in Wilkes-Barre and Geisinger Community Medical Center (GCMC) in Scranton. 

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Geisinger Medical Center receives esteemed Comprehensive Stroke Center status