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Strokes have different causes, but all require fast action

All strokes involve potential damage to an area of the brain. And all strokes have the same symptoms — which makes it easier to know when to seek help.

But strokes have different causes, and that means different treatments and different recovery paths.

Dr. Clemens Schirmer, a neurosurgeon at Geisinger Medical Center, explains the types of strokes, how they differ and recommendations to reduce your risk of having one.

According to Dr. Schirmer, most strokes fall into two categories:

  • Ischemic stroke
  • Hemorrhagic stroke

What is an ischemic stroke?

Most strokes — almost 90 percent — are ischemic. These happen when blood flow through the artery to the brain becomes blocked, usually by a blood clot.

There are two types of ischemic strokes:

  • Embolic stroke
  • Thrombotic stroke

“An embolic stroke occurs when a blood clot travels to the brain and becomes lodged inside an artery,” explains Dr. Schirmer. “Thrombotic strokes happen when a blood clot forms inside one of the brain’s arteries.”

Treatment involves removing the blockage as quickly as possible.

What is a hemorrhagic stroke?

A hemorrhagic stroke happens when the brain leaks blood, damaging or destroying brain cells. Hemorrhagic strokes are typically caused by high blood pressure and aneurysms but can be caused by malformations or fistulas.

There are two types of hemorrhagic strokes:

  • Intracerebral hemorrhage
  • Subarachnoid hemorrhage

Intracerebral are the most common types of hemorrhagic strokes. “Intracerebral hemorrhage strokes occur when bleeding takes place within the brain,” says Dr. Schirmer. “Subarachnoid hemorrhage strokes take place when bleeding occurs between the brain and the spaces that immediately surround it due to a ruptured aneurysm or malformation.”

Treatment of hemorrhagic stroke focuses on controlling bleeding and reducing pressure in the brain.

What’s a “mini stroke”?

You’ve probably heard of “mini” or “warning” strokes. The technical term for these is transient ischemic, or TIA, stroke. “With a TIA, blood flow to the brain is usually blocked for less than 5 minutes and symptoms resolve within 24 hours, and usually much faster,” Dr. Schirmer says. “But a TIA is a warning sign that a future, more severe stroke may occur.”

In other words, a TIA stroke requires immediate treatment and should be managed carefully, just like any other stroke. Doing so can lower your risk of having a major stroke.

Know the signs of stroke

Knowing the warning signs of a stroke and calling 911 as soon as possible can have a big impact on recovery. Use the acronym BE FAST to remember the signs and know when to seek help:

  • Balance difficulties
  • Eyesight changes
  • Face drooping
  • Arm weakness
  • Speech difficulty
  • Time to call 911

Tips to help prevent stroke

The good news is that up to 80 percent of strokes can be prevented through healthy lifestyle behaviors:

If you think you may be at risk for having stroke, talk to your healthcare team.

Next steps:

Watch: Breakthrough stroke treatment saves Charlie’s life
Meet Clemens Schirmer, MD
Learn about stroke care at Geisinger