What are the different types of strokes?

Strokes have different causes, but all require fast action

All strokes involve potential damage to the affected area of the brain. All strokes have the same symptoms, which make it easier to know when to seek help. And all strokes can have far-reaching effects — on your movement, speech, emotional health, brain function and even how you swallow.

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

A stroke, a.k.a. a “brain attack,” is a medical emergency that happens when blood flow is cut off to an area of the brain or an artery in the brain bursts open. Most strokes fall into 2 main categories:

Ischemic stroke
Hemorrhagic stroke

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

“But if you do,” he says, “the sooner a stroke is identified and managed, the better the chances of recovery and minimizing long-term effects.”

What is an ischemic stroke?

Most strokes — an estimated 87 percent — are ischemic. These happen when blood flow through the artery to the brain becomes blocked, usually by a blood clot or a buildup of fatty deposits called plaque.

There are 2 types of ischemic strokes:

Embolic stroke
Thrombotic stroke

“An embolic stroke occurs when a blood clot or plaque debris 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.”

Due to the lack of blood flow, oxygen and nutrients, brain cells begin to die within minutes, making immediate medical attention crucial. Treatment involves removing the blockage as quickly as possible either with blood thinners or surgery.

What is a hemorrhagic stroke?

A hemorrhagic stroke happens when a blood vessel bursts and bleeds on the brain, which puts too much pressure on brain structures and damages brain cells. Hemorrhagic strokes are typically caused by high blood pressure and aneurysms, but can be caused by malformations or fistulas.

There are 2 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, usually from uncontrolled high blood pressure,” 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, usually through a combination of medication and surgery.

What’s a “mini stroke”?

You’ve probably heard of “warning” or “mini” strokes. The technical term for these is transient ischemic attack, or TIA. “With a TIA, blood flow to the brain is temporarily blocked, usually for less than 5 minutes, and symptoms resolve within 24 hours without permanent damage,” 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 ischemic stroke later on.

Risk factors for stroke

Anyone can have a stroke at any age. But, identifying risk factors early can be instrumental in reducing your chances.

While there are risk factors like age (older than 65) and family history you can’t control, the good news is more than 80% of strokes can be prevented through healthy lifestyles and managing chronic conditions.

Controllable risk factors for stroke include:

High blood pressure
High cholesterol
Type 2 diabetes
Smoking
Excessive alcohol consumption
Sedentary lifestyle
Obesity and poor diet

“Many stroke prevention strategies are the same as those recommended to ward off heart disease, because heart health and stroke are closely linked,” says Dr. Schirmer. “It’s also important to have regular checkups with your doctor to manage risk factors and treat underlying causes of stroke.”

Signs of a 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

“Recognizing stroke symptoms is critical for timely medical intervention to minimize or reverse damage by restoring blood flow to the brain,” says Dr. Schirmer. “A stroke is an emergency and every minute counts. So, BE FAST to save a life and reduce the risk of long-term disabilities.”