Stroke is a brain injury that occurs when the brain's blood supply is interrupted. Without oxygen and nutrients from blood, brain tissue starts to die within minutes, resulting in a sudden loss of function. Another term for stroke is cerebrovascular accident (CVA).
In order to change people’s perception of stroke as untreatable, there has been a national effort over the past decade or so to call it a "brain attack," acquiring some of the urgency popularly associated with heart attacks. The acute treatment of "brain attacks" has not reached the level of success now achieved with heart attacks. Nevertheless, acute treatment is beginning to show results if done within three hours of onset.
The types of stroke include:
Ischemic Stroke
An ischemic stroke most often occurs when blood flow to the brain becomes blocked.
One of the following events may cause this blockage:
- The most common cause is a build-up of fatty substances (atherosclerotic plaque) along an artery's inner lining that causes it to narrow, reduces its elasticity, and decreases its blood flow.
-
A clot forms in an artery supplying the brain, usually one affected by
atherosclerosis
.
- A clot forms somewhere in the body (often the heart) and breaks free, traveling to and becoming lodged in an artery supplying the brain. This clot is called an embolus, and the process is called embolism.
Hemorrhagic Stroke
A stroke may also occur if a blood vessel breaks and bleeds into or around the brain; this is called hemorrhagic stroke. Trauma, cocaine abuse, and
high blood pressure
are the leading causes of hemorrhagic strokes, which occur more commonly in younger people. Aneurysms predispose you to hemorrhagic stroke. An aneurysm is a weak spot in an artery that balloons out under pressure and can rupture, causing bleeding into the brain.
In the United States, cerebrovascular disease is the third leading cause of death and disability, striking about 700,000 people each year, and causing about 163,000 deaths per year. Of these, 85% to 90% are due to ischemic stroke and the remainder to hemorrhagic stroke. Asians and African Americans have a higher incidence of hemorrhagic stroke than whites.
Last reviewed May 2007 by
J. Thomas Megerian, MD, PhD, FAAP
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