Ischemic Stroke

Risk factors you cannot control

• Age: People of any age can have a stroke, but your risk increases as you get older.
• Family history: Your risk is higher if someone in your close family—a parent, brother or sister—has had a stroke.
• History of heart attack: Heart attacks share many stroke risk factors, such as high cholesterol.
• History of stroke or TIA: One stroke or TIA increases the likelihood of having another stroke.
• Race: Black and Hispanic people have a higher risk than white people.
• Sex: Women’s risk of stroke is higher than men’s.

Lifestyle risk factors

• Drinking too much: Consuming excess alcohol can increase blood pressure, a stroke risk factor.
• Eating habits: A diet high in sodium, unhealthy fats and sugar can lead to excess weight, diabetes, high blood pressure and high cholesterol, which are all stroke risk factors.
• Sedentary lifestyle: Not moving enough can contribute to health problems that raise stroke risk.
• Smoking: Chemicals in cigarettes can damage blood vessels. Smoking also raises blood pressure.

Medical risk factors

• Atrial fibrillation: This heart rhythm disorder can cause blood clots, which can come loose and block blood vessels in the brain.
• Carotid artery disease: Plaque buildup in the carotid arteries in your neck, which bring blood to your brain, can contribute to blockages.
• Excess weight: Being obese increases your risk of diabetes, high blood pressure and heart disease, each of which can increase stroke risk.
• Diabetes: High blood sugar can cause fatty deposits and blood clots that can lead to a stroke.
• High blood pressure: High blood pressure damages blood vessels, making them more prone to narrowing and blockages.
• High cholesterol: High cholesterol can also damage blood vessels, and it contributes to plaque in the arteries.
• Obstructive sleep apnea (OSA): OSA causes you to stop breathing when you sleep, which can increase your risk of heart disease and stroke.
• Sickle cell disease: Red blood cells have a curved shape and are more likely to stick together. Sickle cells can become stuck in a blood vessel, blocking blood flow to the brain.

Medication

Doctors may use a medication called tissue plasminogen activator (tPA or alteplase) or Tenecteplase (TNK) to break up blood clots and restore blood flow to the brain. For the best results, the clot-busting medication should be given within 4.5 hours of when stroke symptoms first appear. That’s why it’s so important to get emergency care right away.

If the clot-buster medication isn’t an option, doctors may prescribe aspirin or other blood thinners to help prevent new clots from forming. These medications can also help lower the risk of future strokes.

After a stroke, some people may need medications to reduce brain swelling or pressure. Others might require oxygen therapy or IV fluids to stay hydrated and get the nutrients they need for recovery.

Surgery

Surgery to remove a blockage from a brain artery is called thrombectomy. This surgery may be done up to 24 hours after stroke symptoms begin.

Generally, doctors use thrombectomy when a blockage occurs in a blood vessel large enough to insert a catheter and special surgical tools.

In thrombectomy, a doctor threads a catheter through an artery in your groin to reach the blocked artery. Your team will inject dye into the catheter so your surgeon can use imaging to view the artery and perform the procedure. The doctor then inserts a tool that grabs and removes the clot. To help prevent future strokes, doctors may recommend:

• Carotid endarterectomy: A surgical procedure to remove built-up fatty plaque from the inside of the carotid artery, improving blood flow to the brain.
• Carotid artery stenting: A minimally invasive procedure where a small mesh tube (stent) is placed inside the carotid artery using a catheter. The stent helps keep the artery open and reduces the risk of blockages.

Stroke rehabilitation

After a stroke, you will receive rehabilitation to help you recover skills and abilities. Rehabilitation for stroke focuses on any aspect of your life affected by the stroke, including thinking, speaking, movement and everyday activities.

• Cognitive therapy: This helps you with focus and memory.
• Occupational therapy: You learn strategies to perform activities of daily living, such as dressing, brushing your teeth and cooking.
• Speech-language therapy: Speech-language therapists help with forming and understanding words and with issues related to swallowing.
• Physical therapy: You build skills and abilities to help with balance, coordination and strength.