Types Of Stroke And Symptoms That Indicate Them

There are two main types of strokes, an ischemic or a hemorrhagic. “In hemorrhage, too much blood is contained within the closed cranial cavity; in ischemia, too little blood is available to meet the oxygen and nutrient need for an area within the brain.” Intracranial hemorrhage is divided into two categories as well, these are intracerebral hemorrhage and subarachnoid hemorrhage. Intracerebral hemorrhage involves a bleed directly onto the brain. Subarachnoid hemorrhage involves a bleed into the CSF around the brain and spinal cord. Brain ischemia can be divided into three categories, the first is thrombosis which means there is an occlusion in the blood vessel. The second is embolism which is “passage of materials, most often thrombi, from the place where they developed into a distant location in the vascular bed.” The third is systemic hypoperfusion, this is when the cerebral blood flow is significantly decreasing.

There are some risk factors that can be controlled and others that cannot. For example, you cannot control things such as being over 65, being African American, being a male, or having diabetes, or your family history. However, you can control or treat things such as high blood pressure, heart disease, high cholesterol, sleep apnea, smoking, alcohol consumption, and obesity. Another thing that can be a risk factor for future strokes is if you have a “personal history of stroke or TIA [transient ischemic attack].”

It is very important for every healthcare professional and every person to know the symptoms of stroke so that they can be of help in that situation. There are five common symptoms of a stroke, these are: “Numbness or weakness of the face, arm, or leg, especially on one side of the body, confusion, trouble speaking, or trouble understanding, trouble seeing in one or both eyes, dizziness, trouble walking, loss of balance or coordination, [and/or] severe headache with no known cause.” There are some other less common symptoms that could also identify a stroke. These could be nausea, fever, vomiting, or loss of consciousness. A transient ischemic attack is also a symptom of a stroke but should not be confused for a stroke. “The symptoms are similar to those of stroke, but they usually disappear within an hour.” There are even specific symptoms or groups of symptoms for the different subtypes of strokes. Thrombotic stroke symptoms may include headaches before the event, or “weakness of the face, arm, and leg on one side of the body unaccompanied by sensory, visual, or cognitive abnormalities”. Symptoms of embolism may be “sudden onset of a cold, blue limb” or “very slow and very fast pulses”, these pulses are normally irregular as well. Some symptoms of intracranial hemorrhage include “Headache that develops after onset and is accompanied by gradually increasing neurologic signs, decreased consciousness and vomiting”. Symptoms of subarachnoid hemorrhage include severe headache, vomiting, and/or decreased alertness. When you see stroke-like symptoms you should always assume it is a stroke and get the proper help and treatment needed.

The course of illness can be very influential in categorizing and recognizing a stroke subtype. For example, “Thrombosis-related symptoms often fluctuate.” “Patients with ICHs do not improve during the early period but worsen gradually during minutes or a few hours.” “Large focal neurologic deficits that begin abruptly or progress quickly are characteristic of embolism or ICH.” “Rapid recovery also favors embolism.” “Similarly, aneurysmal SAH develops in an instant.” These ways of predicting a stroke subtype can be helpful but ultimately anyone who possibly has a stroke should have a professional medical test done to confirm. Tests include CT, MRI, extracranial and transcranial ultrasounds, CTA, and MRA, Echocardiography, blood tests, and cardiac rhythm monitoring. These are all tests that can be useful in more accurately diagnosing a stroke and the subtype.

Works Cited

1. “Seizures and Strokes.” CNA Training Advisor: Lesson Plans for Busy Staff Trainers, vol. 16, no. 10, Oct. 2018, pp. 2–5. EBSCOhost, search.ebscohost.com/login.aspx?direct=true&AuthType=sso&db=ccm&AN=131746080&site=eds-live&scope=site&custid=s8863735.
2. Bogousslavsky, Julien. Stroke : Selected Topics. Vol. 1st ed, Demos Medical, 2006. EBSCOhost, search.ebscohost.com/login.aspx?direct=true&AuthType=sso&db=nlebk&AN=221199&site=eds-live&scope=site&custid=s8863735.