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A stroke occurs when blood flow to a part of the brain stops. A stroke is sometimes called a "brain attack."

If blood flow is cut off for longer than a few seconds, the brain cannot get nutrients and oxygen. Brain cells can die, causing lasting damage.

Alternative Names:

Cerebrovascular disease; CVA; Cerebral infarction; Cerebral hemorrhage; Ischemic stroke; Stroke - ischemic; Cerebrovascular accident; Stroke - hemorrhagic


There are two major types of stroke:

  • Ischemic stroke
  • Hemorrhagic stroke

Ischemic stroke occurs when a blood vessel that supplies blood to the brain is blocked by a blood clot. This may happen in two ways:

  • A clot may form in an artery that is already very narrow. This is called a thrombotic stroke.
  • A clot may break off from another place in the blood vessels of the brain, or from some other part of the body, and travel up to the brain. This is called cerebral embolism, or an embolic stroke.

Ischemic strokes may also be caused by a sticky substance called plaque that can clog arteries.

Stroke - secondary to cardiogenic embolism
Stroke - secondary to cardiogenic embolism

A hemorrhagic stroke occurs when a blood vessel in part of the brain becomes weak and bursts open. This causes blood to leak into the brain. Some people have defects in the blood vessels of the brain that make this more likely. These defects may include:

Hemorrhagic strokes may also occur when someone is taking blood thinners, such as warfarin (Coumadin). Very high blood pressure may cause blood vessels to burst, leading to hemorrhagic stroke.

An ischemic stroke can develop bleeding and become a hemorrhagic stroke.

High blood pressure is the main risk factor for strokes. Other major risk factors are:

Hypertension - overview
Hypertension - overview

Stroke risk is also higher in:

  • People who have heart disease or poor blood flow in their legs caused by narrowed arteries
  • People who have unhealthy lifestyle habits such as smoking, a high-fat diet, and lack of exercise
  • Women who take birth control pills (especially those who smoke and are older than 35)
  • Women who are pregnant have an increased risk while pregnant
  • Women who take hormone replacement therapy

A stroke is a medical emergency. Quick treatment is needed. Call 911 or your local emergency number or seek urgent medical care at the first signs of a stroke.

People who are having stroke symptoms need to get to a hospital as quickly as possible.

  • If the stroke is caused by a blood clot, a clot-busting drug may be given to dissolve the clot.
  • To be effective, this treatment must be started within 3 to 4 1/2 hours of when the symptoms first started. The sooner this treatment is started, the better the chance of a good outcome.

Other treatments given in the hospital depend on the cause of the stroke. These may include:

  • Blood thinners such as heparin, warfarin (Coumadin), aspirin, or clopidogrel (Plavix)
  • Medicine to control risk factors, such as high blood pressure, diabetes, and high cholesterol
  • Special procedures or surgery to relieve symptoms or prevent more strokes
  • Nutrients and fluids

Physical therapy, occupational therapy, speech therapy, and swallowing therapy will all begin in the hospital. If the person has severe swallowing problems, a feeding tube in the stomach (gastrostomy tube) will likely be needed.

The goal of treatment after a stroke is to help you recover as much function as possible and prevent future strokes.

Recovery from your stroke will begin while you are still in the hospital or at a rehabilitation center. It will continue when you go home from the hospital or center. Be sure to follow up with your health care provider after you go home.

Support Groups:

Support and resources are available from the American Stroke Association:

Outlook (Prognosis):

How well a person does after a stroke depends on:

  • The type of stroke
  • How much brain tissue is damaged
  • What body functions have been affected
  • How quickly treatment is given

Problems moving, thinking, and talking often improve in the weeks to months after a stroke.

Many people who have had a stroke will keep improving in the months or years after their stroke.

Over half of people who have a stroke are able to function and live at home. Others are not able to care for themselves.

If treatment with clot-busting drugs is successful, the symptoms of a stroke may go away. However, patients often do not get to the hospital soon enough to receive these drugs, or they can't take these drugs because of a health condition.

People who have a stroke from a blood clot (ischemic stroke) have a better chance of surviving than those who have a stroke from bleeding in the brain (hemorrhagic stroke).

The risk for a second stroke is highest during the weeks or months after the first stroke. The risk begins to decrease after this period.

When to Contact a Medical Professional:

Stroke is a medical emergency that needs to be treated right away. The acronym F.A.S.T. is an easy way to remember signs of stroke and what to do if you think a stroke has occurred. The most important action to take is to immediately call 9-1-1 for emergency assistance.

F.A.S.T. stands for:

  • FACE. Ask the person to smile. Check to see if one side of the face droops.
  • ARMS. Ask the person to raise both arms. See if one arm drifts downward.
  • SPEECH. Ask the person to repeat a simple sentence. Check to see if words are slurred and if the sentence is repeated correctly.
  • TIME. If a person shows any of these symptoms, time is essential. It is important to get to the hospital as quickly as possible. Call 9-1-1. Act F.A.S.T.

Reducing your stroke risk factors lessens your chances of a having stroke.


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Del Zoppo GJ, Saver JL, Jauch EC, Adams HP Jr: American Heart Association Stroke Council, Expansion of the time window for treatment of acute ischemic stroke with intravenous tissue plasminogen activator: a science advisory from the American Heart Association/American Stroke Association. Stroke. 2009;40:2945-2948. Epub 2009 May 28.

Furie KL, Kasner SE, Adams RJ, Albers GW, Bush RL, Fagan SC, et al. Guidelines for the prevention of stroke in patients with stroke or transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2011;42:227-276.

Goldstein LB, Bushnell CD, Adams RJ, Appel LJ, Braun LT, Chaturvedi S, et al. Guidelines for the primary prevention of stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2011;42:517-584.

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Stein J. Stroke. In: Frontera WR, Silver JK, Rizzo TD, eds. Essentials of Physical Medicine and Rehabilitation. 2nd ed. Philadelphia, PA: Elsevier Saunders; 2008:chap 149.

Review Date: 5/28/2014
Reviewed By: Joseph V. Campellone, MD, Division of Neurology, Cooper University Hospital, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Editorial update: 07/07/2015.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2002 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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