Neurology-Stroke

Types of Stroke and Related Disorders

The Penn Stroke Center treats all types of stroke and other diseases affecting the blood vessels in the brain. If you think you or someone you know may be having a stroke, it is critical to receive immediate care – you should call 911 right away.

There are two main types of strokes, hemorrhagic and ischemic:

• Hemorrhagic stroke occurs when weakened blood vessels in the brain burst, causing blood to leak into the brain.
• Ischemic stroke occurs when blood vessels supplying blood to the brain are blocked by a blood clot.

Other diseases affecting the blood vessels in the brain which are treated at the Penn Stroke Center include:

• Arterial dissection — A tear occurs in the lining of the wall of an artery. This may lead to clot forming in the artery, which can cause a stroke.
• Carotid stenosis — a condition caused by progressive narrowing of one or both carotid arteries; this may cause no symptoms, or may lead to stroke
• Intracranial stenosis — A narrowing of one or more of the large arteries inside the brain
• Transient ischemic attack (TIA) — A TIA is different from a stroke because it is caused by a blood clot that is temporary or "transient."
• Vasculitis — A condition characterized by the inflammation of blood vessels
• Venous sinus thrombosis — A clot forms in one of the large veins that drains blood out of the brain

The Penn Stroke Center has special expertise in:

• Migraine related stroke
• Recurrent stroke despite treatment
• Stroke in the young
• Stroke related to patent foramen ovale (PFO) — A heart condition characterized by a hole in the heart that did not close at birth
• Cryptogenic stroke — Stroke of undetermined cause

Stroke Symptoms

A stroke usually comes on suddenly and with little warning. Symptoms of stroke include:

• Sudden numbness or weakness of the leg, arm or face
• Sudden confusion or trouble understanding
• Sudden trouble seeing in one or both eyes
• Sudden trouble walking, dizziness, loss of balance or coordination
• Sudden severe headache with no known cause

Diagnosing a Stroke

At the Penn Stroke Center we offer patients the latest advanced technology in diagnostic testing for stroke and other diseases affecting the blood vessels in the brain.

Diagnostic testing includes:

• Carotid duplex ultrasound — Uses sound waves to image the carotid and vertebral arteries in the neck. This imaging modality provides information on atherosclerotic plaque formation and blockages within the arteries.
• Catheter angiography (also known as digital subtraction angiography)
• Computed tomography (CT), CT-angiography
• Magnetic resonance imaging (MRI) — Including diffusion and perfusion imaging
• MR-angiography Transcranial doppler ultrasound (TCD) — Uses sound waves to measure blood flow in the intracranial blood vessels. This imaging modality provides information on blockages or narrowing of the vessels supplying the brain.
• Transcranial doppler cerebral vasoreactivity studies — An advanced technique that uses TCD to measure the ability of cerebral blood vessels to properly regulate blood flow to the brain
• Transcranial doppler microembolic signal detection — An advanced imaging modality that uses TCD to detect emboli travelling in the blood vessels of the brain. This if often used to assess the risk of stroke in patients with carotid stenosis that is otherwise not causing symptoms.

Treating a Stroke

After experiencing a stroke, it's important to have a team of experts who will develop an individualized recovery plan and will do everything possible to prevent another stroke from happening.

We work collaboratively with a diverse group of specialists from multiple disciplines including:

• Emergency medicine
• Neurosurgery
• Physical Medicine and Rehabilitation
• Radiology
• Vascular surgery

The Penn Stroke Center offers advanced treatment approaches, including:

• Carotid endarterectomy
• Clinical trials of new stroke therapies
• Dedicated stroke and neuro-critical care units
• Endovascular interventions (including angioplasty and stent placement, mechanical thrombolysis, and aneurysm coiling)
• Extracranial-intracranial bypass surgery
• Intravenous thrombolytic therapy
• Medical therapies for prevention of stroke and enhancement of recovery
• Rehabilitation therapy