Understanding Strokes: Causes And Risk Factors

how can a stroke occur

A stroke, or brain attack, occurs when there is an issue with blood flow to the brain. This can be caused by blocked blood vessels or bleeding in the brain. Strokes are a medical emergency and can lead to permanent brain damage or death if not treated promptly. There are two main types of strokes: ischemic and hemorrhagic. Ischemic strokes, accounting for about 80% of cases, occur when a blood vessel in the brain is blocked by a blood clot or fatty deposits and cholesterol (plaque). Hemorrhagic strokes are caused by a burst blood vessel in the brain, resulting in bleeding into nearby tissues and increased pressure.

Characteristics Values
Type of stroke Ischemic stroke, Hemorrhagic stroke
Cause of stroke Blocked blood flow to the brain, Bleeding in the brain
Ischemic stroke cause Blocked by a blood clot, Blocked by a buildup of fatty deposits and cholesterol (called plaque)
Hemorrhagic stroke cause Blood vessel bursts and spills blood into nearby tissues, Weakened blood vessel leaks
Risk factors High blood pressure, Heart disease, Diabetes, Smoking, Oral contraceptives, High red blood cell count, High blood cholesterol and lipids, Excessive alcohol use, Illegal drugs, Abnormal heart rhythm, Cardiac structural abnormalities, Older age, Race, Gender, History of prior stroke, Heredity or genetics, Temperature, Season, Climate, Social and economic factors
Preventative measures Stop smoking, Healthy food choices, Maintain a healthy weight, Physical activity, Take prescribed medications, Lower blood pressure, Lower cholesterol

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Blocked blood flow to the brain

There are several ways in which blood flow to the brain can become blocked:

  • Thrombosis: This occurs when a blood clot forms in the brain, blocking blood flow. Blood clots can form due to a buildup of plaque or fatty deposits in the arteries, which can narrow or block the blood vessels.
  • Embolism: In this case, a blood clot forms elsewhere in the body and travels to the brain, lodging in one of the blood vessels and causing a blockage.
  • Lacunar stroke: This type of stroke is caused by small vessel blockage, which can be the result of long-term, untreated high blood pressure, high cholesterol, or high blood sugar.
  • Cryptogenic stroke: These are strokes of unknown origin, where the cause of the blockage is not determined.

Certain risk factors can increase the likelihood of experiencing a stroke due to blocked blood flow. These include:

  • Age: The risk of stroke increases with age, especially after 55.
  • Race: In the United States, stroke occurs more frequently in certain racial groups, including Black and Hispanic Americans.
  • Gender: Men are more likely to have a stroke at younger ages, while women tend to have strokes at older ages, making them less likely to recover and more likely to die as a result.
  • Genetics: Individuals with a family history of stroke are at a higher risk.
  • Medical conditions: High blood pressure, high cholesterol, Type 2 diabetes, heart disease, and a history of stroke or heart attack are all associated with an increased risk of stroke.
  • Lifestyle: Unhealthy lifestyle choices, such as smoking, excessive alcohol consumption, illegal drug use, and lack of exercise, can contribute to a higher risk of stroke.

Recognizing the signs of a stroke is crucial, as immediate medical attention is critical to prevent permanent damage or death. The acronym BE FAST can help identify key symptoms:

  • Balance: Sudden loss of balance or coordination.
  • Eyes: Sudden loss of vision or double vision in one or both eyes.
  • Face: Drooping or weakness on one side of the face.
  • Arms: Weakness or paralysis in one arm.
  • Speech: Difficulty speaking or slurred speech.
  • Time: Time is critical; call emergency services immediately if you or someone you know is exhibiting any of these symptoms.

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Bleeding in the brain

A stroke is a life-threatening medical emergency that occurs when there is an issue with blood flow to the brain. This can be due to blocked blood vessels or bleeding in the brain. When brain cells are starved of oxygen, they begin to die, and brain function is lost.

A stroke that leads to bleeding in the brain is called a hemorrhagic stroke. This occurs when a weakened blood vessel, such as an artery, ruptures and bleeds into the brain or the surrounding area. The leaked blood accumulates and compresses the brain tissue, causing further damage.

There are two main types of hemorrhagic strokes: intracerebral hemorrhage and subarachnoid hemorrhage. Intracerebral hemorrhage occurs when there is bleeding inside the brain, while subarachnoid hemorrhage involves bleeding between the brain and the membranes covering it.

Intracerebral hemorrhage happens when a blood vessel inside the brain tears or breaks open, causing bleeding that puts pressure on the surrounding brain tissue. On the other hand, subarachnoid hemorrhage occurs when there is bleeding between the brain and its outer covering, known as the arachnoid membrane. This thin layer of tissue surrounds the brain, and damage to the blood vessels passing through it can lead to bleeding and increased pressure on the underlying brain tissue.

The signs and symptoms of a hemorrhagic stroke are similar to those of an ischemic stroke but may be more severe and rapid in onset. These can include a sudden and severe headache, often described as the "worst headache of your life," loss of consciousness, inability to move or feel, confusion, irritability, muscle pain in the neck and shoulders, sensitivity to light, and one eye pupil appearing larger than the other.

The risk factors for hemorrhagic stroke include older age, high blood pressure, diabetes, high cholesterol, obesity, smoking, lack of exercise, poor diet, and a personal or family history of stroke. It is crucial to recognize the signs of a stroke and seek immediate medical attention to prevent permanent damage or death.

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High blood pressure

There are several factors that can increase your risk of high blood pressure, including family history, age, lack of physical activity, poor diet, gender-related risk patterns, obesity, and drinking too much alcohol.

To reduce high blood pressure, you should:

  • Eat a healthy diet, including reducing salt intake
  • Engage in regular physical activity and maintain a healthy weight
  • Avoid tobacco smoke
  • Take your medication as prescribed
  • Limit your alcohol consumption
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Blood clots

A stroke occurs when there is a blockage in blood flow to the brain, or when there is bleeding in the brain. In the former case, this is known as an ischemic stroke, and in the latter, a hemorrhagic stroke. Ischemic strokes are the most common type, accounting for about 80- 87% of all strokes.

There are two types of blockages caused by blood clots that lead to ischemic strokes:

  • Cerebral Embolism: This occurs when a blood clot forms in the circulatory system, usually in the heart or large arteries in the chest and neck. An irregular heartbeat or atrial fibrillation can cause a clot to form in the heart, which then dislodges and travels through the bloodstream to the brain. Once the clot reaches a blood vessel in the brain that is too narrow to pass through, it obstructs blood flow and oxygen to the brain.
  • Cerebral Thrombosis: This type of blood clot develops at the site of fatty plaque inside a blood vessel in the brain. The clot blocks the passage of blood through the vessel, causing an ischemic stroke.

Other risk factors for blood clots include a family history of blood clots, pregnancy and giving birth, remaining in one position for a prolonged period (such as on long journeys), serious surgeries, and certain medications like birth control pills.

Health conditions that can increase the risk of blood clots include diabetes, high blood pressure, and heart disease.

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Lifestyle factors

Unhealthy Diet: Consuming a diet high in saturated fat, trans fat, cholesterol, salt (sodium), and added sugars can elevate the risk of a stroke. Fatty deposits and cholesterol can lead to plaque buildup in the arteries, known as atherosclerosis, which narrows the arteries and limits blood flow to the brain.

Physical Inactivity: Leading a sedentary lifestyle or not engaging in regular physical activity can increase the likelihood of having a stroke. It is recommended to incorporate daily exercise, such as brisk walking, muscle-strengthening exercises, or physical therapy, to reduce stroke risk.

Obesity: Being overweight is a risk factor for stroke. Maintaining a healthy weight through proper diet and exercise can help lower the chances of experiencing a stroke.

Smoking: Smoking cigarettes or using other tobacco products, including vaping, nearly doubles the risk of an ischemic stroke. Nicotine causes an increase in blood pressure and contributes to fatty buildup in the arteries, making blood clots more likely to form.

Alcohol Consumption: Excessive alcohol intake, typically defined as more than two drinks per day, raises blood pressure and can lead to stroke. Binge drinking, in particular, has been associated with an increased risk of stroke.

Illegal Drug Use: Intravenous drug abuse, including cocaine use, carries a high risk of stroke from blood clots (cerebral embolisms). It is important to avoid recreational drug use to lower the chances of experiencing a stroke.

Sleep Habits: Getting too much sleep (more than 9 hours) or not getting enough sleep (less than 7-8 hours) can impact stroke risk. Maintaining a healthy sleep schedule is essential for overall health and stroke prevention.

Stress and Mental Health: High levels of stress, anxiety, and depression may contribute to an increased risk of stroke. Additionally, working long hours and having limited social contact can be detrimental to overall health and may elevate stroke risk.

While these lifestyle factors are modifiable, it is important to consult with a healthcare professional for personalized advice and guidance on reducing stroke risk.

Frequently asked questions

A stroke can occur when there is a blockage in blood flow to the brain or when there is bleeding in the brain.

The two types of strokes are ischemic and hemorrhagic. Ischemic strokes are the most common and occur when a blood vessel in the brain is blocked by a blood clot or a buildup of fatty deposits and cholesterol (called plaque). Hemorrhagic strokes occur when a blood vessel in the brain bursts and spills blood into the nearby tissues.

Symptoms of a stroke may include: weakness or numbness in the face, arm, or leg, usually on one side of the body; trouble speaking or understanding; problems with vision; dizziness; problems with movement or walking; fainting; and severe headaches.

Risk factors for a stroke include high blood pressure, heart disease, diabetes, smoking, birth control pills, history of transient ischemic attacks (TIAs), high red blood cell count, high blood cholesterol, excessive alcohol use, illegal drug use, abnormal heart rhythm, and cardiac structural abnormalities.

To prevent a stroke, it is important to maintain a healthy lifestyle by eating a healthy diet, exercising regularly, avoiding smoking and excessive alcohol consumption, and managing any underlying health conditions such as high blood pressure or diabetes.

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