
Strokes are the fifth cause of death in the USA and can be categorised into two main types: ischemic and hemorrhagic. Ischemic strokes, which account for 87% of all strokes, occur when blood flow to the brain is blocked. They can be further divided into thrombotic strokes and embolic strokes. Thrombotic strokes are caused by a blood clot that forms in one of the brain's blood vessels, while embolic strokes are caused by a blood clot that forms elsewhere in the body and travels to the brain through the bloodstream. In rare cases, embolic strokes can turn into hemorrhagic strokes if the blocked blood vessel ruptures and bleeds. This can lead to increased pressure and irritation in the surrounding tissues, resulting in further brain damage.
Characteristics | Values |
---|---|
Type of stroke | Ischemic |
Cause | Blockage in an artery |
Blockage type | Blood clot (called an embolus) |
Blockage location | Artery leading to or in the brain |
Clot formation location | Elsewhere in the body |
Clot movement | Travels through the bloodstream to the brain |
Clot size | Variable, but generally large |
Artery type blocked | Larger arteries |
Risk factors | Age, high blood pressure, high cholesterol, diabetes, atrial fibrillation, autoimmune diseases, heart defects |
Symptoms | Sudden confusion, trouble speaking or understanding speech, difficulty moving one side of the body, difficulty walking |
Treatment | Clot-busting medications, surgery to remove the clot, antiplatelet medications |
What You'll Learn
- Embolic strokes are caused by blood clots that form in the heart or arteries of the upper chest and neck
- Embolic strokes can also be caused by atrial fibrillation, an irregular heart rhythm
- Embolic strokes are a type of ischemic stroke, which occurs when an artery to the brain becomes blocked
- Embolic strokes can be treated with clot-busting medications or surgery to remove the clot
- Embolic strokes are one of the most common causes of death and disability worldwide
Embolic strokes are caused by blood clots that form in the heart or arteries of the upper chest and neck
Embolic strokes are a type of ischemic stroke, which occur when blood flow to the brain is blocked. Ischemic strokes account for about 87% of all strokes and can have serious health consequences, including death. Embolic strokes are typically caused by plaque buildup along artery walls or an abnormal heartbeat, such as atrial fibrillation. Atrial fibrillation causes blood to pool and clot due to ineffective pumping, and these clots can then travel through the bloodstream to the brain.
Other risk factors for embolic strokes include high blood pressure, lack of regular exercise, and a family history of stroke or heart attack. Symptoms of an embolic stroke include sudden difficulty speaking or understanding words, weakness or numbness, paralysis in the limbs or face, blurred vision or blindness, and difficulty swallowing.
Prompt diagnosis and treatment are crucial in managing embolic strokes. Doctors may use imaging techniques such as CT scans, MRIs, and ultrasounds to confirm the stroke and determine its cause. Treatment options include administering clot-busting medications, performing mechanical clot removal, and surgery to open blocked arteries.
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Embolic strokes can also be caused by atrial fibrillation, an irregular heart rhythm
An embolic stroke is caused by a blood clot that forms elsewhere in the body and travels through the bloodstream to the brain. Embolic strokes are usually the result of heart disease or heart surgery and occur rapidly and without warning signs. They account for 13% of all strokes.
Atrial fibrillation (AF) is the most common cardiac arrhythmia and a major cause of embolic strokes. It is an abnormal, rapid heartbeat where the two small upper chambers of the heart (the atria) quiver instead of beating. This quivering causes blood to pool and form clots that can travel to the brain and cause a stroke. AF is estimated to affect around 2.7 million Americans and is found in up to 23.7% of patients with acute ischemic stroke.
AF increases the risk of embolic stroke through stasis in the left atrium and subsequent embolization to the brain. The uncoordinated activity of the heart muscles during AF results in impaired contraction, leading to blood stasis and an increased risk of thromboembolism. This is in line with Virchow's triad, which states that the stasis of blood should increase the likelihood of thromboembolic events.
The link between AF and embolic stroke is supported by epidemiological studies and meets several of the widely accepted Bradford Hill criteria for establishing causality. Patients with AF have a significantly elevated risk of stroke, and the association has been consistently observed in different cohorts. Additionally, there is a biologically plausible mechanism linking AF and embolic stroke.
However, the relationship between AF and embolic stroke is complex and involves factors beyond the arrhythmia itself. AF is associated with other vascular risk factors and atrial abnormalities that may contribute to stroke risk. These include age, male sex, hypertension, diabetes mellitus, valvular heart disease, heart failure, coronary heart disease, chronic kidney disease, inflammatory disorders, sleep apnea, and tobacco use.
Furthermore, not all cases of embolic stroke are preceded by AF, and some patients do not develop AF until after their stroke. This suggests that while AF can cause thromboembolism, other factors also play a role in the strong association between AF and embolic stroke.
In summary, embolic strokes can be caused by atrial fibrillation, an irregular heart rhythm that leads to blood pooling and clot formation. The link between AF and embolic stroke is well-established, but it is important to consider the role of additional factors that may contribute to stroke risk in patients with AF.
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Embolic strokes are a type of ischemic stroke, which occurs when an artery to the brain becomes blocked
Embolic strokes specifically occur when a blood clot, or embolus, forms elsewhere in the body and travels through the bloodstream to the brain. This type of clot is often formed in the heart or arteries of the upper chest and neck. Once in the brain, the clot becomes lodged in a blood vessel, blocking blood flow. These blockages, known as emboli, can also be formed from air bubbles, fat globules, or plaque from an artery wall.
Emboli can result from atrial fibrillation, an irregular heart rhythm where the upper chambers of the heart do not beat effectively, causing blood to pool and form clots. Heart disease, heart surgery, and atherosclerosis are also commonly associated with embolic strokes. Embolic strokes occur rapidly and without warning signs, and they account for about 15% of cases where individuals have atrial fibrillation.
The symptoms of an embolic stroke include sudden confusion, difficulty speaking or understanding speech, weakness or paralysis on one side of the body, and difficulty walking. Treatment for embolic strokes involves immediate action to restore blood flow and prevent further clots from forming. This can include the use of clot-busting medications, mechanical procedures to remove clots, and long-term management strategies such as rehabilitation therapy, medication, and lifestyle changes.
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Embolic strokes can be treated with clot-busting medications or surgery to remove the clot
Embolic strokes are caused by blood clots that form in the body and travel to the brain. They account for about 15% of embolic strokes and often occur without warning. Treatment for embolic strokes involves immediate action to restore blood flow and prevent future strokes.
Clot-busting medications, also known as thrombolytics, are often used to treat embolic strokes. These medications work by dissolving clots and improving blood flow to the brain. Alteplase, delivered through an IV in the arm, is one such medication that has been approved by the FDA to treat ischemic strokes. However, it requires an hour-long infusion after the initial injection. A newer clot-busting medication, tenecteplase, has been found to be safer, more effective, and simpler to administer, as it is given through a single injection into the bloodstream.
In some cases, surgery may be required to remove the clot. This procedure, known as thrombectomy, involves inserting a small, thin tube called a catheter into a blood vessel and navigating it to the location of the blockage. Once the catheter reaches the clot, physicians can use a device to suction or trap and remove it. Additionally, thrombolytics can be injected through the catheter to dissolve the clot.
Endovascular surgery procedures or neuro-interventional techniques may be used if patients arrive at the hospital too late for effective intravenous thrombolytic treatment or if intravenous thrombolytics are not suitable for them. These procedures are performed from inside the blood vessel, using a catheter to navigate through the blood vessels to reach the blockage.
It is crucial to recognise the signs of a stroke and seek immediate treatment to increase the chances of survival and reduce the long-term effects.
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Embolic strokes are one of the most common causes of death and disability worldwide
The high mortality and morbidity associated with embolic strokes highlight the importance of prompt diagnosis and treatment. Embolic strokes often occur rapidly and without warning signs, making quick recognition and response critical. The standard treatment for acute embolic stroke within the first 4.5 hours is IV thrombolysis, which aims to dissolve clots and restore blood flow. Mechanical thrombectomy may also be performed within the first 6 hours to mechanically remove the clot.
Embolic strokes can have devastating long-term consequences, including severe disability, particularly due to cortical functional deficits such as aphasia, hemianopia, and cognitive impairment, as well as sensory and motor deficits impacting gait and movement. Stroke is the leading cause of disability, and the road to recovery is often long and challenging. Physical rehabilitation is crucial to assist in recovery and improve outcomes, and most recovery happens within the first 6 months following the stroke.
To reduce the impact of embolic strokes, it is essential to recognize the risk factors and underlying causes, which include atrial fibrillation, carotid artery disease, infection, heart tumours, and air embolisms. Addressing these risk factors and improving public awareness of stroke symptoms can help reduce the incidence and impact of embolic strokes, decreasing the associated mortality and disability globally.
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Frequently asked questions
An embolic stroke occurs when a blood clot (or embolus) that forms in the body breaks loose and travels to the brain via the bloodstream. When the clot lodges in an artery and blocks blood flow, this causes a stroke.
A hemorrhagic stroke occurs when a blood vessel that supplies the brain ruptures and bleeds. When an artery bleeds into the brain, brain cells and tissues do not get oxygen and nutrients.
Embolic strokes can turn into hemorrhagic strokes if the blocked blood vessel ruptures and bleeds. This can happen if the embolus causes a build-up of pressure in the vessel, or if the vessel is weakened by a previous injury or a congenital condition.