Stroke

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Signs and Symptoms

A stroke, or brain attack, is a medical emergency that requires immediate medical attention. Because most strokes do not cause severe pain, patients often delay seeking treatment, resulting in extensive brain tissue damage.

Symptoms of stroke depend on the type and which area of the brain is effected. Signs of ischemic stroke usually occur suddenly, and signs of hemorrhagic stroke usually develop gradually. Symptoms include the following:

• Difficulty speaking or understanding speech (aphasia)
  
• Difficulty walking
  
• Dizziness or lightheadedness (vertigo)
  
• Numbness, paralysis, or weakness, usually on one side of the body
  
• Seizure (relatively rare)
  
• Severe headache with no known cause
  
• Sudden confusion
  
• Sudden decrease in the level of consciousness
  
• Sudden loss of balance or coordination
  
• Sudden vision problems (e.g., blurry vision, blindness in one eye)
  
• Vomiting
  

In transient ischemic attacks (TIAs), one or more symptoms occur suddenly, last a few minutes, and then subside. These "ministrokes" also require immediate medical attention to reduce the risk for damage to brain tissue and to evaluate the risk for stroke.

Complications Stroke is the leading cause of disability in the United States. Prompt medical treatment reduces the risk for irreversible complications and permanent disability. Complications may result from ischemic cascade or develop as a result of the patient becoming immobile or bedridden.

Complications that may occur within 72 hours of stroke include the following:

• Cerebral swelling (edema)
  
• Increased intracranial pressure (ICP)
  
• Intracerebral hemorrhage
  
• Seizures
  

Paralysis on one side of the body (hemiparesis) and speech problems may occur as a result of ischemic cascade. Complications that may develop gradually as a result of immobility include the following:

• Bedsores
  
• Blood clots
  
• Fibrosis of connective tissue resulting in decreased mobility
  
• Malnutrition
  
• Pneumonia
  
• Urinary tract infections (UTIs; if a catheter is required)
  

More than 30% of stroke patients require assistance with daily living and approximately 15% require care in an assisted-living facility (e.g., nursing home, rehabilitation center). Approximately 20% of stroke patients require help walking (e.g., cane, walker) and as many as 33% suffer from depression. Treatment for stroke usually involves rehabilitation.

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