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Ischemic Stroke

What is an ischemic stroke?

An ischemic stroke occurs when blood is suddenly blocked and cannot flow to your brain. The block is usually caused by a blood clot that gets stuck in a narrow blood vessel. When oxygen cannot get to an area of the brain, tissue in that area may get damaged. Damage to an area of the brain causes loss of body functions controlled by that area.


What are the signs and symptoms of an ischemic stroke?

Signs or symptoms may begin suddenly and worsen quickly. One or more of the following may appear minutes or hours after a stroke, and worsen quickly:

  • Severe headache

  • Blurred or double vision, or vision loss

  • Numbness, tingling, weakness, or paralysis on 1 side of your body

  • Trouble walking or communicating

  • Dizziness, confusion, or fainting

What increases my risk for an ischemic stroke?

  • Age 55 or older

  • Male or African-American

  • Physical inactivity or obesity

  • High cholesterol, high blood pressure, or diabetes

  • Smoking

  • Chronic inflammatory disease, such as rheumatoid arthritis or lupus

  • Family history of stroke, or a low birthweight

  • Heart conditions, such as atrial fibrillation, myocardial infarction, or valve disease

  • Birth control pills or hormone replacement medicine

  • Pregnancy or delivery within the past 6 weeks

How is an ischemic stroke diagnosed?

Your healthcare provider will ask about your symptoms and when they started. He will ask if you have any medical conditions. You may need any of the following:

  • A CT or MRI may show where the stroke happened and any damage you have. You may be given contrast liquid to help your skull and brain show up better in the pictures. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if you have any metal in or on your body.

  • An arteriography is used to take x-rays of your arteries to look for blood flow blockage.

How is an ischemic stroke treated?

  • Medicines:

    • Antiplatelets , such as aspirin, help prevent blood clots. Take your antiplatelet medicine exactly as directed. These medicines make it more likely for you to bleed or bruise. If you are told to take aspirin, do not take acetaminophen or ibuprofen instead.

    • Anticoagulants are a type of blood thinner medicine that helps prevent clots. Clots can cause strokes, heart attacks, and death. These medicines may cause you to bleed or bruise more easily.

      • Watch for bleeding from your gums or nose. Watch for blood in your urine and bowel movements. Use a soft washcloth and a soft toothbrush. If you shave, use an electric razor. Avoid activities that can cause bruising or bleeding.

      • Tell your healthcare provider about all medicines you take because many medicines cannot be used with anticoagulants. Do not start or stop any medicines unless your healthcare provider tells you to. Tell your dentist and other healthcare providers that you take anticoagulants. Wear a bracelet or necklace that says you take this medicine.

      • You will need regular blood tests so your healthcare provider can decide how much medicine you need. Take anticoagulants exactly as directed. Tell your healthcare provider right away if you forget to take the medicine, or if you take too much.

      • If you take warfarin, some foods can change how your blood clots. Do not make major changes to your diet while you take warfarin. Warfarin works best when you eat about the same amount of vitamin K every day. Vitamin K is found in green leafy vegetables, broccoli, grapes, and other foods. Ask for more information about what to eat when you take warfarin.

    • Thrombolytics help break apart clots. These medicines make it more likely for you to bleed or bruise.

    • Other medicines may be given to treat high cholesterol, high blood pressure, or diabetes. You may also need medicine to decrease pain, reduce brain pressure, or prevent seizures.

  • Physical and occupational therapy may be needed. A physical therapist teaches you exercises to help improve movement and strength, and to decrease pain. An occupational therapist teaches you skills to help with your daily activities.

  • Surgery may be needed to improve blood flow and prevent clots. A tube may be placed in your skull. The tube drains extra fluid and checks the pressure in your brain. You may also need surgery to widen arteries or to place a filter into a blood vessel.

How can I decrease my risk for a stroke?

  • Manage health conditions. Take your medicine as directed. Check your blood pressure and blood sugar levels as directed. Keep a record and bring it to your follow-up visits.



  • Eat a variety of healthy foods. Healthy foods include whole-grain breads, low-fat dairy products, beans, lean meats, and fish. Eat at least 5 servings of fruits and vegetables each day. Choose foods that are low in fat, cholesterol, salt, and sugar. Eat foods that are high in potassium, such as potatoes and bananas.

  • Maintain a healthy weight. Ask your healthcare provider how much you should weigh. Ask him to help you create a weight loss plan if you are overweight. Ask about the best exercise plan for you.

  • Limit or do not drink alcohol. Limit alcohol to 2 drinks per day if you are a man. Limit alcohol to 1 drink per day if you are a woman. A drink of alcohol is 12 ounces of beer, 5 ounces of wine, or 1½ ounces of liquor.

  • Do not smoke cigarettes or use street drugs. Smoking and drugs increase your risk for a stroke. Ask your healthcare provider for information if you need help quitting.

  • Get a flu vaccine. To prevent influenza (flu), all adults should get the influenza vaccine. Get the vaccine every year as soon as it becomes available.

How can I tell if someone is having a stroke?

Know the F.A.S.T. test to recognize the signs of a stroke:

  • F = Face: Ask the person to smile. Drooping on one side of the mouth or face is a sign of a stroke.

  • A = Arms: Ask the person to raise both arms. One arm that slowly comes back down or cannot be raised is a sign of a stroke.

  • S = Speech: Ask the person to repeat a simple sentence that you say first. Speech that is slurred or sounds strange is a sign of a stroke.

  • T = Time: Call 911 if you see any of these signs. This is an emergency.

Call 911 for any of the following:

  • You have a seizure.

  • You feel lightheaded, short of breath, and have chest pain.

  • You cough up blood.

  • You have weakness or numbness in your arm, leg, or face.

  • You are confused and have problems speaking or understanding speech.

  • You have a severe headache, or loss of balance or coordination.

When should I seek immediate care?

  • You have double vision or vision loss.

  • You are bleeding from your rectum or nose.

  • Your arm or leg feels warm, tender, and painful. It may look swollen and red.

When should I contact my healthcare provider?

  • Your blood pressure is higher or lower than you were told it should be.

  • You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2015 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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