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Learn about Brilinta and how it may lower your risk of having a stroke

Ischemic Stroke

AMBULATORY CARE:

An ischemic stroke

occurs when blood flow to a part of your brain is blocked. The blockage 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. The damage can cause loss of body functions controlled by that area of the brain.

Ischemic Stroke

Warning signs of a stroke:

The word F.A.S.T. can help you remember and recognize signs of a stroke.

  • F = Face: One side of the face droops.
  • A = Arms: One arm starts to drop when both arms are raised.
  • S = Speech: Speech is slurred or sounds different than usual.
  • T = Time: A person who is having a stroke needs to be seen immediately. A stroke is a medical emergency that needs immediate treatment. Some medicines and treatments work best if given within a few hours of a stroke. Early treatment can decrease the risk of long-term effects of a stroke.
FAST Sings of a Stroke

Signs and symptoms

may begin suddenly and worsen quickly. Any of the following may appear minutes or hours after a stroke:

  • Severe headache
  • Blurred or double vision, or vision loss
  • Numbness, tingling, weakness, or paralysis on one side of your body
  • Trouble walking or speaking
  • Dizziness, confusion, or fainting

Call your local emergency number (911 in the US) or have someone else call if:

  • You have any of the following signs of a stroke:
    • Numbness or drooping on one side of your face
    • Weakness in an arm or leg
    • Confusion or difficulty speaking
    • Dizziness, a severe headache, or vision loss
    FAST Sings of a Stroke

  • You have a seizure.
  • You have chest pain or shortness of breath.

Call your doctor if:

  • Your arm or leg feels warm, tender, and painful. It may look swollen and red.
  • You have loss of balance or coordination.
  • You have double vision or vision loss.
  • You have unusual or heavy bleeding.
  • Your blood pressure is higher or lower than you were told it should be.
  • You have questions or concerns about your condition or care.

Treatment

will be based on a plan of care created by you and your healthcare providers. The plan may include any of the following:

  • Thrombolytics help break apart clots. A medicine called tissue Plasminogen Activator (tPA) may be used to dissolve clots. tPA works best if given within 3 hours of an ischemic stroke. tPA can improve recovery within 3 months, but it can increase the risk for brain bleeding or other life-threatening health problems. Your healthcare provider will talk to you or family members about all risks and benefits of tPA.
  • 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.
  • Blood thinners help prevent blood clots. Examples of blood thinners include heparin and warfarin. Clots can cause strokes, heart attacks, and death. The following are general safety guidelines to follow while you are taking a blood thinner:
    • Watch for bleeding and bruising while you take blood thinners. Watch for bleeding from your gums or nose. Watch for blood in your urine and bowel movements. Use a soft washcloth on your skin, and a soft toothbrush to brush your teeth. This can keep your skin and gums from bleeding. If you shave, use an electric shaver. Do not play contact sports.
    • Tell your dentist and other healthcare providers that you take anticoagulants. Wear a bracelet or necklace that says you take this medicine.
    • Do not start or stop any medicines unless your healthcare provider tells you to. Many medicines cannot be used with blood thinners.
    • Tell your healthcare provider right away if you forget to take the medicine, or if you take too much.
    • Warfarin is a blood thinner that you may need to take. The following are things you should be aware of if you take warfarin:
      • Foods and medicines can affect the amount of warfarin in your blood. 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 and certain other foods. Ask for more information about what to eat when you are taking warfarin.
      • You will need to see your healthcare provider for follow-up visits when you are on warfarin. You will need regular blood tests. These tests are used to decide how much medicine you need.
  • Medicines may be given to treat other health conditions such as high cholesterol, high blood pressure, or diabetes.
  • Surgery may be needed to remove the clot. You may also need surgery to widen arteries or to place a filter into a blood vessel. This surgery helps to improve blood flow and prevent clots.

Recovery testing:

Your healthcare provider will test your recovery 90 days (3 months) after your stroke. This may be done over the phone or in person. Your provider will ask how well you can do the activities you did before the stroke. He or she will also ask how well you can do your daily activities without help. Your provider may make recommendations for you based on your test. For example, you may need someone to help you walk safely. You may also need help with daily activities, such as getting dressed. Based on your answers, your provider may do this test again over time.

Manage an ischemic stroke:

  • Go to stroke rehabilitation (rehab) if directed. Rehab is a program run by specialists who will help you recover abilities you may have lost. Specialists include physical, occupational, and speech therapists. Physical therapists help you gain strength or keep your balance. Occupational therapists teach you new ways to do daily activities, such as getting dressed. Your therapy may include movements for everyday activities. An example is being able to raise yourself from a chair. A speech therapist helps you improve your ability to talk and swallow.
  • Wear pressure stockings as directed. Pressure stockings help keep blood from pooling in your leg veins. Your healthcare provider can prescribe stockings that are right for you. Do not buy over-the-counter pressure stockings unless your healthcare provider says it is okay. They may not fit correctly or may have elastic that cuts off your circulation. Ask your healthcare provider when to start wearing pressure stockings and how long to wear them each day.
    Pressure Stockings
  • Make your home safe. Remove anything you might trip over. Tape electrical cords down. Keep paths clear throughout your home. Make sure your home is well lit. Put nonslip materials on surfaces that might be slippery. An example is your bathtub or shower floor. A cane or walker may help you keep your balance as you walk.

What you can do to prevent another stroke:

  • Manage health conditions. A condition such as diabetes can increase your risk for a stroke. Control your blood sugar level if you have hyperglycemia or diabetes. Take your prescribed medicines and check your blood sugar level as directed.
    How to check your blood sugar
  • Check your blood pressure as directed. High blood pressure can increase your risk for a stroke. If you have high blood pressure, follow your healthcare provider's directions for controlling it.
    How to take a Blood Pressure
  • Do not use nicotine products or illegal drugs. Nicotine and other chemicals in cigarettes and cigars can cause blood vessel damage. Nicotine and illegal drugs both increase your risk for a stroke. Ask your healthcare provider for information if you currently smoke or use drugs and need help to quit. E- cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products.
  • Talk to your healthcare provider about alcohol. Alcohol can raise your blood pressure. The recommended limit is 2 drinks in a day for men and 1 drink in a day for women. Do not binge drink or save a week's worth of alcohol to drink in 1 or 2 days. Limit weekly amounts as directed by your provider.
  • 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. A dietitian can help you create healthy meal plans.
  • Maintain a healthy weight. Ask your healthcare provider how much you should weigh. Ask him or her to help you create a weight loss plan if you are overweight. He or she can help you create small goals if you have a lot of weight to lose.
  • Exercise as directed. Exercise can lower your blood pressure, cholesterol, weight, and blood sugar levels. Healthcare providers will help you create exercise goals. They can also help you make a plan to reach your goals. For example, you can break exercise into 10 minute periods, 3 times in the day. Find an exercise that you enjoy. This will make it easier for you to reach your exercise goals.
  • Manage stress. Stress can raise your blood pressure. Find new ways to relax, such as deep breathing or listening to music.
  • Talk to your healthcare provider about risk factors for women. Birth control pills increase your risk, especially if you are older than 35 or smoke cigarettes. Talk to your healthcare provider about other forms of contraception. Estrogen levels drop during menopause. Low estrogen levels may increase your risk for stroke. Talk to your healthcare provider about hormone replacement therapy to reduce your risk for a stroke.

What you need to know about depression after a stroke:

Talk to your healthcare provider if you have depression that continues or is getting worse. Your provider may be able to help treat your depression. Your provider can also recommend support groups for you to join. A support group is a place to talk with others who have had a stroke. It may also help to talk to friends and family members about how you are feeling. Tell your family and friends to let your healthcare provider know if they see any signs of depression:

  • Extreme sadness
  • Avoiding social interaction with family or friends
  • A lack of interest in things you once enjoyed
  • Irritability
  • Trouble sleeping
  • Low energy levels
  • A change in eating habits or sudden weight gain or loss

Follow up with your healthcare provider or neurologist as directed:

You may need to come in over time for brain function or blood tests. Your provider may refer you to a specialist, or to other kinds of care. An example is palliative (comfort) care. Your provider can also give information about respite care to anyone who helps care for you. Respite care is a service to help caregivers take a break or get more rest. Write down your questions so you remember to ask them during your visits.

For support and more information:

  • National Stroke Association
    9707 E. Easter Lane
    Centennial , CO 80112
    Phone: 1- 800 - 787-6537
    Web Address: http://www.stroke.org

© Copyright IBM Corporation 2018 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 IBM Watson Health

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.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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