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Ischemic Stroke

WHAT YOU NEED TO KNOW:

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. When stroke symptoms last a few minutes to hours and do not cause damage, it is called a transient ischemic attack (TIA). A TIA is a warning sign that you are at risk of soon having a stroke.


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 one side of your body
  • Trouble walking or communicating
  • Dizziness, confusion, or fainting

What increases my risk for an ischemic stroke?

  • Age 55 or older
  • Being male or African American
  • Physical inactivity or obesity
  • High cholesterol, high blood pressure, or diabetes
  • Smoking cigarettes or using illegal drugs
  • A chronic inflammatory disease, such as rheumatoid arthritis or lupus
  • A family history of stroke, or a low birthweight
  • A heart condition, such as atrial fibrillation, myocardial infarction, or valve disease
  • Birth control pills or hormone replacement medicine (women)
  • Current 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:

  • CT or MRI pictures 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?

  • 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.
  • Thrombolytics help break apart clots.
  • 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.
  • Surgery may be needed to remove the clot. Surgery may also be used 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.

What can I do to care for myself after a stroke?

  • Go to rehabilitation (rehab) as directed. Rehab is an important part of treatment. A speech therapist helps you relearn or improve your ability to talk and swallow. You may start slowly and start doing more difficult tasks over time. Physical therapists can help you gain strength and build endurance. Occupational therapists teach you new ways to do daily activities, such as getting dressed. Therapy can help you improve your ability to walk or keep your balance. Your therapy may include tasks or movements you will need to do for everyday activities. An example is being able to raise or lower yourself from a chair.
  • 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 lighted. Put nonslip materials on surfaces that might be slippery. An example is your bathtub or shower floor.
  • Use assistive devices. A cane or walker may help you keep your balance as you walk.

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 illegal drugs. Smoking and drugs increase your risk for a stroke. Nicotine and other chemicals in cigarettes and cigars can also cause lung damage. Ask your healthcare provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products. Ask your healthcare provider for information if you need help quitting.

What are the 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.

Where can I find 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

Call 911 for any of the following:

  • 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
  • You have a seizure.
  • You feel lightheaded, short of breath, and have chest pain.
  • You cough up blood.
  • You have a severe headache, or loss of balance or coordination.

When should I seek immediate care?

  • Your arm or leg feels warm, tender, and painful. It may look swollen and red.
  • You have double vision or vision loss.
  • You have unusual or heavy bleeding.

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.

© 2016 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.

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.

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