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What is a stroke?

A stroke is serious medical condition in which there is cessation of blood flow to part of the brain. Each minute of delay in treatment can cause more brain tissue to be permanently destroyed. “Time is Brain” in a stroke and medical attention should be sought immediately.

Causes of Stroke

Strokes occur when blood flow to the brain is disrupted. There are two major classifications: ischemic and hemorrhagic.

In an ischemic stroke, a blood vessel within the brain becomes obstructed. This can either be from the formation of a clot within the blood vessel or a clot from elsewhere (usually from within the heart) traveling into the brain (an embolism).

In a hemorrhagic stroke, a blood vessel within the brain ruptures. This leads to a loss of blood flow to the part of the brain that blood vessels served. Also, the expanding collection of blood compresses and further damages the brain. These types of strokes can be caused by severe hypertension or an aneurysm.

Code 3 ER Stroke

Symptoms of Stroke

Strokes can have a wide variety of symptoms depending on the location of the blood vessel involved. One of the most common forms of ischemic stroke is the MCA stroke which results in the sudden onset of facial droop and arm weakness. Depending on which side of the brain is involved, speech may also be affected. Other types of stroke may only cause the vision to be affected or perhaps only balance and coordination. Any new sudden changes in neurologic function should be presumed to be a stroke and investigated immediately. Ischemic strokes are almost always painless and so unfortunately it is common for patients to wait at home hoping that the symptoms will simply get better with time. However every minute you wait to seek treatment potentially leads to a worse outcome, so you should never delay seeking care.

Some types of hemorrhagic stroke are actually very painful. The sudden onset of a severe headache can also be a warning symptom of a stroke. The types of strokes are not always associated with any neurological deficits such as weakness or numbness but a ruptured artery at the base of the brain is both painful and extremely dangerous. Any sudden onset of a severe headache should also be suspected to be as stroke until proven otherwise.

Code 3 ER Stroke Symptoms

Emergency Management of a Stroke

All patient with suspected strokes need rapid assessment of their airway, breathing, and circulation. We then perform a CT scan of the brain to determine if the stroke is ischemic or hemorrhagic as the treatments are very different between the two causes. In an ischemic stroke of recent onset (within 3 hours) we can administer clot-busting drugs to dissolve the blood clot causing the stroke. However in a hemorrhagic stroke, surgical treatment may be necessary.

Code 3 ER Ischemic Stroke

CT Scan showing an ischemic stroke. Note the dark colored area caused by cessation of blood flow.

Code 3 ER Hemorrhagic Stroke

CT Scan showing a hemorrhagic stroke. Note the bright white area caused by the pooling of blood inside the brain.

Rehabilitation and Long Term Management

In some cases, patients may make dramatic recovery after a stroke. This can occur if treatment is provided rapidly. Although part of the brain may be permanently damaged, there is often a surrounding area of the brain that is only partially injured because of poor blood flow. These so-called “watershed” areas of the brain may actually completely recover with treatment.

Many patients may require rehabilitation from specialists in speech therapy, occupational therapy, and physical therapy. The goal is to return the patient to a high level of functioning.

Why Code 3 ER?

Rapid access to medical care is the most important consideration when faced with a stroke. There is simply no time to wait. Our no wait emergency room and rapid CT scanner insure that we will diagnose and treat your stroke rapidly. If you think you may be having a stroke, go to the nearest ER or call 911.