What is a Stroke?

When a stroke happens, every second counts. Recovery outcomes are directly connected to stroke treatment time: the faster a patient is treated, the better their chance of full recovery. Many of the best stroke treatment methods are only available in the first few hours after a stroke begins. On average, a person in the US dies of a stroke every 3 minutes.

Types of Strokes: Ischemic and Hemorrhagic

The brain relies on blood vessels for the constant supply of oxygen-rich blood it needs to survive. A stroke occurs when there is a blockage (ischemic stroke) or bleeding (hemorrhagic stroke) in these vessels that cuts off the brain’s blood supply. Impacted parts of the brain die very quickly without blood and oxygen, leading to permanent brain damage and, if untreated, death.

Ischemic Stroke

Ischemia is when cells don’t get enough blood flow to supply them with oxygen. This usually happens because something blocks blood vessels in your brain, cutting off blood flow. About 87% of strokes are ischemic, according to the National Institute of Health.

Ischemic strokes usually happen in one of the following ways:

  • Formation of a clot in your brain (thrombosis).
  • A fragment of a clot that formed elsewhere in your body that breaks free and travels through your blood vessels until it gets stuck in your brain (embolism).
  • Small vessel blockage (lacunar stroke), which can happen when you have long-term, untreated high blood pressure (hypertension), high cholesterol (hyperlipidemia) or high blood sugar (Type 2 diabetes).
  • Unknown reasons.

Hemorrhagic Stroke

Hemorrhagic stroke is caused when a weakened blood vessel from an hypertension, an aneurysm, or an arteriovenous malformation (AVM) results in a rupture that bleeds into the brain. The leaked blood puts too much pressure on brain cells, which damages them.

Arteriovenous malformations (AVMs) in particular are extremely difficult to diagnose, and symptoms tend to occur only after the damage they cause to the brain or spinal cord reaches a critical level. AVMs damage the brain or spinal cord through three basic mechanisms:

  • By reducing the amount of oxygen reaching neurological tissues
  • By causing bleeding (hemorrhage) into surrounding tissues
  • By compressing or displacing parts of the brain or spinal cord
stroke treatment - Miami, FL

Stroke Symptoms

  • Stroke symptoms come on suddenly and include:
  • Numbness or weakness in the face, arm, or leg (especially on one side of the body)
  • Confusion, difficulty speaking or understanding speech
  • Vision changes in one or both eyes
  • Dizziness, trouble walking, loss of balance or coordination
  • Severe headache

How to Spot a Stroke

If you aren’t sure whether you’re seeing or experiencing a stroke, remember to BE FAST:

B – BALANCE: Can the person stand? Do they have trouble staying on their feet?
E – EYES: Is the person’s vision blurry or are they “seeing double”?
F – FACE: Is there numbness or drooping in their face? Ask them to smile. Is it uneven?
A – ARM: Is one arm weak or numb? Ask them to raise both arms. Does one pull downward?
S – SPEECH: Is speech slurred or strange? Ask them to repeat a simple phrase.
T – TIME: If you see any of these signs, call 9-1-1 immediately.

Stroke Treatments

Emergency treatment depends on whether you’re having an ischemic or hemorrhagic stroke.  Emergency treatments of ischemic strokes focus on breaking up the clot and/or physically removing the clot. Emergency treatments of hemorrhagic stroke focuses on controlling the bleeding and reducing pressure in the brain caused by excess fluid.

“Clot Buster” Medications for Ischemic Strokes

The main treatment for an ischemic stroke is a medicine called tissue plasminogen activator (tPA). It breaks up the blood clots that block blood flow to your brain. A healthcare provider will inject tPA into a vein in your arm. This type of medicine must be given within 3 hours after stroke symptoms start. Patient with a high risk for bleeding may not be candidates for tPA.

Mechanical Thrombectomy for Ischemic Strokes

A catheterization procedure known as mechanical thrombectomy could be an option for treating an ischemic stroke, depending on the time of onset and size of the infarction. This is particularly helpful with patients who are not good candidates for tPA. Thrombectomy procedures are also time-sensitive, and the best window for these procedures is within 24 hours after symptoms start. This procedure involves one of our neurointerventional surgeons inserting a catheter (tube-like) device into a major blood vessel and steering it up to the clot in your brain. Once there, the catheter has a tool at its tip that can remove the clot.

Endovascular Coiling for Hemorrhagic Stroke

The goal of endovascular coiling is to isolate an aneurysm or AVM from the normal blood circulation, without blocking off any small arteries nearby or narrowing the main vessel. One of our neurointerventional surgeons would perform this procedure using a minimally invasive technique. Our surgeon guides the catheter though the arterial network until the tip of the catheter reaches the site of the aneurysm or AVM. The surgeon then introduces a coil, made of platinum and other materials, and comes in a variety of shapes, sizes, and coatings that promote clotting. Multiple coils are packed inside the dome to block normal blood flow from entering. Over time, a clot forms inside the aneurysm, effectively removing the risk of aneurysm rupture.

Transient ischemic attack (TIA)

A transient ischemic attack (TIA) — sometimes called a “mini-stroke” — is similar to a stroke, but the effects are temporary. These are often warning signs that a person has a very high risk of having a true stroke in the near future. Because of that, a person who has a TIA needs emergency medical care as soon as possible.

Risk Factors

Factors that you can control account for 82% to 90% of all strokes:

  • High blood pressure
  • Obesity
  • Physical inactivity
  • Poor diet
  • Smoking

Services We Provide

IntelliRad Imaging is proud to employ four neurointerventional surgeons as well as three interventional radiologists who are capable and ready for stroke treatments in patients at our partner hospitals in south Florida. We also have an outpatient clinic where we follow up with our post-discharge stroke patients.

To schedule a consultation with us, please click the button below to visit our clinic page.

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