Patient education

Types of Stroke

UF vascular neurologists treat all of the following types of strokes:

Transient Ischemic Attack (TIA)

If an artery to the brain is blocked for a short time, the patient will have symptoms of a stroke for a few minutes but may not have lasting symptoms or damage to the brain. For example, if someone’s speech becomes slurred, but a few minutes later their speech has completely returned to normal, this person may have had a transient ischemic attack (temporary low blood flow attack) or TIA. A TIA is an important warning that a person may have a stroke in the future.

Acute Ischemic Stroke

Ischemic strokes occur when there is not enough blood supply in an area of the brain to support the life of the brain tissue. This type of stroke is usually the result of a complete blockage of an artery. In some cases, a drop in blood pressure and/or narrowing of arteries may reduce the blood supply to brain tissue to the point of causing permanent injury.

Cerebral Hemorrhages

A hemorrhagic or bleeding stroke occurs when an artery within the skull ruptures. Brain damage due to a bleeding stroke mainly happens because the brain is surrounded by the skull and there is very little room for the blood to build up or for the brain to swell when it is injured. Sudden bleeding within the skull causes pressure on the brain and may cause lasting damage.

A cerebral hemorrhage can take several forms:

• Intracerebral hemorrhages. This is bleeding inside the brain. The symptoms and prognosis of an intracerebral bleed vary depending on the size and location of the bleed.
• Subarachnoid hemorrhages. This is bleeding between the brain and the membranes that cover the brain.
• Subdural hemorrhages. This is bleeding between the layers of the brain’s covering (the meninges).
• Epidural hemorrhages. This is bleeding between the skull and the covering of the brain.

Aneurysms and Subarachnoid Hemorrhages

While an ischemic stroke is caused by the blood supply to part of the brain being cut off, a hemorrhagic stroke is caused by bleeding into the brain.

A subarachnoid hemorrhage is sudden bleeding between the brain and the membranes that cover it. Besides killing the brain cells where the bleeding occurs, bleeding inside the skull can quickly raise the pressure on the brain to dangerous levels.

In the Event of a Possible Stroke

Time is vital.

If you are going to receive tPA, a clot-dissolving drug or other appropriate therapy, you must get to a hospital quickly so a doctor can diagnose your stroke and treat you within three hours after symptoms begin.

In the hospital emergency room, tests will determine if a TIA, stroke or another medical problem caused your symptoms.

To increase your chances of surviving a stroke, follow these four steps when you first experience symptoms:

• Know the warning signs and act fast if you experience them. Recognize the warning signs and note the time when they first occur. Call 911 immediately. Tell the operator you or the person you are with is having stroke warning signs.
• Receive early assessments and pre-hospital care by emergency medical services personnel.
• Rapid emergency medical services (EMS) system transport and hospital pre-notification. Get to an appropriate hospital quickly via the EMS. Ambulance personnel will notify the emergency room.
• Rapid diagnosis and treatment at the hospital. Receive prompt evaluation of medical data and treatment to restore blood flow to the brain or other treatments as appropriate by a properly staffed and equipped hospital.

At the UF Health Stroke Program, a neurologist is available 24 hours a day, seven days a week to rapidly evaluate patients who are experiencing warning signs of stroke.

UF Health Shands Hospital has state-of-the-art brain imaging technologies, such as CT and MRI scans, for rapid diagnosis and identification of the location of the stroke.

Medical interventions are available through the stroke program, including tPA, blood pressure management, blood thinners or other medications as needed.

Neurosurgeons and vascular surgeons are on call 24 hours a day, seven days a week. In addition, neuro-interventionalists are on call to treat intracranial blood clots, aneurysms and blocked arteries that cannot be reached by conventional surgery.

Stroke Signs and Symptoms

A stroke can occur suddenly, and it is important to act quickly if you or someone you know has experienced the sudden onset of the following symptoms:

• Weakness or paralysis of an arm, leg, side of the face or any part of the body
• Numbness, tingling or decreased sensation
• Vision changes
• Slurred speech, inability to speak or understand speech, difficulty reading or writing
• Swallowing difficulties or drooling
• Vertigo (spinning sensation)
• Loss of balance or coordination
• Drowsiness, lethargy or loss of consciousness
• Uncontrollable eye movements or eyelid drooping

If you experience these symptoms, or see someone with any of these symptoms, call 911 immediately. If you are in Gainesville, ask the paramedics to take you to Shands.

The symptoms of stroke depend on what part of the brain is damaged. In some cases, a person may not even be aware that he or she has had a stroke.

The American Stroke Association recommends evaluating the five following behaviors to determine if symptoms are a stroke:

• Walk – Is the patient’s balance off?
• Talk – Is the patient’s face droopy or speech slurred?
• Reach – Is one side weak or numb?
• See – Is the patient’s vision all or partially lost?
• Feel – Is the patient’s headache severe?