What is ischaemic stroke?
Ischaemic stroke is damage to brain tissue caused by a sudden reduction or interruption of blood flow to a particular part of the brain. It produces focal neurological symptoms — weakness on one side of the body, speech and vision problems, and so on.
Ischaemic stroke is often not a separate disease but a disorder of the brain’s blood circulation that develops against the background of various cardiovascular diseases and vascular damage. The cause is usually a thrombus blocking a vessel, or an embolus that has broken off from the heart or large arteries. Most strokes are ischaemic; the rest are bleeds into the brain (haemorrhagic stroke). Stroke is an emergency: timely medical care can reduce damage to brain tissue and help prevent severe consequences.
What are the risk factors for ischaemic stroke?
Some risk factors cannot be changed, while others can be kept under control with treatment and lifestyle.
Modifiable factors
- Arterial hypertension (high blood pressure) — the most important risk factor
- Heart disease, especially atrial fibrillation
- Diabetes
- Dyslipidaemia (abnormal blood fat metabolism)
- Smoking and alcohol
- Physical inactivity and obesity
- Stenosis (narrowing) of the carotid arteries
- Use of oral contraceptives (especially combined with smoking)
- Conditions associated with hypercoagulability
Non-modifiable factors
- Age
- Male sex
- Family history
- Previous stroke or transient ischaemic attack (TIA)
What are the symptoms of stroke?
Symptoms start suddenly and depend on which area of the brain the affected vessel supplies. By severity, ischaemic strokes are classed as mild, moderate or severe. The international BE FAST rule is used to recognise them: balance loss, eye (vision) problems, face drooping on one side, arm weakness, speech difficulty and time — call immediately. Read more: The first signs of stroke — BE FAST.
When is emergency help needed?
If the following symptoms appear suddenly, call 103 immediately without waiting.
- Sudden weakness or numbness in the face, arm or leg (especially on one side of the body)
- Speech problems or difficulty understanding what is said
- Vision problems
- Loss of coordination, dizziness
- Difficulty swallowing
- Sudden disturbance of memory and consciousness
- A sudden, very severe headache
- Seizures
In stroke every minute matters: thrombolytic treatment is only possible in the first hours after symptoms begin. Even if the symptoms quickly pass (transient ischaemic attack), urgent assessment is needed — a TIA indicates a high risk of stroke in the following days. Note the time the symptoms started and do not give the person food, drink or medication until the ambulance arrives. Do not drive yourself to hospital.
How is ischaemic stroke diagnosed?
The clinical picture of ischaemic stroke consists of general cerebral and focal symptoms that depend on the location of the vascular disturbance. The most important instrumental diagnostic tools are CT and MRI of the brain: CT is performed urgently, in particular to rule out bleeding, because the treatment approach depends on it. To clarify the cause, the vessels of the neck and brain are examined, and an ECG with heart rhythm monitoring, echocardiography and blood tests are carried out. After the acute phase, a detailed neurological examination is important to assess the extent of lost function.
How is ischaemic stroke treated?
In the acute phase the aim is to restore blood flow in the blocked vessel as quickly as possible. In suitable patients, clot-dissolving (thrombolytic) treatment or removal of the clot from a large vessel with a catheter (thrombectomy) is used. Whether these treatments are possible depends on timing and test results, and the decision is made by doctors in hospital.
After the acute phase, treatment focuses on preventing another stroke: control of blood pressure, blood sugar and cholesterol, medicines that affect blood clotting depending on the cause, and sometimes surgery on the carotid artery. The doctor decides individually which medication to prescribe. Rehabilitation — physiotherapy, speech therapy, occupational therapy — is an integral part of recovery and is started as early as possible.
What can be done to prevent stroke?
- Measure your blood pressure regularly and do not stop prescribed treatment.
- Stop smoking and limit alcohol.
- Eat a diet rich in vegetables, fruit and whole grains, and low in salt.
- Be physically active regularly and maintain a healthy weight.
- If you have diabetes, high cholesterol or a heart rhythm disorder, stay under medical supervision.
Frequently asked questions
If the symptoms have passed, do I still need to see a doctor?
Yes, urgently. Transient symptoms may be a transient ischaemic attack, which indicates a high risk of stroke in the near future.
Does function recover after a stroke?
The degree of recovery depends on the location and size of the damage. The fastest progress usually happens in the first months; early and regular rehabilitation helps recovery.
Can a young person have a stroke?
Yes, although it is rare, stroke can occur at a young age. In such cases the cause is investigated with particular care.
Can someone who has had a stroke have another one?
Yes, a previous stroke increases the risk of another stroke. That is why it is very important not to stop prescribed treatment, to monitor blood pressure, blood sugar and cholesterol regularly, to stop smoking and to attend medical check-ups on time.
How can I help a relative who has had a stroke at home?
Pay attention to continuing rehabilitation exercises, taking medication on time and reducing the risk of falls at home. If there is difficulty swallowing, discuss feeding rules with the doctor or a speech therapist. Do not overlook changes in mood either.