Brain Stroke Facts
- 3rd major cause of death and disability worldwide (2021 WHO data)
- Approximately 93.8 million cases with 11.9 million new cases (in 2021)
- Significant rise in incidence in the last 20 years (50%)
- 1 in 4 adults is predicted to have a stroke during their life
- Major risk factors include high BP, air pollution, smoking, cholesterol, diabetes, kidney issues, obesity, sedentary lifestyle, and excessive alcohol intake
What is a Brain Stroke?
A stroke or a brain attack is a serious neurological condition that happens when the blood supply to parts of the brain is disrupted or when a blood vessel in the brain ruptures.
Whatever the reason, parts of the brain get damaged as brain cells start dying. The patient may suffer permanent brain damage resulting in long-term disability or even death.
What are the Different Types of Brain Stroke?
There are two main types of strokes:
Ischemic Strokes
Cause: Blocked artery (or in rare cases, a vein)
Proportion: Account for 87% of cases
Hemorrhagic Strokes
Cause: Bleeding (due to a ruptured blood vessel)
Proportion: Account for 13% of cases
| 👉 While ischemic strokes are more common, hemorrhagic strokes are often more severe. |
What is an Ischemic Stroke?
When the blood and oxygen supply to a part of the brain is interrupted due to a blockage in a blood vessel, it results in an ischemic stroke.
Risk Factors: Age above 65, smoking and tobacco use, drug abuse, hypertension, high cholesterol, type 2 diabetes, alcohol use disorder, COVID-19.
Result: Brain cells start dying within minutes due to a lack of oxygen and nutrients.
Types: Thrombotic strokes and Embolic strokes.
| Types of Ischemic Strokes | ||
| Thrombotic strokes | Embolic strokes | |
| Cause & Location of the clot (or plaque debris) formation | Development of a blood clot (thrombus) in the arteries supplying blood to the brain. The clot forms inside the brain. | Develops elsewhere in the body (embolus) and reaches the brain via the bloodstream |
| Who is at risk? | Old people with: – High cholesterol – Diabetes – Atherosclerosis (fat and lipids building up inside the walls of blood vessels) | People with: – Heart disease – Heart surgery – Atrial fibrillation (a type of abnormal heartbeat) |
| How does it happen? | – May develop gradually or occur during rest/sleep, often with preceding TIAs – Gradually, over hours and even days | Swiftly, and progresses rapidly |
| Warning Sign(s) | May be preceded by mini-stroke(s)* | Happens all of a sudden without prior warning signs |
| 👉 Nearly 15% of embolic strokes affect individuals with atrial fibrillation – a type of abnormal heartbeat in which the upper chambers of the heart do not beat properly. |
*Transient Ischemic Attacks (TIAs):
- Also called warning strokes
- Mini-strokes that typically last a few minutes
- Typically, the duration is 5 minutes or less
- Mild and transient in nature
- Symptoms similar to those of a stroke but resolve within 1 hour in most cases (by definition in less than 24 hours)
- Often caused by blood clots
- If left untreated, it may lead to a major stroke within 1 year (in over 33% patients)
- Nearly 10 – 15% patients suffer a major stroke within 3 months of a TIA
- Recognising the signs of a TIA and taking action can save lives and prevent disability
Lacunar Infarct Stroke:
- Comes from the Latin word, meaning cavity or hole
- Happens in the tiny blood vessels in the brain
- Occurs in individuals with diabetes or high BP
Cerebral venous sinus thrombosis (CVST):
- A rare type of stroke (1% of all strokes)
- Occurs due to blockage in the brain’s venous sinuses
- Usually affects females and younger patients (even infants)
- Can be treated through medicines and procedures
What is a Haemorrhagic Stroke?
When the blood and oxygen supply to a part of the brain is interrupted due to the rupture and bleeding of a blood vessel in the brain, it results in a haemorrhagic stroke.
Risk Factors: Advanced age, poorly controlled high blood pressure, smoking, excessive alcohol intake, head trauma, drug abuse, and use of anti-clotting medicines.
Result: Brain cells suffer from a lack of oxygen and nutrients, causing damage to the brain. Additionally, there is a buildup of pressure in the neighbouring tissues, causing swelling and irritation, leading to further damage to the brain.
Types: Intracerebral haemorrhage strokes and Subarachnoid haemorrhage strokes
| Types of Haemorrhagic Strokes | ||
| Intracerebral haemorrhage | Subarachnoid haemorrhage | |
| Which blood vessels bleed? | Bleeding in blood vessels inside the brain | Bleeding in blood vessels in the subarachnoid space (the space between the brain and the skull) |
| Typical Cause(s) | High BP | – Aneurysm* – AVM (arteriovenous malformation) – Head injury |
| Result | May lead to coma or even be fatal | Permanent brain damage or even death |
| How does it happen? | Sudden and fast bleeding | Sudden and extreme |
| Warning Sign(s) | Often occurs without warning, though some patients may have symptoms like headache or neurological deficits beforehand | Sudden, extremely severe headache, nausea, vomiting, stiff neck, etc. |
*Aneurysm:
- Weak, ballooned blood vessel on the wall of an artery
- Susceptible to stretching and bursting
- May be present by birth or develop later in life because of high BP or atherosclerosis
AVM:
- A type of weakened blood vessel
- Present at birth (Congenital)
- Tangled web of arteries and veins
- Cause not known
- May be genetic or part of specific syndromes
What are Recurrent Strokes?
Recurrent strokes affect about 25% individuals who have had a stroke:
- Occur within 5 years of the first stroke
- The risk of a stroke occurring again is maximum right after a stroke, and reduces over time
- The probability of extreme disability and fatality rises with each recurrent stroke
- Nearly 3 in 10 people who have had a stroke witness another stroke within a month of the first stroke
- Almost 33% individuals have a 2nd stroke within 2 years
What is a Cryptogenic Stroke?
When the cause of a stroke cannot be detected, it’s referred to as a cryptogenic stroke. Nearly 1 in 3 ischemic strokes are estimated to be cryptogenic.
What is a Brain Stem Stroke?
- A stroke occurring in the brain stem
- Can affect both sides of the body
- May result in a “locked-in” state – the patient loses the ability to speak or move below the neck
Conclusion
Understanding the different types of strokes, their risk factors, and how they can harm a person can help you take care of yourself and your family members. It is critical to act fast if you notice someone around you experiencing a stroke. The earlier an affected person receives treatment, the better the outcomes.
Sohana Hospital, Mohali, is a leading super-speciality hospital with 24×7 emergency preparedness to handle stroke patients. The initial 4.5 hours after a stroke can make a huge difference in the quality of life a person will have post-stroke. It can decide whether a patient survives or not, and if they survive, will they be able to lead a normal life again.
The hospital is equipped with the most advanced diagnostics and provides the latest treatment options to save a precious life, and further, ensure they have an optimal quality of life. Our multidisciplinary team of expert doctors has extensive experience in dealing with stroke patients and ensuring that they make a comeback.
Adopt a healthy lifestyle – Safeguard yourself from stroke!
Act FAST – Improve Outcomes!