Ischemic Stroke
In everyday life, blood clotting is beneficial. When you are bleeding from a
wound, blood clots work to slow and eventually stop the bleeding. In the case of
stroke, however, blood clots are dangerous because they can block arteries and
cut off blood flow, a process called ischemia. An ischemic stroke can occur in
two ways embolic and thrombotic strokes
Embolic Stroke
In an embolic stroke, a blood clot forms somewhere in the body (usually the
heart) and travels through the bloodstream to your brain. Once in your brain,
the clot eventually travels to a blood vessel small enough to block its passage.
The clot lodges there, blocking the blood vessel and causing a stroke. The
medical word for this type of blood clot is embolus.
Thrombotic Stroke
In the second type of blood-clot stroke, blood flow is impaired because of a
blockage to one or more of the arteries supplying blood to the brain. The
process leading to this blockage is known as thrombosis. Strokes caused in this
way are called thrombotic strokes. That's because the medical word for a clot
that forms on a blood-vessel deposit is thrombus.
Blood-clot strokes can also happen as the result of unhealthy blood vessels
clogged with a buildup of fatty deposits and cholesterol. Your body regards
these buildups as multiple, tiny and repeated injuries to the blood vessel wall.
So your body reacts to these injuries just as it would if you were bleeding from
a wound - it responds by forming clots. Two types of thrombosis can cause
stroke: large vessel thrombosis and small vessel disease (or
lacunar infarction.)
Large Vessel Thrombosis
Thrombotic stroke occurs most often in the large arteries, so large vessel
thrombosis is the most common and best understood type of thrombotic stroke.
Most large vessel thrombosis is caused by a combination of long-term
atherosclerosis followed by rapid blood clot formation. Thrombotic stroke
patients are also likely to have coronary artery disease, and heart attack is a
frequent cause of death in patients who have suffered this type of brain attack.
Small Vessel Disease/Lacunar
Infarction
Small vessel disease, or lacunar infarction, occurs when blood flow is blocked
to a very small arterial vessel. The term's origin is from the Latin word lacuna
which means hole, and describes the small cavity remaining after the products of
deep infarct have been removed by other cells in the body. Little is known about
the causes of small vessel disease, but it is closely linked to hypertension.
Hemorrhagic
Stroke
Strokes caused by the breakage or "blowout" of a blood vessel in the brain are
called hemorrhagic strokes. The medical word for this type of breakage is
hemorrhage. Hemorrhages can be caused by a number of disorders which affect the
blood vessels, including long-standing high blood pressure and cerebral
aneurysms. An aneurysm is a weak or thin spot on a blood vessel wall. These weak
spots are usually present at birth. Aneurysms develop over a number of years and
usually don't cause detectable problems until they break. There are two types of
hemorrhagic stroke: subarachnoid and intracerebral.
In an intracerebral hemmorrhage, bleeding occurs from vessels within
the brain itself. Hypertension is the primary cause of this type of hemorrhage.
In a subarachnoid hemmorrhage (SAH), an aneurysm bursts in a large
artery on or near the thin, delicate membrane surrounding the brain. Blood
spills into the area around the brain which is filled with a protective fluid,
causing the brain to be surrounded by blood-contaminated fluid.
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Note: The FDA recently issued a voluntary recall of non-prescription medications containing PPA (phenylpropanolamine) after they were linked to an increased risk of hemorrhagic stroke in women. |