Types of Stroke

What Are the Types of Strokes?

The five types of strokes are medical emergencies that stop or interrupt the flow of blood to the brain. These types are:   

  • Ischemic Stroke

  • Hemorrhagic Stroke

  • Transient Ischemic Attack (Mini-Stroke)

  • Brain Stem Stroke

  • Cryptogenic Stroke (stroke of unknown cause)

What are the warning signs for a stroke?

Think of the word F-A-S-T to help you spot stroke signs and know when to call 911 for yourself or someone else:

  • Face drooping: One side of the face droops or is numb. Your smile is uneven or lopsided.

  • Arm weakness:One arm is weak or numb. One arm drifts downward when you try to raise both arms

  • Speech difficulty: Speech is slurred. You’re unable to speak or hard to understand.

  • Time to call 911:If you have any of these signs, even if they subside, call 911 and get to a hospital immediately.

Ischemic Stroke

An ischemic stroke happens when a blood vessel supplying blood to your brain gets blocked by a blood clot. Most strokes are this type. 

Symptoms of ischemic stroke

The symptoms depend on which parts of your brain are affected. They can include things like:

  • Sudden numbness or weakness of your face, arm, or leg, often on one side of the body

  • Confusion

  • Problems speaking or understanding others

  • Dizziness, loss of balance or coordination, or trouble walking

  • Vision loss or double vision

Causes of ischemic stroke

A fatty substance called plaque collects in your arteries and narrows them. This process is called  atherosclerosis, and it slows the flow of blood. As it pools, blood can clump and form clots -- and your artery gets blocked.

Besides atherosclerosis, other things that can raise your chances of getting an ischemic stroke are:

  • Atrial fibrillation

  • Heart attack

  • Problem with your heart's valves

  • Injury to blood vessels in your neck

  • Blood clotting problem

Types of ischemic stroke

There are two main types of ischemic stroke:

  • Thrombotic strokes. They're caused by a blood clot that forms in an artery that supplies blood to your brain.

  • Embolic strokes. They happen when a clot forms somewhere else in your body and travels through the blood vessels to your brain. It gets stuck there and stops the flow of your blood.

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Risk factors of ischemic stroke

You're more likely to have an ischemic stroke if you:

Complications of ischemic stroke

Sometimes you can get complications. A stroke damages your brain cells. The more damage that's done, the more problems you can have. That's why it's important to get medical help as soon as possible because there’s a limited time for treating an acute stroke. If you don't get treatment, you could have trouble like:

  • Fluid buildup, swelling, and bleeding in your brain

  • Seizures

  • Problems with memory and understanding

Transient Ischemic Attack or Mini-Stroke

Ischemic strokes also include something called a "mini-stroke" or a TIA (transient ischemic attack). This is a temporary blockage in blood flow to your brain. The symptoms usually last for just a few minutes or may go away in 24 hours.

Symptoms of TIA

The symptoms may be similar to an ischemic stroke. You might have:

  • Numbness/weakness on one side of your body

  • Confusion

  • Dizziness or loss of balance

  • Trouble talking or understanding

  • Problems with your vision

  • Severe headaches

Causes and risk factors of TIA

TIAs can happen because the vessels that bring blood to your brain narrow. They also might result from a clot.

Things that can raise your chances of getting a TIA include:

  • Age

  • High blood pressure, high cholesterol, diabetes, and heart disease

  • Obesity

  • Smoking

  • Family history of strokes

  • Atrial fibrillation

A TIA can sometimes be a warning sign that you'll have an ischemic stroke soon.

Don't take chances if you or someone you know has any symptoms that seem like a stroke. Get medical help in a hurry.

Hemorrhagic Stroke

These happen when bleeding in your brain damages nearby cells. 

Causes of hemorrhagic stroke

The most common causes are:

  • High blood pressure

  • Injury

  • Bleeding disorders

  • Cocaine use

  • Abnormal blood vessels (AVMs)

  • Aneurysm (a weak area in a blood vessel that breaks open)

There are two types of hemorrhagic stroke. Which kind you have is based on where the bleeding happens. 

  • Subarachnoid hemorrhagemeans it happened in the area between your brain and skull. 

  • Intracerebral hemorrhage is bleeding inside the brain.

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Symptoms of hemorrhagic stroke

Hemorrhagic stroke symptoms usually increase gradually over minutes or a few hours, although a subarachnoid hemorrhage may come on suddenly. You might notice:

  • Intense headache -- some people describe it as the worst headache they've ever had

  • Confusion

  • Nausea or throwing up

  • Sensitivity to light

  • Problems with vision

  • Passing out

Risk factors of hemorrhagic stroke

You're more likely to have this type of stroke if you:

  • Are over age 65

  • Have high cholesterol, high blood pressure, or diabetes that isn’t under control

  • Are obese

  • Had a stroke in the past

  • Have a family history of strokes

  • Smoke

  • Eat unhealthy foods

  • Don't exercise

Complications of hemorrhagic stroke

A hemorrhagic stroke can cause complications like:

  • Seizures

  • Memory and thinking problems

  • Heart problems

  • Swallowing problems and trouble eating and drinking

  • Permanent neurologic disability

Brain Stem Stroke

This type happens in your brain stem. It can affect both sides of the body. If this happens you’re left in a “locked in” state where you’re unable to speak or move below the neck.

Symptoms of brain stem stroke

It can be hard to recognize when someone is having a brain stem stroke. They may have some symptoms without the hallmark sign of weakness on one side of the body. Symptoms of brain stem stroke include:

  • Vertigo, dizziness and loss of balance

  • Double vision

  • Slurred speech

  • Passing out

  • Trouble with central nervous system functions like blood pressure and breathing

  • “Locked in” syndrome -- you can only move your eyes.

Causes and risk factors of brain stem stroke

Causes include:

  • Blood clots

  • Hemorrhages

  • Injury to an artery due to sudden head or neck movements (these are rare)

Risk factors include;

  • Smoking

  • High blood pressure

  • Diabetes

  • Atrial fibrillation

  • Heart Disease

WebMD Medical Reference Reviewed by Brunilda Nazario, MD on August 13, 2020

Sources

SOURCES:

American Association of Neurologic Surgeons: "Stroke."

American Heart Association/American Stroke Association: "Hemorrhagic Strokes (Bleeds)," "TIA (Transient Ischemic Attacks)," "Why Getting Quick Stroke Treatment is Important."

Beaumont: "Ischemic Stroke."

Bernheisel, C.R. American Family Physician, December 2011.

Cleveland Clinic: "Transient Ischemic Attack (TIA)."

Mount Sinai Hospital: "Hemorrhagic Stroke."

National Stroke Association: "Let's talk about Ischemic Stroke," "What is Stroke?" "What is TIA?"

The Internet Stroke Center: "Ischemic Stroke."

UpToDate: "Patient information: Hemorrhagic stroke treatment (Beyond the Basics)."

American Stroke Association: “Types of Stroke”

Cedars Sinai: “Ischemic Stroke”

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