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Different Strokes for Different Folks, But All Are Dangerous

There’s a saying, “Different strokes, for different folks.” But the same adage is true when it comes to the medical condition as well.

Not only do strokes affect you differently based on where they occur in the brain, strokes can also be broken down into three types:  ischemic strokes, hemorrhagic strokes and transient ischemic attacks or TIAs.

“The important thing to know is that all strokes are associated with a disruption of blood flow to the brain,” said Jeremy Payne, MD, PhD, a neurologist with Banner – University Medicine Neuroscience Clinic. “Our brain needs a constant supply of oxygen and energy. When brain cells don't get the blood supply, they stop working normally. And when it comes to our brain, seconds count.”

Not only can a stroke be life-threatening, according to the Centers for Disease Control and Prevention, it is also the leading cause of serious, long-term disability in adults. It’s crucial not to hesitate or second guess yourself if there are any stroke warning signs.

Dr. Payne helps break down the different types of strokes – and how they occur – so you can be armed with the knowledge on how to recognize them.

Ischemic Stroke

The most common stroke, accounting for roughly 85% of all cases, are known as ischemic. These occur when there is a blockage in one of the arteries.

“I often describe this to patients as a plumbing problem in your pipes,” Dr. Payne said. “Ischemic strokes are like a clog in your pipes. It can occur when a blood clot forms in an artery leading to the brain or from elsewhere in your body, cutting off blood flow to the brain.”

Caught in time, they can be treated effectively (This means, don’t stop to think—just call 911 and get to a hospital!). In some cases, doctors can give clot-busting medications to dissolve the clot. Larger clots may require a minimally invasive treatment known as thrombectomy in which a catheter is used to physically remove the clot.

Hemorrhagic Stroke

The other 15% of strokes are known as hemorrhagic. Instead of blocking your pipes, hemorrhagic strokes cause a rupture in your arteries. Hemorrhages can occur in a blood vessel inside the brain or on the surface of the brain.

“Imagine your pipes burst, and water starts flooding the room,” Dr. Payne said. “While ischemic strokes cause blockages, hemorrhagic strokes cause blood vessels to burst, causing blood to flood the brain.”

Blood is very toxic to the brain and can cause damage to brain tissue and cells through increased swelling and pressure. Specific treatments and sometimes surgery are required to remove the blood, repair the damaged blood vessels and relieve pressure on the brain, but treatment can depend on the volume and location of bleeding.

TIAs: What Happens If Stroke Symptoms Go Away?

A transient ischemic attack or TIA marks a temporary interruption of blood flow to the brain. It may look and feel like a stroke, but symptoms don’t persist and resolve on their own, with no permanent damage.

This might be why people often get confused by TIAs and strokes—but nonetheless, it is important to seek immediate medical care when one strikes. To help patients better understand, Dr. Payne often describes the difference between stroke and TIA like a freezer full of ice cream.

“Imagine you have a freezer full of ice cream and the power goes out,” Dr. Payne said. “The power in this case is the blood supply, and the ice cream is your brain. If the power goes out for a short period of time and then comes back on, your ice cream might be saved. If it goes out for longer, the ice cream will melt, essentially like the damage that occurs to the brain in a stroke.  It is hard to know how long the power can be out before our ice cream melts, and so it’s important to call 911 as soon as a stroke is suspected. Even if the symptoms resolve quickly, TIAs are warning signs that something isn’t right and should be checked out.”

This is why recognizing symptoms of a TIA and seeking immediate treatment will reduce the risk of a major stroke.

Know the Signs and Take FAST Action

With strokes, no matter the type, every second counts. Remember to BE FAST to save your brain. Dr. Payne shared this important analogy on why it’s important not to delay care:

“A stroke is like coming home to see your house on fire. The more you watch it, the worse it will get,” he said. “Don’t mess around or overthink your symptoms. Get to the hospital, so we can quickly put out the fire.”

Instead of getting stuck on differing signs and symptoms of ischemic or hemorrhagic strokes, remember this simple test:

B: Balance – Sudden loss of balance

E: Eyes – Sudden changes in vision in one or both eyes (can’t see or seeing double)

F: Face – Sudden weakness on one side of the face

A: Arm – Sudden weakness in one arm or leg

S: Speech – Sudden loss of speech or slurred speech

T: Time – Call 911 if even when one of these problems is sudden or new

These signs and symptoms don't always mean someone is having a stroke. Many other problems can look like a stroke. However, it is very important to get help right away, just to be sure.

“The quicker we can ‘put out the fire,’ the better the outcome,” Dr. Payne said. “We can evaluate the cause, how to prevent another one and begin the rebuilding process. Once we understand someone’s risks for stroke, we can prevent 80% of them from ever happening.”

Do you believe you may be at risk for a stroke?

Schedule an appointment with a Banner Health neurologist. Identify your risk factors and ways to improve them by visiting our Stroke Risk Profiler, and read about prevention tips to lower your risk. For more information on stroke care, visit bannerhealth.com.

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