Ischemic Stroke

What Is an Ischemic Stroke?

An ischemic stroke occurs when a blood clot blocks or narrows a blood vessel supplying blood to the brain. This interruption in blood flow deprives brain tissue of oxygen and nutrients, causing brain cells to begin dying within minutes. It’s the most common type of stroke, accounting for more than 80% of all strokes.

Who Is Affected?

Ischemic strokes can affect anyone, but the risk increases with age. They are more common in individuals over 60, but they can also strike younger adults and even children in rare cases. Men have a higher risk overall, but women are more likely to die from a stroke. Black, Hispanic, and Native American populations are disproportionately affected due to a higher prevalence of risk factors.

What Causes an Ischemic Stroke?

An ischemic stroke is typically caused by a blood clot (thrombus or embolus) that forms in or travels to the arteries supplying the brain. The two main types are:

• Thrombotic stroke: A clot forms in a brain artery.
• Embolic stroke: A clot forms elsewhere in the body (often the heart) and travels to the brain.

Risk Factors

• Age: Risk increases after age 55.
• Gender: Men are at slightly higher risk, though women tend to have worse outcomes.
• Family History: Genetics can play a role.
• Race/Ethnicity: African Americans and Hispanics face higher risks.

Controllable Risk Factors

• High blood pressure (hypertension) 
  
• High cholesterol
  
• Smoking
• Diabetes
• Obesity
• Atrial fibrillation (AFib)
• Physical inactivity
• Excessive alcohol intake

Who Is Most at Risk?

People with multiple risk factors, especially those with high blood pressure, heart disease, or diabetes, are most vulnerable. Those who have already experienced a stroke or TIA (mini-stroke) are also at significantly increased risk of recurrence.

How to Reduce Your Risk

You can dramatically reduce your stroke risk by:

• Controlling blood pressure and cholesterol
• Quitting smoking
• Eating a heart-healthy diet
• Exercising regularly
• Managing diabetes and heart conditions
• Limiting alcohol
• Taking prescribed medications as directed

Common Stroke Symptoms (BE FAST)

Recognize stroke symptoms using the BE FAST acronym:

Other symptoms may include:

• Sudden severe headache with no known cause

How Is Ischemic Stroke Diagnosed?

Prompt diagnosis is critical. Medical professionals will:

• Review symptoms and medical history
• Perform a physical and neurological exam

Common Diagnostic Tests

• CT Scan: Quickly distinguishes between ischemic and hemorrhagic stroke while ruling out a tumor
• MRI: Detects areas of brain damage.
• Carotid Ultrasound: Looks for narrowed neck arteries.
• Cerebral Angiography: Maps brain blood flow.
• Echocardiogram: Checks for heart clots.
• Blood tests: Assess clotting, blood sugar, and infection.

How Is an Ischemic Stroke Treated?

Time is brain - immediate treatment improves outcomes dramatically.

Medical Treatments

• Thrombolytic medications: A clot-busting drug effective within 3–4.5 hours of symptom onset.
• Antiplatelet or anticoagulant medications: Prevent future clots.
• Statins: Lower cholesterol.

Surgical & Interventional Treatments

• Mechanical thrombectomy: Clot removal via catheter (within 24 hours of the start of symptoms).
• Carotid endarterectomy: Removes plaque from neck arteries.
• Stenting: Keeps narrowed arteries open.

Lifestyle Changes

• Adopt a heart-healthy diet
• Exercise regularly
• Get enough sleep
• Maintain a healthy weight
• Quit smoking
• Manage blood sugar and/or diabetes
• Control cholesterol
• Manage blood pressure
• Manage stress and chronic conditions

Other Therapies

• Rehabilitation: Physical, occupational, and speech therapy to regain lost function.
• Assistive devices: Mobility aids, communication tools.

Immediate Signs You Need Help

Call 911 immediately if you or someone else experiences any of the BE FAST symptoms:

• BALANCE: If there is a sudden loss of balance or coordination
• EYES: If there is a sudden loss of vision in one or both eyes or if vision becomes blurry
• FACIAL DROOPING: If there is a sudden weakness in the face – especially on only one side
• ARM WEAKNESS: If there is sudden weakness in an arm or leg
• SPEECH: If there is a sudden difficulty speaking or slurring of speech
• TIME TO CALL 911

Why Urgency Matters

Ischemic stroke treatments are most effective when started early, and some treatments are only available within a certain time window. Delaying care could mean permanent brain damage or death.

What Should You Do Next?

• Know the signs of a stroke and teach them to your family. Check out our Stroke Smart Community page you want materials and resources to help teach others to recognize the signs and symptoms of stroke.
• Manage your risk factors: Schedule regular checkups and follow your treatment plan.
• Talk to your doctor if you have concerns about stroke prevention or symptoms.