Stroke – Ischemic

Ischemic stroke occurs when an area of the brain does not receive enough blood and oxygen. This may be caused by blockage in an artery carrying blood to the brain. Stroke is a medical emergency. If the blood flow does not quickly improve, more and more brain cells in the area will die.

Time is especially important when a blockage involves an artery which supplies a large area of the brain. Treatments which may possibly restore the blood flow are time dependent.

Signs and Symptoms

Symptoms of ischemic stroke usually begin suddenly and commonly include the following:

  • Headache
  • Weakness, tingling or paralysis, typically on one side of the body
  • Difficulty swallowing
  • Confusion
  • Trouble seeing or loss of vision
  • Difficulty with balance
  • Trouble speaking
  • Issues reading, writing or understanding speech
  • Fatigue
  • Changes in alertness or consciousness
  • Difficulty breathing

Potential Causes

Ischemic strokes can be caused by blockage in an artery supplying blood to the brain, an embolus (blood clot or other substance lodged in the artery) or inadequate oxygen or blood pressure. Ischemic strokes may be seen more commonly in patients with hypertension, diabetes mellitus, atherosclerosis or a history of smoking.


Diagnosis starts with a medical history and neurological examination. When there is suspicion of a large vessel occlusion, rapid evaluation with specialized CT scans (including CT perfusion ) and CT angiography or MRI (including MR perfusion ) and MR angiography may be utilized.

Treatment Options

Treatment depends on the severity and length of time that symptoms have been present, as well as the suspected cause of the stroke.

  • Thrombectomy  This neuro-interventional procedure may be used in the emergent treatment of stroke due to large vessel occlusion (blockage) by an embolus in selected candidates. A small, flexible catheter (tube) is inserted into an artery in the groin or wrist. Fluoroscopy (a type of X-ray) is used to guide the catheter through the arteries in the neck and brain to remove the blood clot at the site of blockage.
  • Thrombolytic medication given through an IV or catheter Drugs that dissolve blood clots can be given intravenously (IV) or through a catheter directed to the site of blockage in the brain blood vessel.

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