An ischemic stroke is when there’s some kind of blockage that keeps blood from reaching all areas of your brain. The areas without blood flow stop working and start to die. If blood flow doesn’t return quickly enough, an ischemic stroke will cause permanent brain damage or even death. This is a medical emergency that needs immediate care.
An ischemic stroke is a life-threatening medical condition that happens when there’s a lack of blood flow to a part of your brain. These usually happen because of blood clots, but they can also happen for other reasons.
Ischemia (pronounced “iss-key-me-uh”) is when cells in your body don’t have enough blood flow, which causes them to die. When this happens in areas of your brain, you lose the abilities controlled by those brain areas. If those brain cells die, that can lead to permanent brain damage or even death.
IMPORTANT: A stroke is a life-threatening emergency condition where every second counts. If you or someone with you has symptoms of a stroke, you need to IMMEDIATELY call 911 (or your local emergency services number). The longer it takes to receive care, the more likely a stroke will cause permanent brain damage or death.
To recognize the warning signs of a stroke, remember to think FAST:
An ischemic stroke involves a blockage in blood flow in your brain. A hemorrhagic stroke involves bleeding in or around your brain that disrupts blood flow.
Ischemic strokes are most common in people who have a problem that affects how blood circulates in their brain. Those problems are usually age-related, so ischemic strokes are more common as people get older.
About two-thirds of all strokes happen in people over the age of 65. However, younger individuals are still at risk for ischemic strokes. There are also certain medical conditions that can either cause these kinds of strokes or make them more likely to happen.
Strokes are very common. Worldwide, strokes rank second among the top causes of death. In the United States, they rank fifth. Strokes are also one of the leading causes of disability worldwide. Ischemic strokes make up about 85% of all strokes.
An ischemic stroke is the brain’s version of a heart attack. When you have an ischemic stroke, part of your brain doesn’t get enough blood. Your brain cells need blood flow to supply them with oxygen, vital nutrients and more.
Different areas of your brain control specific abilities. The symptoms of a stroke happen because the brain cells in the affected brain area aren’t getting enough blood flow, so they stop working like they should and start to die. If they don't get blood flow back fast enough, too many brain cells in that area die off, and you permanently lose any abilities they controlled. In severe cases or cases that go untreated for too long, this can also cause death.
The symptoms of an ischemic stroke can involve one or more of the following:
A transient ischemic attack (TIA) — sometimes called a “mini-stroke” — is like an ischemic stroke, but the effects are temporary and usually go away on their own. These are often warning signs that a person has a very high risk of having a true stroke soon. Because of that, a person who has a TIA needs emergency medical care as soon as possible.
Ischemic strokes usually involve certain processes. These are:
Blood clots and other forms of ischemia can happen for many reasons, such as:
There are other conditions and circumstances that might not cause a stroke directly, but that still contribute to your risk of having a stroke or the severity of a stroke you have. These include:
Ischemic strokes aren’t contagious and can’t spread from one person to another.
A healthcare provider can diagnose a stroke using a combination of a neurological examination, diagnostic imaging and other tests. To do a neurological examination, a provider will ask you to move your hands, feet, arms, legs, eyes and head in specific ways, and answer some questions. As you perform these tasks or answer these questions, the provider will look for signs or clues that indicate a problem with how different areas of your brain are working. That can help them determine if you’re having a stroke and may even hint at where in your brain it’s happening.
The most common tests that happen when a healthcare provider suspects an ischemic stroke include:
The highest priority with ischemic stroke is restoring circulation to the affected brain areas. That’s because restoring circulation quickly can limit the damage and preserve brain tissue. The less permanent brain damage you have, the more likely you’ll keep all or most of the abilities you had before the stroke.
If you’re at risk for a stroke, your healthcare provider may recommend changing your diet to maintain or lower your blood pressure, which can also help in managing blood sugar and cholesterol. Changing your diet like this includes avoiding or limiting:
The treatments for ischemic stroke depend strongly on how long it’s been since the stroke symptoms started. That’s one of the main reasons why it’s so important not to delay going to the emergency room if you have stroke symptoms.
Thrombolytic drugs are an option within the first three hours to four and a half hours after stroke symptoms start. These medications dissolve existing clots (their name is a combination of the Greek words “thrombus,” which means “clot,” and “lysis,” which means “loosening/dissolving”). However, they’re only an option within that three- to four-and-a-half-hour time frame because after that, they increase the risk of dangerous bleeding complications.
This is a procedure to remove a clot from your brain using a catheter-based approach. Thrombectomy means “surgery to remove a blood clot.” The term “endovascular” means “inside blood vessels.” Thrombectomy procedures are also time-sensitive, and these usually are only possible in the first 24 hours after symptoms start.
During this procedure, a healthcare provider will insert a small, tube-like device called a catheter into a major blood vessel somewhere on your body. Once it’s inside the vessel, the provider will then thread the catheter up to the clot in your brain. When the tip of the catheter reaches the clot, it can either suck up the clot directly or break it apart and suck up the fragments.
Some examples include:
It’s common for people to have some lingering effects from a stroke in the days and months that follow. For many, the effects of a stroke will get slightly worse in the first few days after the stroke, and then they’ll improve.
Because it’s common for people to have lingering problems from a stroke, rehabilitation and therapy methods are common to help people recover from a stroke. In some cases, therapy simply helps you return to how you were before your stroke. In other cases, this kind of therapy can help you relearn how to do certain things.
Your brain has a remarkable ability called “neuroplasticity” (pronounced “new-row-plass-tiss-it-ee”). That means your brain can adapt and change when it needs to. In some cases, your brain will “re-map” an ability, transferring control of that ability to an undamaged part of the brain. Many stroke therapy methods take advantage of that ability and speed up the process.
Stroke rehabilitation can take many forms, including:
Other treatments are possible, depending on your case and circumstances. Your healthcare provider is the best person to tell you what kind of treatments can benefit you.
The possible side effects or complications can change depending on where a stroke happens in your brain, the treatments used, your medical history and many other factors. Your healthcare provider can tell you more about the side effects that you can or should expect, and what you can do to manage or even prevent them.
A stroke is a life-threatening medical emergency, which means you shouldn’t try to self-diagnose it. If you have — or someone with you has — stroke symptoms, it’s critical that you immediately call 911 (or your local emergency services number). Any delay in getting treatment for a stroke increases the risk of permanent brain damage or even death.
How long it takes to feel better after treatment and the time to recover after a stroke can vary from person to person. That’s because many factors play a part in how you feel over time. If you have questions about the likely timeline for your treatment and recovery, your healthcare provider is the best person to answer that question and give you information that is most accurate for your situation.
There are many things you can do to reduce your risk of having an ischemic stroke. While this doesn’t mean you can prevent a stroke, it can lower your risk: Actions you can take include:
If you have a stroke, many factors affect what you can expect. These include, but aren’t limited to, the size of the stroke and the specific areas of the brain it affects. In general, the larger the stroke, the more severe the symptoms. Larger strokes also have a higher risk of an unfavorable outcome. Some strokes can be smaller, but can still be severe if they affect a critical area of your brain. An example of this is a stroke that affects areas of your brain that control your ability to speak. These can severely disrupt your life, but are less likely to be life-threatening.
The more severe an ischemic stroke is, the more likely that you’ll lose — at least temporarily — certain abilities. Larger strokes are also more likely to cause permanent damage or death. That’s why getting medical attention quickly is so important. The faster you get medical attention for stroke symptoms, the better your chances that these effects will be temporary or less severe.
Strokes can happen in very different ways from person to person. While there are many similarities in how strokes happen and the symptoms unfold, not all cases are the same. Because of that, your healthcare provider is the best person to tell you what you can and should expect.
Even after you receive treatment for your stroke and blood flow returns to the affected brain areas, you may feel lasting effects. Some of these effects are short-term and will get better over the coming days, but others may last for weeks or months before improving. Some effects may be permanent. Your healthcare provider is the best person to tell you how long you should expect to feel the effects of a stroke, but it can still be hard to predict and can vary greatly from person to person.
The outlook for an ischemic stroke can vary widely from person to person. That’s because many factors can play a role in how this condition affects you. In general, getting care quickly increases the odds that you’ll have a better outcome. Your healthcare provider is the best person to tell you what the outlook is for you based on your specific circumstances.
If you have an ischemic stroke, your healthcare provider will provide you with information and resources that can help as you recover. They’ll likely recommend that you take certain kinds of medications, especially blood thinners, to prevent another stroke.
The best things you can do to care for yourself after having a stroke include:
Your healthcare provider will schedule follow-up appointments for you, and you should also call or see them if you notice any changes and symptoms that might have a link to your stroke. You also should talk to them if you notice symptoms or issues that are disrupting your life or routine, even if those symptoms don’t have a connection to your stroke or don’t seem very important.
You should call 911 (or your local emergency services number) and go to the nearest ER if you experience any symptoms of another stroke (see the FAST criteria at the top of this article to know the symptoms for which you should watch).
You should also go to the hospital if you experience any of the symptoms of dangerous complications that are common after a stroke. The most common complicating conditions include:
Ischemic strokes are a life-threatening medical emergency. It’s important to immediately get medical care if you notice you have the symptoms of one or if you’re with someone who has those symptoms.
A note from Cleveland Clinic
An ischemic stroke is a life-threatening medical emergency that needs immediate care. These kinds of strokes can have sudden, frightening symptoms. Fortunately, there are many things you can do to prevent these or reduce your risk of them happening.
If you notice you’re having these symptoms or are with someone having them, it’s important to get medical attention right away. With fast medical care, many people recover from an ischemic stroke and will get back most or all of their abilities.
Last reviewed by a Cleveland Clinic medical professional on 09/22/2022.
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