Atherosclerosis and Ischemic Stroke
How does a stroke happen? You probably know that a heart attack is caused by a narrowing or blockage of the coronary arteries. The same process happens in arteries as these bring blood to the brain (the carotid and vertebral arteries) or arteries within the brain itself (cerebral arteries). Whenever any of these arteries become narrowed or blocked, the brain may experience shortage of blood supply and oxygen it needs. The result is stroke, also known as a cerebral vascular accident (CVA).
Ischemic strokes lead to ischemia, which is a lack of blood flow in the brain. Ischemic disease can be caused by stenosis (extracranial or intracranial), thrombosis, or embolism.
Ischemic stroke often has no symptoms. In some cases, patients present with temporary stroke-like events called transient ischemic attacks (TIAs). Receiving treatment with tissue plasminogen-activator (tPA) at the first signs of a TIA or stroke may prevent brain damage if it is administered within three hours of the initial symptoms.
Patients should seek immediate medical attention if they experience the following symptoms:
- Difficulty seeing
- Loss of strength, coordination or feeling on one side of the body
- Severe headache similar to a migraine
- Slurred speech
- Difficulty eating or swallowing
Treatment Options for Ischemic Stroke
Physicians at the Mount Sinai’s Cerebrovascular Center treat ischemic stroke by one or more of the following:
- Intravenous tPA (tissue plasminogen activator) may improve clinical outcome if a patient presents with stroke or TIA symptoms within three hours of onset of symptoms. Intravenous tPA is usually administered via the emergency department
- Administering antiplatelet and anticoagulation agents
- Intra-arterial tPA
- Balloon angioplasty
- Extracranial and intracranial stenting
- Clot removal with new devices that are proven to improve stroke outcomes in certain patients
- Medications may be prescribed to reduce blood pressure, prevent embolism and/or control cholesterol
- Lifestyle changes may be recommended such as smoking cessation and nutritional and exercise counseling
- When a stroke has resulted in loss of function, physical therapy and stroke rehabilitation is recommended
Several intravenous, clot-busting medications are now available to treat strokes within just a few hours of the onset of symptoms (acute stroke). Using endovascular technology, your doctor can deliver these medications directly to the affected artery in your brain. Additionally, there are newer endovascular approaches pioneered by the physicians on our team that physically remove the clot from the blocked artery – thereby restoring blood flow and saving the brain. These new techniques have recently been proven to help certain patients suffering from stroke.
Klingenstein Clinical Center, 1-North
1450 Madison Avenue
New York, NY 10029