Stroke: Prevention, Symptoms and Treatment

Author: Melanie Lising, MD, Neurologist, MarinHealth
Stroke: Prevention, Symptoms and Treatment

It’s National Stroke Awareness Month, the perfect time to brush up on our knowledge of stroke and stroke prevention. Stroke is the fifth most common cause of death in the U.S., cutting short the lives of 140,000 Americans each year. Meanwhile, tens of thousands of stroke survivors suffer long-term disabilities. Statistics like these are what makes stroke such a time-sensitive emergency. There are two types of stroke—ischemic and hemorrhagic.

A common analogy used to explain stroke compares our arteries to home plumbing. If you pour grease down the drain, it eventually clogs your pipes. In an ischemic stroke, arteries can be clogged by plaque buildup or a blood clot, blocking blood fl ow to the brain. Hemorrhagic stroke is more like a burst pipe: a thin or malformed blood vessel ruptures and bleeds into the surrounding brain tissue, just as a broken pipe leaks water. 87% of strokes are ischemic. The other 13% are hemorrhagic.

In an ischemic stroke, the brain is damaged due to lack of oxygen. In a hemorrhagic stroke, the damage is compounded by pressure from the brain bleed on surrounding tissues. Either way, it’s essential to call 911 and get to the emergency department immediately. It’s a good idea to keep a list of the signs of stroke handy so you can recognize them. Download a pdf outlining how to recognize symptoms of a a stroke at

The sooner stroke treatment can begin, the better the outcome. That’s why physicians say, “time is brain.” The most common treatment for ischemic stroke is the use of clot dissolving medication called IV-tPA. The traditional “window” is three hours but IV-tPA has been used with some success as late as 4.5 hours from the onset of stroke symptoms. In some cases, a large clot can be removed minimally invasively through catheter-based procedure called a thrombectomy. Treatment is different in the case of hemorrhagic stroke, where the problem is bleeding. Where possible, such strokes are treated surgically through a procedure known as a craniotomy. In some cases of hemorrhage, a portion of the skull is removed so the surgeon can access the brain and repair the affected blood vessel.

Ultimately, the best treatment for stroke is prevention. Even if you have already had a stroke, taking these preventive measures can help avoid a recurrence:

  • Control your blood pressure—monitor it frequently and take your medication as directed
  • Limit your intake of fats, salt, and sugar and take statins as prescribed
  • If you have Atrial Fibrillation (AFib) be sure to take your blood thinners as prescribed
  • If you are overweight, ask your doctor to recommend a weight-loss program
  • Exercise regularly
  • Don’t smoke or take illegal drugs and limit your alcohol consumption to one drink a day for women and two for men—no binge drinking
  • Monitor and control your blood sugar carefully if you have diabetes or prediabetes