Brain Attack (Stroke)

A brain attack, also called a stroke or cardiovascular accident (CVA), can cause both temporary and permanent brain damage, and may result in death. Permanent effects can result in loss of function of one of more parts of the body, such as being unable to speak, paralysis, confused mental state or loss of control of bodily functions. Brain attack is the third leading cause of death in the US.

What is a brain attack?

A brain attack is the disrupted flow of blood to part, or all, of the brain. This can be either due to blockage of a blood vessel or bleeding into the brain.

High Blood Pressure and Brain Attack

Having high blood pressure increases the risk of brain attack by about five fold.

The two main types of stroke are ischemic (pronounced is-keemic), which is a blockage in a brain blood vessel, and hemorrhagic, which is bleeding from a rupture in a blood vessel. If you have high blood pressure there is an increased risk of brain attack of both types. If there is a weakness in any blood vessel, increased blood pressure will increase the likelihood of the blood vessel bursting resulting in a hemorrhagic brain attack. High blood pressure can cause of ischemic (blockage) brain attack, in particular a type called lacunar infarction, which is the blockage by pieces of connective tissue and fat, not blood clots.

Symptoms of a brain attack

There are a range of symptoms for the onset of brain attacks (strokes). This is due to the fact that it depends on the cause of the stroke, the parts of the brain that are affected, and the parts and functions of the body controlled by the affected areas.

Common symptoms include one or more of the following;

• Sudden very severe headache with no known cause
• Sudden numbness, weakness or paralysis in arm and/or leg. Frequently only one side.
• Drooping, or paralysis on one side of the face
• Sudden loss of coordination or balance, or trouble walking
• Sudden trouble speaking or understanding speech
• Sudden loss, or poor vision in one or both eyes, or double vision
• Sudden confusion
• Sudden severe dizziness, may be accompanied by nausea and vomiting
• Sudden trouble swallowing
• Sudden loss of bowel or bladder function
• Sudden stiffness in the neck
• Sudden loss of hearing
• Brief loss of consciousness

Note: The onset of all of these common symptoms is rapid.

If you suspect that you, or somebody else, is having a brain attack, call an ambulance and get to the emergency department immediately. Getting treatment as soon as possible after the start of the attack can make a big difference in reducing the amount of brain damage. Better a false alarm, than delaying seeking help and having a much more serious outcome.

Transient Ischemic Attack or TIA

As the name suggests a TIA is short in duration. The range of potential symptoms is the same as above, but often will only last from seconds to 20 minutes. The affect on the brain is only temporary and short enough that the symptoms go away as brain function returns to, or near, normal. Generally the brain is not permanently damaged, or damage is minor.

Don’t wait to see if an event is a TIA, and even if all the symptoms go away, it is important to seek treatment quickly. Having a TIA puts you at high risk for having a major brain attack in the near future. Getting medical care can greatly reduce the risk of having a major brain attack and getting permanent brain damage.

Risk factors for a brain attack

Factors for which you may be able to do something

• High blood pressure
• Smoking
• High cholesterol
• Artery disease and other heart disease
• Diabetes
• Obesity
• Physical inactivity
• Alcohol abuse
• Poor diet

Risk factors that you cannot change

• Heredity – your racial background and family genetics
• Sex – females are at higher risk
• Age – risk increases with age

After a Brain Attack

The level of impairment of the body and mind can vary from minor to very severe. The location in the brain of the attack and the size of the area of damage determines which functions are affected. As an example, a brain attack on the left side of the brain can affect movement of parts or all of the right side of the body, can cause speech problems, can make impair memory and can make a person very cautious and hesitant. With time and therapy there is usually improvement in the affected body and mind functions. Some people show great improvement, others have limited return of function.. There is very active research into why certain people seem to be able to repair some of the damage, and others have little or no repair. Unfortunately, so far it remains a mystery.