Posted: Monday, November 15, 2021

Differences in Types of Stroke

When you or someone you love is having a stroke or experiencing stroke symptoms, there’s simply no time to determine what type of stroke is occurring. Strokes happen either when a blood clot blocks an artery or when a blood vessel breaks, interrupting blood flow. This means the brain is no longer getting blood and oxygen. That can result in lost brain cells, making time a huge element in both treatment and outcome. That said, there are multiple types of stroke, and while they may have similar warning signs and symptoms, they’re ultimately quite unique.

Blount Memorial stroke medical director Dr. Deaver Shattuck says there are two broad categories of stroke. “You have a stroke that cuts off blood supply to the brain and you have the kind of stroke where you actually bleed into the brain,” he said. “Bleeding into the tissue of the brain is far less common and typically occurs if you have an aneurysm or a tumor. You can also have a stroke where you’re losing oxygen to the brain and then the vessel bursts, which can result in bleeding into the brain. Unfortunately, those are the strokes you can do very little about and are much more dangerous. In some cases, the blood can be drained off through neurosurgery. Usually though, all you can do is support the patient and hope that they get better,” he explained. “Strokes that involve bleeding into the brain are much more deadly and can result in more disabilities for those patients, mostly because there just aren’t many effective therapies for them,” he added.

Within the category of stroke that involves a loss of blood supply to the brain are several more stroke classifications. “You can have a stroke in which the arteries in your brain harden and narrow to the point that you develop a blood clot. Those are the kind of strokes where we can administer TPA (tissue plasminogen activator) or the clot-buster drug, break up the clot and save brain tissue,” he said. “You also have what are known as embolic strokes, where you have a clot in another part of your body, typically in the heart or in the carotid arteries, which moves up into the brain. When a piece of that blood clot wedges into a smaller artery into the brain, it deprives the brain of the oxygen and that part of the brain begins to die,” he explained. “This also can be treated with TPA,” he added.

“The other type of stroke that patients always ask about is mini strokes,” Shattuck said. “A mini stroke is when you had an area of brain that was deprived of oxygen for a period of time, but that got better quickly. Maybe the vessel was not 100 percent blocked, but was only partially blocked. This is similar to having chest pains that don’t necessarily result in a heart attack. With mini strokes, symptoms tend to disappear in under 24 hours without intervention,” he added.

But, again, because you cannot immediately tell which type of stroke you’re having, the message remains the same – seek help immediately. “If we have a patient experiencing stroke-like symptoms and they’re inside the window of time to administer TPA, we’re going to do that,” Shattuck said. “You only know for sure you’ve had a mini stroke after the fact, so it is crucial to get here as quickly as possible,” he added.

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