The Different Types of Stroke
A stroke has many different names, such as apoplexy, cerebral infarction, or simply “stroke,” and occurs when the blood supply to the brain is interrupted due to a blockage. A stroke can cause various symptoms, such as paralysis, sensory disturbances, or blindness.
- Ischemic Stroke
This is the most common type of stroke. An ischemic stroke occurs when a blood clot blocks a blood vessel. The nerve cells in the affected area then receive insufficient oxygen and may become damaged or die within a few minutes. - Cerebral hemorrhage
A cerebral hemorrhage, on the other hand, is less common. In this case, a blood vessel in the brain ruptures, causing blood to flow unimpeded into the brain tissue and thereby irritating the brain—both chemically and mechanically. - Subarachnoid
hemorrhage A subarachnoid hemorrhage occurs when a blood vessel on the meninges ruptures, causing blood to accumulate between the meninges and the brain. This creates pressure, and this pressure is responsible for the subsequent symptoms.
Stroke Symptoms
A stroke is always a medical emergency. Every minute counts—it is therefore essential to respond quickly and correctly. Always dial the emergency number—144 in Switzerland (= ambulance emergency number), 112 in Germany—and call an ambulance. The most common signs of a stroke are:
Sudden loss of sensation, paralysis, or weakness in the face, arms, or legs (usually on only one side of the body), blindness, blurred vision, double vision, slurred speech, difficulty understanding others, unsteady gait, dizziness, and severe, unusual, and sudden headaches.
Have you received a diagnosis and would like a second opinion, or are you unsure whether you have risk factors for a stroke? One of our specialists would be happy to take the time to see you during a consultation.
Transient Ischemic Attack (TIA)
A so-called “mini-stroke” (also known colloquially in Switzerland as a “Schlägli”) refers to a transient episode that often serves as a warning sign of a full-blown stroke. In this case, the stroke symptoms disappear within 24 hours and leave no lasting effects. Nevertheless, caution is advised, and this warning sign should definitely be taken seriously. It is important to determine why this so-called transient ischemic attack occurred and what caused it.
Acute Treatment
Time is brain! Up to two million brain cells are permanently destroyed every minute during a stroke. That is why it is crucial that the patient be admitted as quickly as possible to a specialized hospital with a so-called “stroke unit.” Every minute counts. The sooner treatment is administered, the greater the chance that the patient will survive with as little long-term damage as possible.
If tests rule out a cerebral hemorrhage, intravenous thrombolysis (a medical therapy to dissolve blood vessel blockages caused by clots) is performed to dissolve the clot (i.e., the thrombosis) that caused the stroke. In cases of major blockages in the central cerebral vessels, the clot can be removed interventionally using a catheter (the term “interventional” refers to diagnostic or therapeutic procedures that—unlike conservative approaches — involve targeted interventions on the affected tissue to positively influence the course of the disease).
Risk Factors
The risk factors listed below can lead to a stroke:
Arterial hypertension: High blood pressure leads to damaged blood vessels, bleeding, and clots.
Atrial fibrillation: The most common cardiac arrhythmia that can cause a stroke. Atrial fibrillation can cause clots to form in the left atrial appendage; in addition, taking blood thinners can lead to internal bleeding.
Other risk factors include: elevated blood lipid levels, an unhealthy diet, lack of exercise, smoking, obesity, or sleep apnea syndrome. These are also risk factors for atrial fibrillation. The risk of stroke—just like the risk of atrial fibrillation—can be significantly reduced by managing these risk factors.
CHA2DS2-VASc Score
The CHA2DS2-VASc score is a clinical prediction rule used to assess stroke risk in patients with atrial fibrillation. This score is primarily used to determine whether taking a blood-thinning medication is necessary. A high score corresponds to a higher risk of stroke, while a low score corresponds to a lower risk of stroke. You can find more information about alternatives to taking blood thinners here.
If you would like to calculate your CHA2DS2-VASc score, please click here: CHA2DS2-VASc Score
Emergency Checklist
In an emergency, call 144 (in Switzerland) or 112 (in Germany) immediately. Every second counts!
Check whether the person is having a stroke
- Ask the person to smile. If one side of their face droops, this indicates facial weakness on one side.
- Ask the person to extend their arms forward with their palms facing up. If they have paralysis, they won’t be able to raise both arms at the same time.
- Have the person repeat a simple sentence. If they are unable to do so or if their voice sounds slurred, they likely have a speech disorder.
If the person shows signs of a stroke, you should...
- immediately call 144 (Switzerland) or 112 (Germany) and state that a stroke is suspected!
- Do not leave the person alone; instead, position them comfortably with their upper body slightly elevated and reassure them.
- Loosen any tight clothing and remove loose dentures.
- Do not give the person anything to eat or drink, as their swallowing mechanism may be impaired.
- If the person is vomiting or unconscious, place them in the recovery position.
- Check for a pulse and breathing; if neither a pulse nor breathing can be detected, you must immediately begin appropriate resuscitation measures. To do this, place the person on a hard surface—such as the floor—and begin chest compressions and rescue breathing.