An ischemic stroke is a medical emergency caused by a blockage in a blood vessel that supplies blood to a region of the brain. Symptoms may include facial drooping, limb weakness on one side, and slurring words.

Ischemic stroke is also called brain ischemia and cerebral ischemia. Ischemia is the medical term for “lack of blood supply.” The blockage is often caused by blood clots or fatty deposits inside the blood vessel.

According to the American Stroke Association, ischemic is the most common type of stroke, accounting for about 87% of all stroke cases.

Hemorrhagic stroke is another type of stroke that involves the rupture of a blood vessel in your brain. A third type of cerebrovascular accident is a transient ischemic attack (TIA). They are temporary and don’t involve brain damage. Often called “ministrokes,” they are considered an early sign of a stroke.

Strokes are medical emergencies

The sooner you get emergency medical care after noticing the early symptoms, the more chances you have to recover from a stroke.

It’s not a good idea to “wait it out” to see if symptoms resolve after a few hours. Immediate care after the first signs will improve your outcome.

Seeking care within 2–3 hours of the first symptom is vital.

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Specific symptoms of an ischemic stroke depend on what region of the brain is affected. Strokes typically occur without warning, so the symptoms may be sudden and intense.

Common symptoms of a stroke may include:

  • drooping of the face or mouth on one side
  • weakness or paralysis in one or more of your limbs, on one side of the body (hemiparesis)
  • speech difficulties, like slurring your words
  • dizziness and vertigo
  • mental confusion
  • loss of coordination
  • vision problems, such as blindness in one eye, blurry vision, or double vision
  • headache (less common but possible)

Ischemic stroke symptoms are typically sudden. Immediate medical care is essential as soon as you experience the first symptoms. This makes it less likely that the symptoms become permanent.

To test if you or someone else may be having a stroke, consider the FAST method:

  • Face: Is one side of the face or mouth drooping as you smile or talk? Is one of your eyelids drooping?
  • Arms: When raising both arms, does one drift downward? Is raising one arm difficult? Does one arm feel weaker than the other?
  • Speech: When talking or repeating a complete sentence, are the words slurred or otherwise strange? Does the speech sound coherent?
  • Time: If the answer to any of these questions is yes, it’s time to call your local emergency services as soon as possible. The sooner you get care, the better your chances of surviving the stroke.

Symptoms of TIAs, also called mini-strokes, may last for a brief period before the blockage of blood flow is resolved on its own. However, medical care is still essential to prevent complications. In some cases, TIAs are followed by ischemic strokes.

Strokes are a leading cause of death in the United States, but not all cases are fatal.

An ischemic stroke occurs when an artery that supplies blood to a region of the brain is blocked by a blood clot or fatty buildup, called plaque. This blockage may appear at the neck level or in the skull.

Clots usually start in the heart and travel through the circulatory system. A clot can break up on its own or become lodged in an artery. When it blocks a brain artery, a region of the brain doesn’t get enough oxygen-rich blood, and cells start to die.

Ischemic stroke caused by a fatty buildup happens when plaque breaks off from an artery and travels to the brain. Plaque can also build up in the arteries that supply blood to the brain and narrow those arteries (atherosclerosis) enough to cause the ischemic stroke.

Global ischemia, which is a more severe type of ischemic stroke, happens when the flow of oxygen to the brain is greatly reduced or completely stopped. This is usually caused by a heart attack, but it can also be the result of other conditions or events, such as carbon monoxide poisoning.

Circulatory conditions are the main risk factor for ischemic stroke. That’s because they increase the chance of developing blood clots or fatty deposits. Not everyone with these conditions will experience a stroke, though. These conditions include:

Other factors that may increase your chance of having a stroke may include:

You may also have a higher likelihood of an ischemic stroke if you have a family history of stroke or you’ve had past strokes.

A healthcare professional usually diagnoses strokes based on a physical exam, family history review, and symptom checklist. Based on your symptoms, they can also get an idea of where the blockage may be located, but they may need to perform tests to confirm if you’ve had a stroke.

If you have symptoms such as mental confusion and slurred speech, your healthcare team may perform a blood sugar test. That’s because confusion and slurred speech are also symptoms of severe low blood sugar.

They may also want to rule out an aneurysm, which causes similar symptoms to a stroke. An MRI may help with this diagnosis.

Learn more about the differences between a stroke and an aneurysm.

A cranial CT scan can also help distinguish ischemic stroke from other causes of brain tissue damage, such as hemorrhages or brain tumors.

Once your medical professional has diagnosed ischemic stroke, they’ll try to assess when it started and what the root cause is.

An MRI is a good way to determine when the ischemic stroke started. Tests used to determine a root cause may include:

The first goal of the treatment for strokes is to restore blood flow to the affected area of the brain.

The main treatment for ischemic stroke is the use of intravenous (IV) tissue plasminogen activator (tPA), a medication that breaks up blood clots.

tPA may be most effective when given within 4 hours of the first symptoms. This treatment can’t be performed more than 5 hours after the start of the stroke.

Because tPA may result in bleeding, you may not receive it if you have a history of:

  • hemorrhagic stroke
  • bleeding in the brain
  • recent major surgery or head injury
  • anticoagulant use

If tPA doesn’t work, blood clots may be removed with surgery. A mechanical clot removal can be performed up to 24 hours after the onset of stroke symptoms.

Long-term treatments may include the use of aspirin or an anticoagulant to prevent further clots.

If the ischemic stroke is caused by a condition such as high blood pressure, cholesterol, or atherosclerosis, treatment for those conditions is indicated. For example, a healthcare professional may recommend a stent to open an artery narrowed by plaque or statin use to lower cholesterol levels.

After an ischemic stroke, you may need to stay in the hospital for observation for at least 5 days. If the stroke causes paralysis or severe weakness, you may also need physical rehabilitation to regain function.

Recovery from a stroke may take weeks or months, depending on its severity. Physical rehabilitation is often necessary to regain motor skills and coordination. Occupational, physical, and speech therapy may be useful to help regain other challenged functions.

If you continue to present challenges after a year of treatment, this may suggest that they are likely to be permanent.

Having one ischemic stroke puts you at a higher risk of having another. Your healthcare professional may recommend lifestyle changes to reduce your risk, such as quitting smoking and increasing physical activity.

An ischemic stroke results from a blockage in one of the arteries supplying blood to the brain. Early signs include a drooping face or mouth, speech slurring, mental confusion, and muscular weakness. A stroke is a medical emergency and getting care within 3 hours of the first symptoms improves the outcomes.