What is an embolic stroke?
An embolic stroke occurs when a blood clot that forms elsewhere in the body breaks loose and travels to the brain via the bloodstream. When the clot lodges in an artery and blocks the flow of blood, this causes a stroke.
This is a type of ischemic stroke. Ischemic strokes can happen if an artery to the brain becomes blocked. The brain relies on nearby arteries to bring in blood from the heart and lungs. This blood flow allows oxygen and nutrients to reach the brain.
If one of these arteries is blocked, the brain can’t produce the energy it needs to function. These brain cells will begin to die off if the blockage lasts for more than a few minutes.
Blood clots that lead to embolic stroke can form anywhere. They usually come from the heart or arteries of the upper chest and neck.
After breaking free, the clot travels through the bloodstream to the brain. When it enters a blood vessel that’s too small to allow it to pass, the clot becomes stuck in place. This blocks the flow of blood to the brain.
These blockages are called emboli. They can form from air bubbles, fat globules, or plaque from an artery wall. Emboli can also result from an abnormal heartbeat. This is known as atrial fibrillation. When the heart doesn’t beat effectively, it can cause blood to pool and clot.
Controllable risk factors for ischemic stroke include:
- high blood pressure
- high cholesterol
- smoking
- obesity
- lack of exercise
- drug use
Some risk factors are beyond your control. For example, African-Americans typically have a higher risk of stroke than people of other races. Men are at a higher risk for stroke than women are, although women are more likely to die from stroke.
People with a family history of stroke, or who have previously had a ministroke, are also at greater risk. A ministroke is also known as a transient ischemic attack (TIA).
Other uncontrollable risk factors include:
- being over age 40
- recent childbirth
- autoimmune diseases such as diabetes or lupus
- heart disease
- heart structure defects
Stroke happens suddenly, often without warning. When symptoms do occur, they differ depending on which part of the brain is affected.
Common symptoms
The most common symptoms of stroke include:
- difficulty speaking or understanding words
- trouble walking
- numbness in the limbs or either side of the face
- temporary paralysis
Embolic stroke doesn’t cause any unique symptoms. Symptoms can vary widely from person to person and stroke to stroke.
Muscular symptoms
Muscular symptoms can include:
- difficulty with coordination
- stiff muscles
- feelings of weakness on one side, or all, of the body
- paralysis on one side of the body
Cognitive symptoms
Cognitive symptoms may consist of:
- mental confusion
- an altered level of consciousness, meaning you may be more lethargic
- visual agnosia, or the inability to recognize a large portion of your line of sight
Other symptoms
Other symptoms include:
- blurred vision or blindness
- slurred speech
- dizziness
- feeling faint
- difficulty swallowing
- nausea
- sleepiness
These symptoms will typically start suddenly. If you notice a pronounced start to any of these symptoms, immediately call 911 or your local emergency services. They can review your symptoms and provide treatment.
There’s a simple acronym to help you determine whether someone is having a stroke. If you think someone is experiencing a stroke, you should act FAST.
| F | FACE | Ask the person to smile. Does one side of the face droop? |
| A | ARMS | Ask the person to raise both arms. Does one arm drift downward? |
| S | SPEECH | Ask the person to repeat a simple phrase. Is their speech slurred or strange? |
| T | TIME | If you observe any of these signs, it’s time to call 911 or your local emergency services immediately. |
Embolic stroke is a life-threatening condition. Every second counts. Blood flow to the brain must be restored as quickly as possible. Your doctor may do this with oral or intravenous clot-busting medications. They may also use a catheter to deliver drugs directly to your brain or to remove the clot.
In 2018, the American Heart Association (AHA) and American Stroke Association (ASA) updated their guidelines for treating stroke. Clot-busting medications can be administered up to 4.5 hours after you first experience stroke symptoms. The mechanical clot removal, also known as the mechanical thrombectomy, can be performed up to 24 hours after you first experience stroke symptoms.
Your doctor may also use one of the following imaging tests to verify and treat a stroke:
- CT scan. The CT scan uses a series of X-rays to show the blood vessels in your neck and brain in greater detail.
- MRI. This testuses radio waves to detect any brain tissue that’s been damaged by a stroke or brain hemorrhage.
- Carotid ultrasound. Using detailed images, this is a way to view your blood flow and depict any fatty deposits in your carotid arties.
- Cerebralangiogram. This test involves inserting a catheter through a small incision and into your carotid or vertebral arteries. From there, your doctor can establish a detailed view of the arteries in your neck and brain.
- Echocardiogram. The echocardiogram uses sound waves to determine the location of any blood clots that may have traveled from your heart to your brain.
Your doctor may also conduct blood tests to help determine:
- how quickly your blood clots
- whether your critical blood chemicals are unbalanced
- your blood sugar level
- if you have an infection
Understanding these factors can help inform your treatment plan.
To help prevent additional strokes, a surgeon can open arteries that have been narrowed by plaque. This procedure is called a carotid endarterectomy. Your doctor may also use stents to keep an artery open.
After the crisis of the stroke has passed, treatment revolves around regaining strength and recovering any function that you’ve lost. Specific treatments will depend on the area of your brain involved and the extent of the damage.
You’ll probably need ongoing outpatient care, medication, and close monitoring for some time after a stroke. In the event that you can’t care for yourself, an inpatient rehabilitation facility or program may be in order.
Having a stroke can have a lasting impact on your health. Whether you experience any complications depends on the severity of the stroke and the part of your brain that was affected.
Common complications include:
- cerebral edema, or the swelling of the brain
- pneumonia
- urinary tract infection (UTI)
- seizures
- depression
- bedsores
- limb contractures, or shortened muscles resulting from reduced movement in the affected area
- shoulder pain
- deep vein thrombosis (DVT), or a blood clot deep inside your body, typically the legs
A stroke may also lead to the following conditions:
- aphasia, or difficulty speaking and understanding speech
- hemiparesis, or difficulty moving one side of the body
- hemisensory deficit, or difficulty experiencing sensation on one side of the body
Your quality of life following a stroke will depend on the extent of the damage. If you’re experiencing lost function, you can work with a team of specialists to recover.
Your risk of a stroke recurring is highest immediately following a stroke. It lessens over time. About 3 percent of people who have a stroke will have another within 30 days, estimates a
The risk of serious disability, coma, or death increases with each stroke.
Knowing your level of risk can help you prevent a future stroke, especially if you’re taking other preventive measures.
Visit your doctor regularly if you have high cholesterol, diabetes, or a chronic autoimmune disease. Monitoring your condition and following your doctor’s recommendations can help prevent or limit potential complications from a stroke.
You can further prevent a stroke by following a healthy lifestyle:
- Maintain a healthy weight.
- Eat a diet rich in fruits and vegetables.
- Exercise regularly.
- Drink alcohol only in moderation.
- Refrain from illegal drug use.