Stroke

There are two main types of strokes:

• Ischemic Stroke — This type of stroke accounts for approximately 80 to 85 percent of all strokes. With ischemic stroke, the blood supply to a part of the brain becomes blocked. This prevents oxygen and nutrients from reaching brain cells. Within a few minutes, these cells may begin to die. The underlying cause for this type of obstruction is usually atherosclerosis, a condition in which plaque or fatty deposits within the wall of the arteries in the brain and neck can lead to obstruction or narrowing. These fatty deposits can cause cerebral thrombosis or cerebral embolism. With a cerebral thrombosis, a blood clot forms within the blood vessel. Cerebral embolisms are clots that can form at another location in the circulatory system, break loose from an artery wall or from the inside lining of the heart, travel through the brain's blood vessels and can lodge in an artery in the brain.

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Your neurologist will perform a physical examination to determine if you've had a stroke. Your examination may include blood or urine tests, an electrocardiogram (ECG or EKG), electroencephalogram (EEG) or imaging tests.

Imaging tests may include:

• Arteriography — This shows arteries in the brain that can't be seen in regular X-rays. An arteriogram may be performed if other tests don't reveal the cause of the stroke. Your doctor will make a small incision, usually in your groin, then insert a catheter, which is a flexible, thin tube, carefully through your arteries and into your carotid or vertebral artery. Your doctor will then inject a dye into the catheter that helps your cranial arteries appear more clearly in an X-ray image.

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The neurology team at UCSF Medical Center, along with your primary care doctor, will design a treatment plan tailored to your medical condition, state of health and individual needs. You may need more than one kind of treatment and treatment may require several visits to UCSF. You may be referred to additional doctors or other medical professionals.

It is critical to come to the hospital immediately if you experience a stroke because treatments might reduce or completely reverse the brain injury from stroke. These treatments must be given within the first few hours of stroke symptoms, so call 911 to get transportation to the Emergency Room quickly. These treatments include administration of a t-PA — a drug that opens blocked blood vessels — or devices to remove the clot from the brain using a catheter.

The next step in treating a stroke is to carefully control and monitor your blood pressure. Once your blood pressure is under control, we focus on cholesterol, smoking cessation, control of diabetes and analysis of any heart conditions you may have.

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