Embolic Stroke

Overview

Embolic strokes are also ischemic strokes. They are caused by blockage of one of the arteries to
the brain by a blood clot that has formed elsewhere (usually in the heart), broken free, and
traveled to the brain as an embolus. Sometimes the clot can form in the aorta, which is the largest
artery in the body. These clots can travel to any artery in the brain, but more often they block the
larger arteries, causing more severe strokes. Embolic strokes can cause any of the typical
symptoms of ischemic stroke.

Symptoms

The five most common symptoms of a stroke are:

1. Sudden weakness or numbness of face, arm or leg; especially if the numbness is all on one
side of the body
2. Sudden confusion, trouble speaking or understanding
3. Sudden trouble seeing in one or both eyes
4. Sudden trouble walking, dizziness, loss of balance or coordination
5. Sudden severe headache with no known cause

Causes

An embolic stroke, which is a type of ischemic stroke, is caused by blockage of a blood vessel
(artery) supplying the brain. Brain tissue that no longer receives its blood supply can die within a
few hours unless something is done to stop the damage. Ischemic stroke represents about 80
percent of all strokes in the United States.

The blockage of arteries can occur in large arteries in the neck or the base of the brain, or in
small arteries inside the brain itself. A blood clot can form in the brain or it can form elsewhere
and be carried to the brain by an artery. As many as 20 percent of victims die in the month after
having an ischemic stroke, and the majority of survivors have some long-term disability.
Risk Factors

There are many conditions that increase a persons risk of ischemic stroke. These include high
blood pressure, heart disease, high cholesterol, diabetes, smoking and an unhealthy lifestyle.
Treating these conditions can decrease stroke risk.

Complications

Common complications resulting from a stroke are:

Urinary tract infection

Bladder control
Pneumonia
Brain swelling
Seizures
Depression
Bedsores
Fatigue

Common conditions resulting from a stroke are:

Difficulty speaking or understanding speech (aphasia)

Difficulty with movement on one side of the body (hemiparesis)
Difficulty with sensation on one side of the body (hemisensory deficit)
Difficulty with thinking and/or paying attention to the world around you

The team of health-care professionals caring for you in the hospital has many options available
to treat these complications.

Recovery

Movement of the extremities is often impaired after a stroke, but the ability to move usually
improves substantially during the first months after the stroke and can continue to improve for
some time thereafter. Recovery takes longer when there is serious impairment of movement.
Most patients will have some remaining impairment of motion following their stroke. Speech
ability also is often impaired after a stroke. Speech improves in most patients. Some patients
continue to show improvement for months or years afterward.

Strokes can be very different for different people, and the effects will vary depending on what
part of the brain is injured. Because of this, it is not easy to generalize about the extent of
improvement that you can expect. In addition, the patients outcome will depend on his/her
general health. A healthy, active, young person will have a better outcome than an elderly, ill
person.

If a person has only mild symptoms during the first few days after a stroke, they will generally
be able to function better after recovery than a person who had severe symptoms after their
stroke. Younger patients will have better recovery than elderly patients. The larger the area of
damage to the brain, the less chance there is of getting full recovery.

When brain cells die as a result of a stroke, the body removes the dead cell debris. The brain
function that has been impaired by the stroke can recover. Undamaged brain areas near the area
of the stroke may have impaired function as a result of the loss of normal communication with
the damaged tissue. But after time, these regions resume their activity and some of the functions
that were performed by the damaged area can be taken over by a neighboring healthy area of the
brain and allow recovery to occur.
In the normal brain, an activity, such as pointing a finger, is the result of coordinated activity in
many different parts of the brain. When a stroke damages one part of this network of activity, the
remaining parts of the brain increase their activity in an effort to recover the function.
In addition, there are two brain hemispheres and when an area in one hemisphere is damaged,
many patients start to use both sides of the brain to perform a task.

Today, good medical care allows the brain to heal after a stroke. Physical, occupational and
speech therapy all play an important role in patients that have disabilities from their stroke.
Family and other caregivers are vital to support the patients efforts toward recovery.

The brain has mechanisms to repair itself, but scientists are just beginning to understand them.
The results from some experimental studies show that some medicines that stimulate brain cell
activity or cause brain cells to grow can increase recovery from stroke. In other studies,
introducing cells into the brain can promote recovery. There are many reasons to be optimistic
about meaningful recovery after a stroke.