About Stroke (Brain Attack, TIA)

General information

• Stroke or Brain Attack is a disease that involves the blood vessels that supply blood to the brain.
• A stroke occurs when a blood vessel that brings oxygen and nutrients to the brain ruptures or is clogged by a blood clot or some other mass.
• Without adequate supply of oxygen, nerve cells of the brain can't work and die within minutes. When nerve cells can't work, the area of the body they control can't work either.
• TIA are transient ischemic attacks or mini-strokes that occur when the inadequate blood supply to the brain is recovered after few minutes of an occlusion of a vessel. They represent warning signs of more serious or permanent strokes.
• Causes of stroke and TIA include wandering clots (an embolus) from the heart, fatty buildups (atherosclerotic lesions) on the aortic arch or the vessels of the neck or brain, stenosis or narrowing of the arteries of the neck and the brain or primary diseases affecting the arteries of the central nervous system known as vasculitis.
• Diseases associated with strokes include diabetes, high blood pressure, high cholesterol, carotid disease, atrial fibrillation or other heart disease, history o TIAs (mini-strokes), sickle cell anemia, obesity, fibromuscular dysplasia, connective tissue disorders, other family members with history of strokes.
• Approximately 700,000 strokes occur in the United States annually.

Symptoms

• Sudden numbness or weakness of the face, arm or leg, especially on one side of the body.
• Sudden confusion, difficulties speaking or understanding.
• Sudden loss of vision in one or both eyes.
• Sudden gait troubles, dizziness or loss of balance and or coordination.

Diagnosis

• MRI and CT scans can recognize the presence of strokes.
• MR-angiograms, CT-angiograms and Cerebral angiography provide complementary, important information regarding the location of the vessel occlusion, the degree of brain tissue affected, and the collateral circulation to the affected part of the brain.

Treatment

• The treatment of strokes requires rapid interventions including use of medications for dissolving clots or endovascular mechanical removal of the clot, and use of neuroprotectants and close critical care monitoring.
• Patients at risk of stroke or with TIA’s can be treated with medications to thin their blood, reduction of risk factors, and correction of the cause of the clots or vascular occlusion.
• Carotid stenosis can be treated with surgery to remove the fatty buildups or with applications of angioplasty and stents.
• Intracranial narrowing of the vessels can be treated with angioplasty and stenting or extracranial to intracranial bypass surgery
• Inadequate blood supply, due to diseases like moyamoya, is treated with revascularization techniques including bypass surgery and EDAS.

The Neuro-ICU cares for patients with all types of neurosurgical and neurological injuries, including stroke, brain hemorrhage, trauma and tumors. We work in close cooperation with your surgeon or medical doctor with whom you have had initial contact. Together with the surgeon or medical doctor, the Neuro-ICU attending physician and team members direct your family member's care while in the ICU. The Neuro-ICU team consists of the bedside nurses, nurse practitioners, physicians in specialty training (Fellows) and attending physicians. UCLA Neuro ICU Family Guide