Understanding the Different Types of Stroke

By: Michaela Crutsinger, OTD, OTR/L

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Stroke? CVA? TIA? With so many acronyms and names, it can be overwhelming to understand how and why a stroke might happen.

A stroke, or a cerebral vascular accident (CVA), is a medical emergency in which the blood supply to the brain is limited or interrupted. This causes a lack of nutrients and oxygen that may result in brain damage and cell death.1

What Are the 3 Main Types of Stroke?

There are three main types of stroke:

  1. Ischemic stroke
  2. Hemorrhagic stroke
  3. Transient ischemic attack (TIA)

Most strokes, about 87%, are ischemic strokes.1 These occur when an artery carrying oxygen-rich blood to the brain is blocked, often by a blood clot.

In contrast, a hemorrhagic stroke occurs when an artery in the brain breaks open and leaks blood into the surrounding areas, placing pressure on brain cells and causing cell death.1

A transient ischemic attack is often referred to as a “mini-stroke” and can be a warning sign for a high risk of a future stroke. The blood flow to the brain is blocked for a shorter amount of time, about five minutes or less. TIAs should also be considered an emergency event, as more than a third of people who experience a TIA and do not receive treatment have a major CVA within a year.1

What are Cryptogenic & Brain Stem Strokes?

In addition to these more common types of strokes, there are also cryptogenic strokes and brain stem strokes.

A cryptogenic stroke occurs when physicians are unable to determine the cause of the event, even with testing. This can be extremely frustrating for patients, their families, and their healthcare providers, as it is difficult to treat without a known underlying cause.2

Similarly, a brain stem stroke occurs with complex symptoms and may be difficult to diagnose. The brain stem controls three key functions of the central nervous system: breathing, blood pressure, and consciousness; the brain stem also impacts all motor function. Symptoms of a brain stem stroke may include imbalance, dizziness and double vision.2

What Are the Risk Factors & Causes of Stroke?

There are a variety of risk factors and causes for strokes, including high blood pressure, obesity, high cholesterol levels, diabetes, and family history. Atherosclerosis, or the narrowing of arteries over time, is sped up by habits such as smoking, excessive drinking of alcohol, and lack of exercise. These fatty plaques cause blockages and increase the risk of a blood clot, which prevents oxygen flow to the brain.3

Related Article: For more information on how to reduce your risk of stroke, click here.

Time is important when identifying the symptoms of a TIA or a stroke.4 The signs of a stroke can be remembered with the acronym BE FAST.

Balance: Watch for loss of balance

Eyes: Check for vision loss

Face: The person’s face may droop on one side, or they may not be able to smile normally

Arm: They may notice weakness or numbness in one arm

Speech: Their speech may be garbled or slurred

Time: If you notice these signs in yourself or a family member, it’s time to dial 911.4

With quick identification and response to symptoms, there are treatments that can decrease or stop the damage to the brain. One of the most effective treatments is tPA, which is a clot-dissolving enzyme that must be administered within three hours of onset. The functional deficits resulting from a stroke can range from mild to severe and depend on the area of the brain that was impacted.1

How Can Stroke Rehabilitation Help in Your Recovery?

Sheltering Arms Institute offers a multifaceted approach to stroke rehabilitation. We understand that having a stroke can be a life-changing event, and we cater our treatment plans specifically to address your individualized goals. Through our team-based approach, we combine the efforts of physical therapy, occupational therapy, and speech therapy to return you to valued and meaningful activities, including activities of daily living (ADLs), work, sports, hobbies and, even driving.

Our team of occupational therapists may work with you on safely returning to ADLs such as dressing and bathing, regaining function in a weaker upper extremity, improving safety and skills in the kitchen, or getting back on the road with our driving simulator. Our physical therapists specialize in addressing functional mobility, balance, strength, endurance, and vision deficits resulting from stroke. Our speech-language pathologists can work with you on swallowing difficulties, speech deficits, memory changes, and thinking skills necessary for returning to home or work.

In combination with these professionals, our state-of-the-art technology for both upper and lower-extremity rehabilitation provides an exciting, evidence-based way to maximize therapy gains. For the upper body, the DIEGO robotic upper-extremity rehabilitation device provides a 3D workspace and an intelligent weight support system that allows patients to practice functional movements and regain strength in a gamified, interesting way.

Similarly, the ArmeoSpring provides a spring-loaded arm and shoulder support system with motivating therapy activities to maximize repetitions performed in a session. The Neofect Raphael SmartGlove and smart pegboard incorporate biofeedback-based training with engaging games to help patients regain hand and fine motor coordination.

The Bioness Vector may be used by both physical and occupational therapists for stroke rehabilitation, providing dynamic bodyweight support during tasks such as gait training, ADLs, and balance exercises while providing a safe environment to practice necessary skills. Additionally, the Bioness Integrated Therapy System (BITS) is a large touchscreen display that can be used to challenge visual perception, functional reach, reaction time, balance, and cognition.

This is only a short description of some of the technology available through Sheltering Arms Institute; other pieces include functional electrical stimulation bikes; a Power Plate vibration plate for proprioceptive input, postural control, and muscle performance; and orthoses for rehabilitating the wrist and hand with electrical stimulation.

With the latest technology as an adjunct, our skilled therapists will ensure that your therapy sessions are engaging, fun, and meaningful to you. If you or a loved one has suffered a stroke and are seeking physical rehab, Sheltering Arms Institute offers a well-rounded, effective care experience. Fill out our contact form or call (804) 764-1000 to schedule an appointment or learn more.

References:

1. Centers for Disease Control and Prevention. Types of stroke. cdc.gov https://www.cdc.gov/stroke/types_of_stroke.htm Updated 2020. Accessed April 28, 2021.

2. American Stroke Association. Types of stroke and treatment. stroke.org https://www.stroke.org/en/about-stroke/types-of-stroke Updated 2020. Accessed April 29, 2021.

3. NHS. Overview: Stroke. NHS Choices. https://www.nhs.uk/conditions/stroke/symptoms/ Published 2015. Updated April 28, 2021. Accessed April 28, 2021.

4. Mayo Clinic. Stroke symptoms. mayoclinic.org https://www.mayoclinic.org/diseases-conditions/stroke/symptoms-causes/syc-20350113#:~:text=A%20stroke%20occurs%20when%20the,and%20prompt%20treatment%20is%20crucial Published 2020. Accessed April 28, 2021. 

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