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Acute Ischemic Stroke

Overview

Acute ischemic stroke is a neurological pathology that occurs when a blood vessel in the brain gets blocked by a clot, resulting in decreased blood flow and oxygen supply in the area supplied by that blood vessel. It is a medical emergency and requires immediate medical attention to reverse the symptoms and dissolve the clot. In severe cases, the condition can prove to be life-threatening or result in a permanent neurological deficit in the patient.

The symptoms usually appear suddenly and should never be ignored. Common signs include:

  • Sudden numbness or weakness in the arm, face, or leg (often on one side of the body)
  • Difficulty in talking with slurring of speech
  • Confusion or imbalance
  • Visual disturbance such as blurred or double vision
  • Severe headache without a known cause

Several underlying health conditions and lifestyle factors can cause a stroke:

  • High blood pressure
  • High cholesterol
  • Obesity
  • Diabetes
  • Smoking habits
  • Genetics/family history of stroke or heart disease
  • Sleep disorders

To confirm a stroke and decide on the best treatment, doctors may perform:

  • Computed tomography (CT): A quick brain scan to detect bleeding.
  • Magnetic resonance imaging (MRI) with angiography of brain: Gives a detailed view of brain tissue and blood vessels.
  • CT/MRI perfusion scans: Show areas of the brain not getting enough blood supply
  • 2D Echocardiography and Holter monitoring: Heart tests to check for abnormal rhythms or clots that could cause stroke.
  • Blood tests: To determine risk factors such as diabetes, cholesterol, and clotting problems.

The goal of treatment is to restore blood flow quickly and prevent further strokes. Options include:

  • Thrombolysis (clot-busting injection): Medicines like alteplase or tenecteplase are given within 4.5 hours of symptom onset to dissolve the clot.
  • Mechanical thrombectomy (clot removal surgery): A minimally invasive procedure where doctors use special devices to remove the clot from the brain’s blood vessel. This can be done within 24 hours of onset of symptoms.
  • Medical management: Blood-thinning medicines (antiplatelets or anticoagulants) and drugs to control blood pressure, sugar, and cholesterol are used to minimise the risk of future episodes

Seek emergency medical care immediately if you or someone near you develops:

  • Sudden weakness, facial drooping, or slurred speech
  • Sudden loss of balance or vision
  • Severe unexplained headache

Although not all strokes can be prevented, you can lower your risk by:

  • Controlling blood pressure, diabetes, and cholesterol
  • Quitting smoking
  • Maintaining a healthy weight and diet
  • Treating sleep disorders like sleep apnoea
  • Taking prescribed medicines consistently if you have heart or vascular conditions

Patients with suspected or confirmed stroke should consult a Neurologist (specialist in brain disorders)/ Neurosurgeon (if surgical intervention is needed)/ Neuro-interventionist (specialist in minimally invasive clot removal procedures)

Disclaimer:

The information in this Health Library is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional with any questions about a medical condition or before starting any treatment. Use of this site and its content does not establish a doctor–patient relationship. In case of a medical emergency, call your local emergency number or visit the nearest emergency facility immediately.