Strokes rank second among the top causes of death worldwide, with an annual mortality rate of about 5.5 million. Fortunately, research into strokes has come far in the last few decades, and approximately 80% of strokes can be prevented with certain lifestyle and health management changes. In this article, Ability Central will answer your top questions about strokes, including:

• What is a stroke?
• What are the types of strokes?
• What is a transient ischemic attack (TIA)? 
• What causes a stroke?
• Are strokes hereditary?
• What are the long-term challenges associated with strokes?
• What are the steps for stroke prevention?
• Where can I get more information about strokes?

What is a stroke?

A stroke, the brain’s equivalent to a heart attack, happens when there’s an issue with blood flow to part of the brain. Strokes happen when blood vessels become blocked by a clot, or if a blood vessel bursts and causes bleeding in the brain.

Without a steady supply of blood, the cells in that area of the brain start to die from lack of oxygen.

A stroke is a medical emergency that can lead to lasting brain damage, long-term disability, or death. Immediate medical attention is necessary. See How Do I Know If Someone’s Having a Stroke? to understand early warning signs like facial drooping, partial paralysis, and slurred speech.

What are the types of strokes?

There are two types of stroke: ischemic and hemorrhagic. 

About 90% of strokes are ischemic. An ischemic stroke is when a major blood vessel in the brain becomes blocked. This can be because of a blood clot in the vessel, or a buildup of fatty deposits and cholesterol called plaque. This blockage cuts off the brain’s oxygen supply, which can cause lifelong disability or even death if not treated quickly. 

Hemorrhagic strokes are much less common. A hemorrhagic stroke happens when an artery in the brain leaks blood or bursts. The blood puts dangerous pressure on brain cells. Brain irritation and damage from a hemorrhagic stroke is often worse than damage from an ischemic stroke, but outcomes always depend on the location and size of the stroke. 

What is a transient ischemic attack (TIA)?

As the name suggests, a transient ischemic attack (TIA) stroke is a type of ischemic stroke. Also called a mini stroke or mild stroke, TIA strokes typically last between five minutes and 24 hours and can clear up independently.

However, TIA is still a medical emergency. Mild stroke symptoms can still cause long-lasting damage, and TIA can also be a warning sign of a major stroke. Even if TIA symptoms go away quickly, it’s still critical to receive emergency care as soon as possible. 

The Centers for Disease Control and Prevention (CDC) warns that TIA strokes should be taken seriously. They state: 

• TIA strokes are warning signs of a major stroke.
• About 13% of people will have a major stroke within three months of a TIA.
• About 35% of people who have a TIA and don’t get treatment have a major stroke within one year.

To learn more about the differences between strokes and TIA, see What Is the Difference Between Stroke, Mini-Stroke, and Transient Ischemic Attack (TIA)?

What causes a stroke?

Some risk factors for a stroke are based on lifestyle, and some are out of a person’s control. For risk factors caused by substance use, medication, or lifestyle factors like a lack of exercise, talk to your doctor to explore ways to reduce your risk of a stroke.

Unless tied to another medical condition, changeable risk factors associated with lifestyle include:

• Diet/nutrition
• Drug abuse
• Excessive alcohol use
• Physical inactivity or lack of exercise
• Obesity
• High blood pressure
• High cholesterol
• Smoking

Stroke risk factors that require medical management include:

• Atrial fibrillation (A-Fib)
• Use of prescriptions like certain birth control pills
• Carotid artery disease
• Congenital heart defects
• Coronary heart disease
• Diabetes
• Dilated cardiomyopathy 
• Heart valve disease
• High red blood cell count
• Peripheral artery disease (PAD)
• Sickle cell disease
• Sleep apnea

Stroke risk factors that are beyond a person’s control include:

• Age. The risk of stroke doubles for each decade between the ages of 55 and 85. 
• Gender. Men have a higher risk for stroke in young and middle age, although strokes are more likely to be fatal for women.
• Race. People of African or Hispanic descent are twice as likely to have a stroke than people who are Caucasian.
• Family history of strokes.

Are strokes hereditary?

Stroke risks sometimes run in families. This may be because of an inherited predisposition for known stroke risk factors, like high blood pressure or diabetes, or it may be because lifestyle choices like diet and exercise are often shared within a family.

What are the long-term challenges associated with strokes?

Of the 15 million people around the world who are affected by stroke each year, it is estimated that 50% will live with permanent or chronic disability. These disabilities may include:

• Paralysis or weakness
• Aphasia, difficulty with either language or speech
• Dysphagia, difficulty swallowing
• Sensory problems
• Physical or mental fatigue
• Anxiety and depression
• Dysarthria, difficulty speaking due to weakened muscles
• Dexterity issues
• Speech problems like muteness, stuttering, or apraxia 

Whether temporary or permanent, these effects can impact a return to normalcy for someone who has had a stroke. The severity of these effects determines whether someone can continue to work, travel, or care for themselves the way they used to.

These effects can also impact communication. Many stroke survivors must relearn how to speak, and some develop permanent speech disorders or impediments. Weakness or paralysis following a stroke can make it difficult to write, text, or use computers and phones. 

Because of this, post-stroke recovery is often isolating and frustrating, especially if the associated disabilities turn out to be permanent. For more information, see Long-term Care Challenges After a Stroke.

What are the steps for stroke prevention?

Causes of stroke are often linked to lifestyle. Talk to your doctor about risk factors and current health. Ability Central has a searchable database of nonprofits that specialize in stroke support to help connect you with a specialist in your area.

Where can I get more information about strokes?

Want to learn more? Ability Central has a series of articles about strokes and other related conditions. 

To learn more about strokes, see:

• How Do I Know If Someone’s Having a Stroke? 
• The First Steps of the Stroke Recovery Journey
• Long-term Care Challenges After a Stroke

To learn about conditions related to strokes, see:

• Aphasia
• Auditory processing disorder (APD)
• Dementia
• Dysarthria
• Expressive language disorder (ELD)
• Muteness
• Phonological processing disorder (PPD)
• Receptive language disorder (RLD)
• Stuttering