What Is an Acute (or Sudden) Stroke?

An acute stroke is a stroke that occurs or develops abruptly. And the key feature of an acute stroke is that it starts suddenly and without warning.

An acute stroke is an unexpected stroke. Yet few people 'expect' to have a stroke. Sometimes, however a stroke can develop slowly, taking hours to reach its peak. Other times a stroke can begin and then resolve and may continue to get better or worse over a few hours or days. An acute stroke or a slowly developing stroke both need urgent medical attention and care.

An acute stroke can be either ischemic or hemorrhagic.

Ischemic Stroke

During an ischemic stroke, the blood supply to a region of the brain is cut off because a blood vessel has been blocked by a blood clot. Several conditions can predispose a person to ischemic stroke. These conditions include heart disease, high cholesterol, and high blood pressure. Other causes of an ischemic stroke include the use of recreational drugs, blood clotting disorders, or trauma to the blood vessels in the neck.

Hemorrhagic Stroke

A hemorrhagic stroke occurs when an artery in the brain bleeds. This can be caused when an abnormally shaped artery, such as an arterial venous malformation (AVM) or an aneurysm, bursts. The blood that seeps into the brain when a blood vessel bleeds causes pressure to build up within the skull, compressing the brain and potentially causing permanent brain damage.

There are two types of hemorrhagic stroke—intracerebral and subarachnoid. A intracerebral hemorrhage occurs when a blood vessel deep in the brain ruptures and bleeds into the surrounding brain tissue. A subarachnoid hemorrhage occurs when blood accumulates in the space between the brain and the lining of the brain.

Risk Factors

The most common risk factors for stroke include heart disease, high blood pressure, high cholesterol, smoking and diabetes. Additional risk factors for stroke include the following:

• Prior stroke or heart attack
• A family history of stroke
• Overweight
• Cerebrovascular disease
• Carotid artery disease
• Lack of physical exercise or activity
• Use of birth control pills or other hormone therapies
• Pregnancy
• Heavy or binge drinking
• Recreational drug use

If you have any of these risk factors, you can substantially reduce your risk of having an acute stroke by getting these conditions under control with the help of your doctor.

A condition called a transient ischemic attack (TIA) can serve as a warning of an impending stroke. A TIA is like a stroke, but the symptoms resolve without any permanent brain damage. If you have a TIA, this means that you probably have at least one stroke risk factor. Most people who experience a TIA will have a stroke within three to six months unless the risk factors are identified and medically treated.

The major symptoms of a stroke include:

• Numbness or weakness on one side of the body
• Difficulty speaking or trouble understanding
• Difficulty with vision
• Falling or difficulty walking
• A sudden, severe headache involving a stiff neck, facial pain, pain between the eyes, or vomiting
• Loss of balance or coordination
• Confusion

If you experience symptoms of an acute stroke, you need to get urgent medical attention. After your medical team does a neurological examination, the following diagnostic tests may be conducted to determine the cause of stroke and to make a plan for treatment:

• Imaging examinations such as CT scan and MRI scan
• Blood tests and other medical tests

An ischemic stroke is potentially manageable with a number of medical treatments, including a powerful treatment called tissue plasminogen activator (t-PA.) This treatment is effective if the stroke is rapidly diagnosed and evaluated and if the treatment can by given within three hours of the onset of stroke symptoms.

A combination of blood vessel surgery and medication to control bleeding may be used in the treatment of an acute hemorrhagic stroke. Treatment may include procedures that involve clipping the ruptured aneurysm or an endovascular embolization in which a coil is placed into the aneurysm in order to diminish blood flow.