Brain & Nervous System Stroke Print What Is an Acute (or Sudden) Stroke? Medically reviewed by Medically reviewed by Claudia Chaves, MD on June 06, 2017 Claudia Chaves, MD is board-certified in cerebrovascular disease and neurology, with a subspecialty certification in vascular neurology. Learn about our Medical Review Board Claudia Chaves, MD Written by linkedin Written by Jose Vega MD, PhD Jose Vega MD, PhD, is a board-certified neurologist and published researcher specializing in stroke. Learn about our editorial policy Jose Vega MD, PhD Updated on November 09, 2019 Stroke Overview Symptoms Causes Diagnosis Treatment Coping utah778/Getting Images In This Article Table of Contents Expand Symptoms TIA Causes Ischemic Stroke Hemorrhagic Stroke Risk Factors Diagnosis Treatments Recovery View All An acute stroke starts suddenly and typically worsens rapidly. Most strokes are acute strokes. Sometimes, a stroke may be preceded by a transient ischemic attack (TIA), which is a temporary stroke that reverses before it causes any lasting effects. Symptoms Stroke symptoms can progress quickly but may wax and wane over the course of a few hours. It is not possible to predict how severe a stroke will become or how long it will take to reach its maximum effect. The most common symptoms of an acute stroke include:Numbness or weakness on one side of the bodyDifficulty speaking or trouble understanding what others are sayingDifficulty with vision or loss of visionFalling or difficulty walkingA sudden, severe headache involving a stiff neck, facial pain, pain between the eyes, or vomitingLoss of balance or coordinationConfusion TIA A (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. Causes An acute stroke is caused by interruption of blood flow to a region in the brain, and it 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 an 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 happen 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. 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 attackA family history of strokeObesityCerebrovascular diseaseCarotid artery diseaseLack of physical exercise or activityUse of birth control pills or other hormone therapiesPregnancyHeavy or binge drinkingRecreational drug use If you have 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. Diagnosis If you experience symptoms of an acute stroke, you need to get urgent medical attention as soon as you notice your symptoms. 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 scanBlood tests and other medical tests If you are with someone who is having unusual symptoms, it is important that you call for medical help. Do not try to diagnose the stroke on your own. Treatments An acute 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 be given within a few 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. Recovery Rehabilitation and recovery after an acute stroke takes time, involving a combination of specially tailored post-stroke programs. Newer methods in stroke rehabilitation are currently being examined in research studies, and include electrical therapy and mirror therapy. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial policy to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Musuka TD, Wilton SB, Traboulsi M, Hill MD. Diagnosis and management of acute ischemic stroke: speed is critical. CMAJ. 2015;187(12):887-93. doi: 10.1503/cmaj.140355 Lee RHC, Lee MHH, Wu CYC, et al. Cerebral ischemia and neuroregeneration. Neural Regen Res. 2018;13(3):373-385. doi: 10.4103/1673-5374.228711 Hajar R. Risk Factors for Coronary Artery Disease: Historical Perspectives. Heart Views. 2017;18(3):109-114. doi: 10.4103/HEARTVIEWS.HEARTVIEWS_106_17 Kim JH, Jung YJ, Chang CH. Simultaneous Onset of Ischemic and Hemorrhagic Stroke Due To Intracranial Artery Dissection. J Cerebrovasc Endovasc Neurosurg. 2017;19(2):125-128. doi: 10.7461/jcen.2017.19.2.125 Boehme AK, Esenwa C, Elkind MS. Stroke Risk Factors, Genetics, and Prevention. Circ Res. 2017;120(3):472-495. doi: 10.1161/CIRCRESAHA.116.308398 Zivin JA. Acute stroke therapy with tissue plasminogen activator (tPA) since it was approved by the U.S. Food and Drug Administration (FDA). Ann Neurol. 2009;66(1):6-10. DOI: 10.1002/ana.21750 Goldstein JN, Gilson AJ. Critical care management of acute intracerebral hemorrhage. Curr Treat Options Neurol. 2011;13(2):204-16. doi: 10.1007/s11940-010-0109-2 Additional Reading Medley TL, Miteff C, Andrews I,et al. Australian Clinical Consensus Guideline: The diagnosis and acute management of childhood stroke. Int J Stroke. 2018 Oct 4:1747493018799958. doi: 10.1177/1747493018799958. [Epub ahead of print] Zrelak PA. Sex-Based Differences in Symptom Perception and Care-Seeking Behavior in Acute Stroke. Perm J. 2018 Sep 20;22. doi: 10.7812/TPP/18-042. Continue Reading