Betty Clooney Center: Serving Persons with Traumatic Brain Injury with TBISince 1983

Stroke and Traumatic Brain Injury

The brain is the center of thought, emotion and sensory experience. It coordinates all of our bodily functions from breathing to walking. Like other organs, the brain must receive oxygen-rich blood to function. If blood flow to a portion of the brain is obstructed for more than several minutes, the affected brain tissue dies permanently. The loss or alteration of bodily function that results from an insufficient supply of blood to part of the brain is called a stroke. If enough of the brain is affected, death is the result.

Two Types of Strokes

There are two kinds of strokes. The most common, ischemic stroke, is caused when a blood clot slows or blocks blood flow to a portion of the brain. Ischemic strokes usually occur in individuals who have atherosclerosis -- a disease process that causes the lining of the arteries to become narrowed by the accumulation of fatty deposits on the vessel walls. This is the same disease process that causes most heart disease. Over 80 percent of strokes are ischemic.

Less common, a hemorrhagic stroke is caused by a tear in a weakened blood vessel wall. The tear allows blood to leak into the brain, causing the death of surrounding brain tissue. Hemorrhagic stroke may be caused by an aneurysm, a ballooning of a weakened area of a blood vessel, or an arteriovenous malformation, a cluster of abnormally formed blood vessels that can rupture. Both of these conditions are usually congenital, meaning that an individual is born with these abnormalities in their blood vessels.

Aneurysms can be small, and may not cause symptoms. Or, they may cause pain at the location of the weakened vessel. They can be treated by surgery during which a metal clip is secured around the base of the aneurysm.

Improved Treatments

Within the last few years, the prognosis for doing well after stroke has improved dramatically with the availability of tPA (tissue plasminogen activator), a “clot-busting” drug that can stop some strokes in progress. Tissue plasminogen activator works by dissolving a blood clot, allowing blood flow to resume to the affected part of the brain. Therefore, less tissue dies and the individual suffers less disability. But there is an important caveat to the use of tPA: the individual who is suffering a stroke must get to a hospital quickly -- within three hours of the onset of the first symptoms-so that a doctor can make a correct diagnosis of ischemic stroke and start tPA therapy.

Reduce your Risks

Although we don’t yet know everything about strokes, especially ischemic strokes, we do know how to help individuals reduce their risks of having one. Some of the controllable, major risk factors for stroke may sound familiar to individuals interested in reducing the risk of heart disease-strategies such as lowering blood pressure through strategies such as lowering blood pressure through lifestyle and medication, not smoking, controlling diabetes and improving physical activity.

Other controllable risk factors for stroke include carotid artery disease-atherosclerosis in the blood vessels in the neck that lead to the brain-which can be treated surgically. Moreover, people with heart disease have more than twice the risk of stroke than individuals without heart disease. A high red blood cell count can also predispose an individual to stroke, because excess red blood cells can thicken the blood, making it more prone to clotting.

Risk factors for stroke that cannot be controlled include increasing age, gender (strokes are more common in men than in women, but more women die of stroke), prior stroke and race (African-Americans are more likely than whites to have a stroke and die from a stroke), sickle cell anemia, and TIAs (transient ischemic attacks). TIAs are “mini strokes” that produce fleeting, stroke like symptoms, but no lasting damage. People who experience TIAs are 10 times more likely to have a stroke.

Stroke is the third leading cause of death in the United States-someone has a stroke every 53 seconds. It is a leading cause of disability. Quick action and speedy treatment are required to prevent disability or death. Call 911-because every stroke must be treated as a life-threatening emergency.

Edgar J. Kenton, III is the chair of the American Stroke Association’s Advisory Committee and professor of clinical neurology, Thomas Jefferson University.

Knowing the Symptoms of Stroke Could Save Your Life!

The National Stroke Association says the body will likely have one or more of these symptoms:

  • Sudden numbness or weakness of face, arm or leg, especially on one side of the body
  • Sudden confusion, trouble speaking or understanding
  • Sudden trouble seeing in one or both eyes
  • Sudden trouble walking, dizziness, loss of balance or coordination
  • Sudden severe headache with no known cause

If you notice one or more of these symptoms in yourself or another person, don’t wait. Call 911 or your emergency medical services immediately.

Symptoms that come and go quickly could mean a TIA-transient ischemic attack or mini stroke a serious warning of a stroke waiting to happen.

Every minute counts. Treatment can be more effective if given quickly.