Stroke health centre

Stroke types

What are the types of stroke?

The main types of stroke are ischaemic stroke and haemorrhagic stroke.

A stroke is a medical emergency that happens when the blood supply doesn’t reach part of the brain.

Prompt treatment is needed to save the life of a person who has had a stroke, and to prevent brain damage and disability.

Although strokes may have different causes, the symptoms are the same.

The key message with stroke is to act FAST:

Face - has the face dropped on one side?

Arms - is the person unable to lift both arms and keep them raised?

Speech - is the person's speech slurred or are they not making sense?

Time - call 999 for an ambulance.

Ischaemic stroke

This type of stroke is the most common. Blood clots in arteries prevent the brain from getting the oxygen it needs from blood.

Over time, arteries become narrowed by plaques - fatty deposits - building up. This is called atherosclerosis and gradually narrows the artery. Eventually a blockage can form.

The emergency treatment for ischaemic stroke is clot-busting drugs that need to be given as soon as possible after the stroke symptoms appear, to help reduce lasting disability.

Contributors to artery narrowing include:

• Natural artery narrowing with age
• Smoking
• High blood pressure
• Being obese
• High blood cholesterol levels
• Diabetes
• Alcohol abuse

Irregular heartbeat ( atrial fibrillation) is a common underlying condition that can result in an ischaemic stroke.

A person's risk of ischaemic stroke can be reduced by quitting smoking, maintaining a healthy weight, managing blood pressure, keeping diabetes well managed and keeping within safe alcohol consumption guidelines.

Haemorrhagic strokes

Doctors may also refer to haemorrhagic strokes as cerebral haemorrhages or intracranial haemorrhages. In this less common type of stroke, a blood vessel in the brain ruptures causing bleeding in the brain.

Clot-busting drugs won’t help with this type of stroke, so doctors need to make sure which type of stroke a person has experienced before treating it.

Haemorrhagic strokes are usually caused by high blood pressure. Good blood pressure management can help reduce the risk of this type of stroke.

Risk factors for haemorrhagic strokes include being over 65, a close family history of stroke, being of Asian, African or Caribbean background or having previous strokes.

Another cause of haemorrhagic stroke is an abnormal blood vessel - called a brain aneurysm - rupturing.

Treatment for haemorrhagic stroke includes:

• Blood pressure medication
• A brain surgery operation to drain excess blood from the brain and repair damaged blood vessels. Part of the skull is cut away for this procedure and will be replaced with a metal plate afterwards.
• In the case of hydrocephalus complications, where fluid builds up in the brain's ventricles, special drainage tubes may be fitted.

Transient ischaemic attack (TIA)

Although this type of stroke is sometimes called a mini stroke, it is still a medical emergency.

With this type of stroke, there's a temporary blockage of blood flow to the brain from a clot. This clot may have been carried from another part of the body in the blood stream.

TIA risk factors include:

• Smoking
• High blood pressure
• Obesity
• High blood cholesterol levels
• Alcohol abuse
• Irregular heartbeat
• Diabetes
• Being over 60
• Being from an Asian, African or Caribbean background.

After a TIA, doctors will recommend treatments and lifestyle changes to help reduce the risk of another TIA or full stroke.