Stroke & Vascular Disease

Left Side Stroke | Right Side Stroke | Vascular Disease


Left Side Stroke

The cerebrum is the largest part of the brain. It is made of a left and a right section. The left side of the brain is in charge of the right side of the body. In most people, it is also controls the ability to speak, or use language.

A left brain stroke happens when the blood supply to the left side of the brain is interrupted. Blood brings oxygen and nutrients to brain tissue. When blood flow is stopped, the brain tissue quickly dies.

Copyright © Nucleus Medical Media, Inc.

There are 2 main types of stroke: ischemic and hemorrhagic . An ischemic stroke is the most common type of stroke.

Causes

An ischemic stroke is caused by a blockage of blood flow, which may be due to:

  • A clot from another part of the body like the heart or neck. The clot breaks off and flows through the blood until it becomes trapped in a blood vessel supplying the brain.

  • A clot that forms in an artery that supplies blood to the brain.

  • A tear in an artery supplying blood to the brain—arterial dissection.

A hemorrhagic stroke is caused by a burst blood vessel. Blood spills out of the broken blood vessel and pools in the brain. This interrupts the flow of blood and causes a build up of pressure on the brain.

Hemorrhagic vs. Ischemic StrokeCopyright © Nucleus Medical Media, Inc.

Risk Factors

Certain factors increase your risk of stroke but can not be changed, such as:

  • Race—People of African American, Hispanic, or Asian/Pacific Islander descent are at increased risk.

  • Age: Older than 55 years of age.

  • Family history of stroke.

Other factors that may increase your risk can be changed, such as:

  • Drug abuse from cocaine , amphetamines, or heroin use

  • Smoking

  • Physical inactivity

Certain medical condition that can increase your risk of stroke. Management or prevention of these conditions can significantly decrease your risk. Medical conditions include:

  • High blood pressure

  • High cholesterol levels —specifically high-LDL cholesterol

  • Low bone mineral density, especially in women

  • Obesity and metabolic syndrome

  • Sleep apnea

  • High blood homocysteine level

  • Atherosclerosis

  • Type 2 diabetes or impaired glucose tolerance

  • Atrial fibrillation

  • Blood disorders such as sickle cell disease and polycythemia

  • Vascular dementia

  • Disease of heart valves, such as mitral stenosis

  • Prior stroke or cardiovascular disease, such as heart attack

  • Peripheral artery disease

  • Transient ischemic attack (TIA)—a warning stroke with stroke-like symptoms that go away shortly after they appear

  • Conditions that increase your risk of blood clots such as:

    • Cancer

    • Certain autoimmune diseases

  • Migraine with aura

  • Having a blood vessel abnormality

  • Psychological disorders, such as depression or anxiety

Risk factors specific to women include:

  • Previous pre-eclampsia

  • Use of birth control pills , especially if you are over 35 years old and smoke

  • Long-term use of hormone replacement therapy

  • Menopause

  • Pregnancy—due to increased risk of blood clots

Symptoms

Symptoms occur suddenly. Exact symptoms will depend on the part of the brain affected. Rapid treatment is important to decrease the amount of brain damage. Brain tissue without blood flow dies quickly.

Call for emergency medical help right away if you notice any of the following:

  • Sudden weakness or numbness of face, arm, or leg, especially on the right side of the body

  • Sudden confusion

  • Sudden trouble speaking or understanding— aphasia

  • Sudden trouble seeing the right side of the world from both eyes—homonymous hemianopsia

  • Sudden lightheadedness, trouble walking, loss of balance, or coordination

  • Sudden severe headache with no known cause

Longer-lasting effects of the stroke may include problems with:

  • Left-sided weakness and/or sensory problems

  • Speaking and swallowing

  • Vision, like the inability for the brain to take in information from the left visual field

  • Perception and spatial relations

  • Attention span, comprehension, problem solving, judgment

  • Emotions

  • Interactions with other people

  • Activities of daily living, such as going to the bathroom

  • Mental health, such as depression , frustration, impulsivity

Diagnosis

You will be asked about your symptoms and past health. A physical exam will be done to look for muscle weakness and movement difficulty. Vision and speech will also be checked.

Images may be taken of your bodily structures. This can be done with:

  • CT scan

  • MRI scan

  • Magnetic resonance angiography (MRA)

  • CT angiogram (CTA)

  • Doppler ultrasound

Blood tests can also help determine if there is a bleeding problem.


Right Side Stroke

The cerebrum is the largest part of the brain. It is made of a left and a right section. The right side of the brain is in charge of the left-side of the body. It also does some of our thought processing, help us know body position, and judge space and distance.

A right brain stroke happens when the blood supply to the right side of the brain is interrupted. Blood brings oxygen and nutrients to brain tissue. When blood flow is stopped, the brain tissue quickly dies.

Copyright © Nucleus Medical Media, Inc.

There are 2 main types of stroke: ischemic and hemorrhagic. An ischemic stroke is the most common type of stroke.

Causes

An ischemic stroke is caused by a blockage of the blood flow, which may be due to:

  • A clot from another part of the body like the heart or neck. The clot breaks off and flows through the blood until it becomes trapped in a blood vessel supplying the brain.

  • A clot that forms in an artery that supplies blood to the brain.

  • A tear in an artery supplying blood to the brain—arterial dissection.

A hemorrhagic stroke is caused by a burst blood vessel. Blood spills out of the broken blood vessel and pools in the brain. This interrupts the flow of blood and causes a build up of pressure on the brain.

Hemorrhagic vs. Ischemic StrokeCopyright © Nucleus Medical Media, Inc.

Risk Factors

Certain factors increase your risk of stroke but can not be changed, such as:

  • Race—People of African American, Hispanic, or Asian/Pacific Islander descent are at increased risk.

  • Age: Older than 55 years of age.

  • Family history of stroke.

Other factors that may increase your risk can be changed, such as:

  • Drug abuse from cocaine , amphetamines, or heroin use

  • Smoking

  • Physical inactivity

Certain medical condition that can increase your risk of stroke. Management or prevention of these conditions can significantly decrease your risk. Medical conditions include:

  • High blood pressure

  • High cholesterol levels —specifically high-LDL cholesterol

  • Low bone mineral density, especially in women

  • Obesity and metabolic syndrome

  • Sleep apnea

  • High blood homocysteine level

  • Atherosclerosis

  • Type 2 diabetes or impaired glucose tolerance

  • Atrial fibrillation

  • Blood disorders such as sickle cell disease and polycythemia

  • Vascular dementia

  • Disease of heart valves, such as mitral stenosis

  • Prior stroke or cardiovascular disease, such as heart attack

  • Peripheral artery disease

  • Transient ischemic attack (TIA)—a warning stroke with stroke-like symptoms that go away shortly after they appear

  • Conditions that increase your risk of blood clots such as:

    • Cancer

    • Certain autoimmune diseases

  • Migraine with aura

  • Having a blood vessel abnormality

  • Psychological disorders, such as depression or anxiety

Risk factors specific to women include:

  • Previous pre-eclampsia

  • Use of birth control pills , especially if you are over 35 years old and smoke

  • Long-term use of hormone replacement therapy

  • Menopause

  • Pregnancy—due to increased risk of blood clots

Symptoms

Symptoms occur suddenly. Exact symptoms will depend on the part of the brain affected. Rapid treatment is important to decrease the amount of brain damage. Brain tissue without blood flow dies quickly.

Call for emergency medical help right away if you notice any of the following:

  • Sudden weakness or numbness of face, arm, or leg, especially on the left side of the body

  • Sudden confusion

  • Sudden trouble speaking or understanding— aphasia

  • Sudden trouble seeing in one or both eyes

  • Sudden lightheadedness, trouble walking, loss of balance, or coordination

  • Sudden severe headache with no known cause

  • Difficulty understanding or expressing the emotional tone of language (unable to change pitch, tone, or rhythm)

  • Difficulty with learned movements

  • Lack of attention to the left side of the body

Longer-lasting effects of the stroke may include problems with:

  • Left-sided weakness and/or sensory problems

  • Speaking and swallowing

  • Vision, including an inability of the brain to take in information from the left visual field

  • Perception and spatial relations

  • Attention span, comprehension, problem solving, and judgment

  • Emotions

  • Interactions with other people

  • Activities of daily living, such as going to the bathroom

  • Mental health, including depression , frustration, and impulsivity

Diagnosis

You will be asked about your symptoms and past health. A physical exam will be done to look for muscle weakness and movement difficulty. Vision and speech will also be checked.

Images may be taken of your bodily structures. This can be done with:

  • CT scan

  • MRI scan

  • Magnetic resonance angiography (MRA)

  • CT angiogram (CTA)

  • Doppler ultrasound

Blood tests can also help determine if there is a bleeding problem.


Vascular Disease

Peripheral artery disease (PAD) is a condition that leads to a decrease of blood flow to the arms and legs.

Causes

PAD is most often caused by a narrowing of blood vessels that supply blood to the arms and legs. The narrowing is usually caused by a buildup of plaque called atherosclerosis . The build up occurs over long periods of time and is increased with:

  • High blood pressure

  • High cholesterol

  • Diabetes

  • Smoking

Other conditions that can slow blood flow include blood clots and inflammation of the blood vessels. Certain conditions like congenital heart disease can also decrease the amount of oxygen rich blood that reaches the arms and legs.

AtherosclerosisCopyright © Nucleus Medical Media, Inc.

Risk Factors

PAD is more common in men and in people over 50 years of age. Other factors that may increase your chances of PAD:

  • Family history of PAD

  • Diabetes

  • Smoking

  • High blood pressure or family history of high blood pressure

  • Stroke or family history of stroke

  • High cholesterol or family history of high cholesterol

  • Coronary artery disease (CAD)

  • Metabolic syndrome

  • HIV infection

Symptoms

Symptoms of PAD will depend on the area that is most affected. Common symptoms include:

  • Pain, fatigue, aching, tightness, weakness, cramping or tingling in the leg(s) brought on by exercise that goes away when resting

  • Numbness and pain of the legs or feet at rest

  • Cold hands, legs, or feet

  • Loss of hair on the legs and/or feet

  • Paleness or blueness of the legs

  • Weak or absent pulse in the leg

  • Sores, ulcer, or infection of the feet and legs that heal slowly

  • Erectile dysfunction

  • Swelling in lower extremities

  • Muscle atrophy—loss of muscle

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done.

During the exam, your doctor may do the following:

  • Check the strength of the pulse in the legs

  • Use a stethescope to listen for abnormal sounds in leg arteries or the abdomen

  • Check blood pressure in the leg

If the doctor suspects a change in blood flow, other tests may be done to confirm change or look for causes. Images of blood vessels can be done with:

  • Doppler ultrasound

  • Angiography

  • MRI scan

Your heart activity may need to be tested. This can be done with an ECG .



This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

RESOURCES

American Heart Association http://www.heart.org 

National Stroke Association http://www.stroke.org