Stroke: the "Brain Attack"

A stroke is an interruption of the blood supply to any part of the brain; it is sometimes called a "brain attack." If blood flow is stopped for longer than a few seconds and the brain cannot get blood and oxygen, the brain cells can die causing permanent damage. Other names for stroke are cerebrovascular disease; CVA; Cerebral infarction and cerebral hemorrhage.

There are 2 types of strokes: Ischemic and hemorrhagic strokes. Ischemic stroke is when a blood vessel carrying blood to the brain is blocked by a blood clot; hemorrhagic stroke is when a blood vessel breaks open, causing blood to leak into the brain.

Symptoms of Stroke...

For Nancy Richardson, she experienced neck pain and headaches 3 days prior to her acute stroke where her right-sided arm, leg, and face became paralyzed and she had difficulty speaking. In Richardson's case, the major artery on the left side of her brain spontaneously developed a tear in the wall that resulted in blood clot formation which obstructed the internal carotid artery that impacted Richardson's areas of strength, sensation and speech.

A perfusion MRI study was conducted and determined the area of the impaired blood flow, figure 2 shows the left middle cerebral artery territory, the white area is where the blockage occur; here, the connecting vessels of the right to the left side at the base of the brain only allowed some flow into the first portion of the left middle cerebral artery (fig. 1).

Treatment of Stroke...

Richardson was given rTPA intravenously to help the body break down the blood clot. A small catheter from the femoral artery was simultaneously placed in the groin up through the blocked internal carotid artery and into and beyond the blood clot on the left middle cerebral artery were more rTPA was infused and was successful in reopening the majority of the middle cerebral artery (fig. 3). A second perfusion MRI was completed after treatment and showed normalization of flow to the effected area (fig. 4).