Strokes

Every minute, 750 milliliters of blood flows to the brain, supplying 20% of the body’s oxygen. A sudden disruption—whether from a clot (ischemic stroke) or a bleed (hemorrhagic stroke)—can be life-threatening. From ancient Greek theories to modern CT and MRI scans, here’s how stroke science has evolved over time.

A stroke occurs when blood flow to part of the brain is suddenly interrupted, either by a blockage (ischemic stroke) or bleeding (hemorrhagic stroke). Each year, nearly 800,000 Americans experience a stroke, with around 85% of them being ischemic.

Every 40 seconds, someone in the US experiences a stroke—and every minute without treatment destroys millions of brain cells. This explainer breaks down the two main types of strokes, their risk factors, and how early detection could change outcomes in the future.

While age is the greatest risk factor, genetics, diet, and overall health play a prominent role in determining individual stroke risk. Prevention focuses heavily on modifiable risk factors. High blood pressure is the single most important controllable risk factor, contributing to both types of stroke.

By far the most common type of stroke is what is known as an ischemic stroke. This occurs due to either an embolus (a blood clot that travels to the brain from elsewhere in the body) or a thrombus (a blockage that forms within the brain itself).

Clotting is how our body stops bleeding in the event of an injury. Typically, platelets adhere to exposed tissue, becoming sticky and forming a plug. Chemical signals trigger the coagulation cascade, converting fibrinogen into fibrin threads that stabilize the plug. This prevents bleeding but can obstruct vessels if overactive or misplaced.

A hemorrhagic stroke occurs when a faulty blood vessel within the brain bleeds. Though this is less common than an ischemic stroke, it is often far more deadly. This in-depth resource from the American Stroke Association provides a comprehensive overview of the two main subtypes of hemorrhagic stroke along with a useful animation of the condition.

Modern stroke treatment is a delicate balance between obtaining an accurate diagnosis and delivering treatment quickly. Each stroke has its own cause, and the appropriate treatment must be paired with the correct diagnosis to prevent further harm. Typical treatments pair emergency surgery to relieve the affected area and long-term regimens to avoid recurrence.

One of the most exciting recent advances in treating stroke is a medication known as tissue plasminogen activator, or tPA. It is only effective for use in some ischemic strokes, and it must be delivered within 4.5 hours of symptom onset to have a chance at working.

The primary factor in surviving a stroke is how quickly one gets the appropriate medical treatment. “FAST” refers to the four most noticeable symptoms of a stroke: face-dropping ("F"), arm weakness ("A"), speech difficulty ("S"), and "time to call 911" ("T").