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Five types of strokes and how to spot warning signs

12 December 2022 dot 5-minute read
Healthy Body Feel Well Feature Stroke Illnesses and diseases
According to the World Stroke Organization, about 53 per cent of all types of strokes happen to women, while 47 per cent occur in men. (Credit: Shutterstock)
Just how prevalent is a stroke? The International Journal of Stroke reported in 2017 that stroke mortality was higher in Asia than in Western Europe, the Americas or Australasia, making all types of strokes a grave public health issue.
 
Globally, one in four people over age 25 will have a stroke in their lifetime, according to the World Stroke Organization (WSO). It is the second leading cause of death worldwide, with over 12.2 million new strokes yearly and 6.55 million stroke-related deaths in 2019 alone.
 
A stroke – technically known as a Cerebrovascular Accident (CVA) – is a potentially life-threatening medical condition caused by a sudden disruption of the blood flow to the brain. It can severely damage brain cells and tissues and lead to temporary or lasting paralysis.
 
Recognising the signs and acting fast can save stroke victims, prevent severe consequences and improve the chances of a full recovery.
 
Learn about the warning signs and possible causes of the three main types of strokes: ischemic, haemorrhagic and transient ischemic attack (TIA).

Ischaemic stroke

Numbness in the face, arm or leg, especially on one side of the body is a common sign of ischaemic stroke. (Credit: Shutterstock)
An ischaemic stroke accounts for over 62 per cent of cases worldwide, according to the WSO. It occurs when a blood clot clogs a blood vessel that supplies the brain, obstructing blood flow. An ischaemic stroke has two types:

Thrombotic stroke

A thrombotic stroke occurs when a blood clot happens in the arteries supplying blood to the brain. People with atherosclerosis, a build-up of fatty deposits that causes the narrowing of the blood vessels, are at risk of a thrombotic stroke.

Embolic stroke

An embolic stroke happens when a blood clot or plaque debris develops elsewhere in the body and travels to the brain. A 2016 survey of 19 countries published in an American Heart Association (AHA) journal estimated that about 28 per cent of embolic strokes occur in people with atrial fibrillation, a condition where the heart beats irregularly.

Haemorrhagic stroke 

Globally, haemorrhagic strokes account for 28 per cent of cases. This type of stroke happens when blood vessels rupture or leak in or around the brain. As a result, the blood accumulates and compresses the surrounding brain tissues, resulting in inflammation and swelling, potentially leading to further brain damage.
 
There are two types of haemorrhagic strokes. One is intracerebral haemorrhage – the bleeding starts from a blood vessel inside the brain. The other type is subarachnoid haemorrhage, which can be triggered by trauma or injury to the head, affecting the subarachnoid space between the skull and the brain.

TIAS or Transient ischaemic attack

If you experience sudden vision loss in one or both eyes, immediately call for an ambulance or ask someone to take you to the nearest hospital. (Credit: Shutterstock)
Like other strokes, a transient ischaemic attack (TIA) temporarily blocks blood flow to the brain. But its symptoms typically last no more than five minutes, and it does not usually lead to lasting brain damage.
 
While a TIA, also known as a mini-stroke, will resolve on its own, it still requires immediate medical attention because it can be a warning sign of a major stroke. For example, a 2017 review on the diagnosis and management of transient ischemic attacks, published in Continuum journal, saw an estimated 10 per cent risk of recurrent stroke after a TIA.
 
The good news is the same study says up to 80 per cent of this risk is preventable through assessment and proper treatment by a medical professional.

Cryptogenic and brain stem strokes

Stroke is possible with no apparent cause despite testing. Specialists classify this type as cryptogenic (of uncertain origin), and finding the proper treatment is more challenging. But lifestyle changes and medication to reduce brain damage can help recovery and lower the risk of having another stroke.
 
An ischemic or haemorrhagic stroke can occur in the brain stem. Only a half-inch in diameter, the brain stem controls all basic nervous system activities, any of which can potentially be impaired by a stroke.
 
While most strokes cause symptoms on one side of the body, a brain stem stroke can affect both sides, making one unable to speak or move below the neck.

Symptoms and warning signs of a stroke

Remember the FAST symptoms to act swiftly during an emergency. (Credit: Shutterstock)
TIA and ischaemic or haemorrhagic strokes cause similar symptoms because they impact blood flow to the brain. Medical attention is the only way to determine the type of stroke one may have.
 
Health professionals recommend remembering the acronym "FAST" to recognise the warning signs.
 
F – Facial drooping. One side of the face is drooping and numb. A person's smile may only be one-sided.
 
A – Arm weakness and numbness. A person having a stroke may only be able to extend one arm.
 
S – Speech difficulties. Someone having a stroke could have trouble speaking, or their speech might be slurred.
 
T – Time. Time to call for emergency medical attention. The sooner medical help is provided after a stroke, the higher chances of a better recovery.
 
Additional symptoms that don't fit in the FAST description include:
 
  • confusion, such as difficulty understanding what a person is saying
  • dizziness, or loss of coordination
  • difficulty walking
  • sudden, severe headache that doesn't have any other known cause
The key is to seek emergency care if any of these signs are spotted as soon as possible.
A healthy diet and lifestyle can help lower the risk of a stroke. But people with high blood pressure, diabetes and other conditions of the cardiovascular system like coronary artery disease should consult their doctors on the best preventive care.
 
Medical protection might be worth considering for more peace of mind against all types of strokes and other medical conditions. Medical insurance can cover costs from diagnosis to treatment and help lift the financial burden in times of need.
 
 
References:
 
JCH, The Journal of Clinical Hypertension. 2020. Hypertension and stroke in Asia: A comprehensive review from HOPE Asia. [online][Accessed on 9 August 2022]
 
International Journal of Stroke. 2017. Stroke Epidemiology in South, East, and South-East Asia: A Review. [online] [Accessed on 9 August 2022]
 
World Stroke Organization (WSO). 2022. Global Stroke Fact Sheet 2022. [online] [Accessed on 9 August 2022]
 
AHA Journals. 2016. Global Survey of the Frequency of Atrial Fibrillation–Associated Stroke. [online] [Accessed on 9 August 2022]
 
Stroke Research and Treatment. 2018. Stroke in the 21st Century: A Snapshot of the Burden, Epidemiology, and Quality of Life. [online] [Accessed on 9 August 2022]
 
JACC Journals. Journal of the American College of Cardiology. 2021. Epidemiological Features of Cardiovascular Disease in Asia. [online] [Accessed on 9 August 2022]
 
 
CDC, Center for Disease and Control Prevention. 2022. Stroke Patient Education Handouts. [online] [Accessed on 9 August 2022]
 
Stat Pearls Publishing. 2022. Ischemic Stroke.  [online] [Accessed on 9 August 2022]
 
Journal of Mid-Life Health. 2016. Risk factors of transient ischemic attack: An overview. [online] [Accessed on 9 August 2022]
 
Continuum. 2017. Diagnosis and Management of Transient Ischemic Attack. [online] [Accessed on 9 August 2022]
 
Disclaimer:
This is general information only and is not intended as financial, medical, health, nutritional or other advice. You should obtain professional advice from a financial adviser, or medical or health practitioner in relation to your own personal circumstances.