by Adrian Perkasa

Created on: September 18, 2011   Last Updated: September 19, 2011

Ischemic stroke is a medical emergency accident which marked by sudden, rapidly developing, and persist neurological dysfunction due to disturbance in the blood flow to our brain. Disturbance in the brain’s blood flow could be caused by interruption of blood supply (known as ischemic stroke) or caused by rupture of blood vessels supplying blood to brain (known as hemorrhagic stroke).

Typically ischemic stroke symptoms start suddenly, in only few minutes on most of the case, because some area of brain will stop functioning in few seconds after disturbance of blood flow begun. Area of brain affected by blood flow disturbance will suffered ischemia, which will end as infarct or permanent deficit if remains without adequate blood flow in few minutes. Permanent neurological dysfunction will developed if some important area of brain left as permanent deficit after the prolonged blood flow disturbance. WHO divides stroke with transient ischemic attack (TIA) which has similar symptoms with stroke but resolve completely in less than 24 hours.

Basically, symptoms of ischemic stroke depend on the area of brain affected. Brain has two hemispheres, which each hemisphere controls opposite side of our body. Hemispheres are supplied by three pairs of arteries, specifically anterior, medial, and posterior cerebral arteries. Mostly blood flow disturbance occurred at one of the arteries above, affecting brain area supplied by that artery.

Most notable ischemic stroke symptoms are sudden weakness and numbness of the face, arm, and leg on one side of body, and abnormal speech. Patient and people around can easily noticed sudden change that happened to patient, and on some cases they could provide exact time when the stroke attack begun to paramedics. Ischemic stroke attack is not likely to be accompanied with severe headache and unconsciousness. If infarct developed on central nervous system pathways, muscle weakness may be replaced with spasticity.  

Ischemic stroke mostly affect brain hemispheres, but sometimes it could affect brainstem, cortex, and cerebellum. If infarct occurred on brainstem, it would be developed as cranial nervous deficit symptoms (drooping of eyelid, altered breathing and heart rate, muscle weakness of face, tongue, and neck, decrease of sensation and reflexes, etc). If cortex affected by ischemic stroke, it would induce additional symptoms related to cortex disturbance (visual field defect, dysarthria, apraxia, and altered behavior). If ischemic stroke developed on cerebellum, it would induce additional symptoms related to cerebellum disturbance, most notably alteration of body movement and balance.

In 1998 some physician and paramedics in UK developed FAST as mnemonic to help detect and enhance responsiveness to help sudden stroke attack. FAST stands for Facial weakness, Arm weakness, Speech difficulty, and Time to act. Today this mnemonic has been accepted widely, as easy guidance for seeking first aid o stroke victim.

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