Clinical Signs and Diagnosis

Ischemic Stroke Symptoms:

• Develops gradually and progressively.
• Facial paralysis or heaviness on one side.
• Weakness in the arms and legs, difficulty moving.
• Speech impairment – difficulty in understanding or articulating words.
• Vision problems – impaired vision in one or both eyes.
• Dizziness – loss of balance and coordination.

Hemorrhagic Stroke Symptoms:

• Sudden and severe onset.
• Severe headache – often described by patients as “the worst headache of my life.”
• Loss of consciousness or confusion.
• Vomiting – due to increased intracranial pressure.
• Epileptic seizures – may occur during or immediately after stroke.

Causes and Risk Factors

• Arterial hypertension – tension and rupture of blood vessels.
• Aneurysm – congenital or acquired dilation and rupture of blood vessels.
• Arterio-venous malformations (AVM) – abnormal development of blood vessels.
• Incorrect use of anticoagulant drugs – disturbances in the blood coagulation system.
• Head trauma – may lead to intracranial bleeding.

Treatment Approaches

Ischemic Stroke:

• Thrombolytic therapy – opening the blocked vessel with drugs such as alteplase (tPA) (effective only within 4.5 hours).
• Antiplatelet drugs – aspirin, clopidogrel to prevent blood clot formation.
• Anticoagulants – warfarin or NOACs (rivaroxaban, apixaban) to reduce stroke risk associated with atrial fibrillation.
• Rehabilitation – physiotherapy and speech therapy to restore movement and communication.

Hemorrhagic Stroke:

• Blood pressure control – beta-blockers or calcium channel blockers to prevent further bleeding.
• Stopping bleeding – in some cases, surgery is required.
• Neurosurgical intervention – removal of large hematomas or AVM.
• Rehabilitation – recovery process after stroke.

Key Points

• Ischemic stroke occurs due to blockage of a blood vessel, while hemorrhagic stroke results from vessel rupture.
• Ischemic stroke develops gradually, while hemorrhagic stroke occurs suddenly.
• The main diagnostic methods are CT and MRI.
• The main goal in ischemic stroke is to restore blood flow, whereas in hemorrhagic stroke the priority is to stop bleeding.