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Ischaemic stroke

Infarctus cerebri (ictus ischaemicus) · Ischemická cévní mozková příhoda

What it is

A brain artery blocks; the tissue it feeds dies within minutes. 85% of all strokes.

Symptoms & signs

  • Sudden one-sided weakness
  • face droop
  • slurred speech
  • vision loss
  • sudden dizziness or loss of balance
  • confusion

🚩 Get help if…

  • call 112 / 911 now Face drooping on one side, arm weakness or slurred speech — note the time
  • call 112 / 911 now Sudden loss of vision, double vision or loss of balance
  • call 112 / 911 now Symptoms that worsen or drowsiness after a stroke
  • see a doctor soon New chest pain, fever or leg swelling during recovery

Where it strikes

Medical treatment

  • Clot-buster (alteplase/tenecteplase) within 4.5 h
  • mechanical thrombectomy up to 24 h
  • aspirin + clopidogrel
  • statin
  • blood-pressure control
  • carotid endarterectomy
  • vagus-nerve-stimulation-paired rehab (Vivistim) — FDA-approved 2021 for arm weakness after stroke

Natural & lifestyle

  • Mediterranean diet
  • salt below 5 g/day
  • daily walking
  • stop smoking
  • treat sleep apnoea
  • omega-3

Emerging & experimental

  • Neuroprotectants (nerinetide)
  • stem-cell therapy
  • robotic exoskeleton training

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Acupuncture in rehabilitation — Chinese trials report benefit; Western trials are mixed mixed evidence
  • Cerebrolysin (pig-brain peptides) — used in Central and Eastern Europe; trials disagree mixed evidence
  • Hyperbaric oxygen months after a stroke — a small Israeli trial improved function; not confirmed early / small studies
  • Citicoline — the large ICTUS trial found no benefit not confirmed in trials
  • Cupping and herbal 'blood movers' — traditional; untested anecdotal / traditional

ICD codes