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Acute Stroke (Cerebrovascular Accident) — Emergency

Stroke is a brain attack where every minute kills 1.9 million neurons; rapid recognition and reperfusion preserve brain function.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

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This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Acil Servis department. Book Appointment →

What is Acute Stroke (Cerebrovascular Accident) — Emergency?

Stroke (cerebrovascular accident, CVA) is an acute neurological deficit caused by sudden interruption of blood supply to a region of the brain. Eighty-five percent are ischaemic (arterial occlusion) and 15% haemorrhagic (intracerebral or subarachnoid haemorrhage).

Ischaemic stroke results from atherothrombotic occlusion of large or small vessels, cardio-embolism (most often atrial fibrillation), or paradoxical embolism. The penumbra is the salvageable tissue surrounding the infarct core.

Diagnosis requires immediate non-contrast CT to exclude haemorrhage, followed by CT-angiography and CT-perfusion (or MRI-DWI) to identify large vessel occlusion (LVO) and viable penumbra.

Time is brain: 1.9 million neurons die every minute that ischaemic stroke goes untreated. Door-to-needle time of ≤60 minutes for IV thrombolysis and door-to-puncture ≤90 minutes for thrombectomy are quality benchmarks.

Symptoms

FAST: Face droop (facial asymmetry), Arm weakness, Speech difficulty, Time to call 112
Sudden weakness or numbness on one side of the body (hemiparesis, hemianaesthesia)
Sudden confusion, difficulty understanding or producing speech (aphasia, dysarthria)
Sudden visual loss in one or both eyes, double vision, gaze palsy
Sudden severe vertigo, ataxia, loss of balance and coordination
Sudden severe headache (thunderclap) — suggests subarachnoid haemorrhage
Decreased consciousness, neglect, denial of deficit (anosognosia)

Risk Factors

Hypertension (the single most important modifiable risk factor)
Atrial fibrillation and other cardio-embolic sources
Diabetes mellitus, dyslipidaemia and metabolic syndrome
Smoking, alcohol abuse, illicit drug use (cocaine, amphetamines)
Carotid stenosis ≥70% and prior transient ischaemic attack (TIA)
Older age, male sex, family history, sickle cell disease
Obesity, sedentary lifestyle, obstructive sleep apnoea, oral contraceptive use

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Any sudden focal neurological deficit requires immediate 112 call — never wait at home
  • Note exact time of symptom onset (last seen well) — critical for treatment eligibility
  • Do not give aspirin or food/drink before haemorrhage is excluded
  • Transient symptoms (TIA) also require urgent evaluation — high risk of stroke within 48 hours
  • Family members should learn FAST signs and rehearse emergency response

Treatment Methods

01
Intravenous thrombolysis with alteplase 0.9 mg/kg or tenecteplase within 4.5 hours of onset
02
Mechanical thrombectomy within 6–24 hours for large vessel occlusion (anterior circulation)
03
Aspirin 300 mg within 24–48 hours after thrombolysis (or immediately if no thrombolysis)
04
Blood pressure control: <185/110 before thrombolysis, <180/105 for 24 hours after
05
Strict glycaemic control (140–180 mg/dL), normothermia and DVT prophylaxis
06
Stroke unit admission with multidisciplinary care reduces mortality and disability
07
Secondary prevention: antiplatelet, statin, anticoagulation for AF, carotid endarterectomy if indicated

Which Department to Visit?

You can visit our Acil Servis department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.