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Samwel Mikaye։ Key Insights on Stroke Types, Diagnosis, and Management
Samwel Mikaye/LinkedIn
Mar 4, 2026, 15:46

Samwel Mikaye։ Key Insights on Stroke Types, Diagnosis, and Management

Samwel Mikaye, Medical Doctor at MSK, shared a post on LinkedIn:

”Stroke (Cerebrovascular Accident – CVA)

Definition

  • Sudden onset of neurological deficit due to interruption of blood flow to the brain, lasting >24 hours or causing death, with vascular origin.

Types of Stroke

1. Ischemic Stroke (≈85%)

  • Cause: Thrombosis, embolism, systemic hypoperfusion
  • Subtypes: Large artery atherosclerosis, cardioembolic, small vessel (lacunar)
  • Risk factors: Hypertension, diabetes, atrial fibrillation, smoking

2. Hemorrhagic Stroke (≈15%)

  • Cause: Rupture of a blood vessel
  • Types:

– Intracerebral hemorrhage – often due to hypertension
– Subarachnoid hemorrhage – often due to aneurysm rupture
– Risk factors: Hypertension, aneurysms, anticoagulation, trauma

Clinical Features

Depends on brain area affected:

  • Sudden weakness or numbness (face, arm, leg), usually one side
  • Speech difficulties: Aphasia (expressive/receptive)
  • Visual changes: Hemianopia, blurred vision
  • Coordination problems: Ataxia, dizziness
  • Severe headache: Common in hemorrhagic stroke

Other signs:

  • Facial droop, limb weakness, difficulty walking, altered consciousness

Diagnosis
1. Immediate: Clinical assessment (FAST: Face, Arm, Speech, Time)
2. Imaging:

  • CT scan non-contrast – differentiates ischemic vs hemorrhagic
  • MRI – more sensitive for early ischemia

3. Lab tests: CBC, electrolytes, coagulation profile, glucose, cardiac enzymes (if cardioembolic suspected)

Management

Ischemic Stroke:

  • Acute: Thrombolysis (IV tPA within 4.5 hours), mechanical thrombectomy (large vessel occlusion)
  • Secondary prevention: Antiplatelets, anticoagulation if atrial fibrillation, statins, blood pressure control

Hemorrhagic Stroke:

  • Acute: Blood pressure control, reversal of anticoagulation, surgical intervention if needed
  • Supportive care: ICP management, seizure control

All strokes:

  • Supportive: Airway, fluids, glycemic control, physiotherapy, nutrition

Complications

  • Cerebral edema, raised ICP
  • Seizures
  • Recurrent stroke
  • Functional deficits: hemiplegia, aphasia, cognitive impairment
  • Early recognition and imaging are critical – ‘time is brain.’
  • Ischemic vs hemorrhagic stroke determines treatment; do not give anticoagulants until confirmed.
  • Multidisciplinary rehab improves functional outcomes.”

Samwel Mikaye։ Key Insights on Stroke Types, Diagnosis, and Management

Other posts  featuring Samwel Mikaye on Hemostasis Today.

Aneurysms Anticoagulation Cerebrovascular Accident CVA Health Hematology Hemorrhagic Stroke Hemostasis Hemostasis News Hemostasis Today hypertension intracerebral hemorrhage Ischemic stroke Medicine Samwel Mikaye stroke subarachnoid hemorrhage thrombosis trauma
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