Is an ischemic stroke fatal?

Massive strokes can be fatal due to brain edema/swelling.

An ischemic stroke is a serious condition that can be fatal. Strokes are the fifth leading cause of death in the United States. One study found that 14.5 percent of people that suffer an acute ischemic stroke die within 30 days. About a quarter of those who have a stroke will have another within 5 years. Early treatment is important to not only save a person's life, but to also reduce permanent damage to the brain.

Usually ischemic stroke is not fatal. Ischemic stroke refers to the loss of brain tissue from loss of blood flow. It is usually the result of a clot that forms in the brain in an area of arterial narrowing (in situ thrombosis), or the result of a clot that forms elsewhere and then travels to a location in the brain where it lodges (artery to artery embolization).

As result of the loss of blood flow, the brain tissue supplied by that blood vessel is damaged or dies as result. If the the blood vessel involved is large, a large volume of brain is involved. A small blood vessel blockage (occlusion), will usually result in only a small amount of brain tissue damage.

If a large volume of brain is damaged or dies there may be a substancial amount of swelling that occurs. The swelling can result in pressure on the surrounding normal brain. Since the brain is located in a rigid container (the skull), a large amount of swelling can result in a large amount of injury to the "normal" brain. If the volume of swelling and brain damage is large enough death can occur. Sometimes the brain swelling will result in compression of the automatic part of the brain (brainstem) and interfere with the functions of the automatic brain such as maintaince of breathing and blood pressure. This also can cause death.

Sometimes a stroke in a particular location in the brain, such as the brainstem can cause death independently of brain swelling.

Fortunately, most strokes are small to moderate in size and therefore do not usually cause death.

Complications from small to moderate sized strokes can sometimes lead to complications, which may result in death. For example, pneumonia is a potential complication of stroke which can contribute to death. Irregular heart rate, a blood pressure which is too low, swallowing problems, infections, are other complications from even small to moderate sized stroke which can lead to death.

No, ischemic stroke is not always fatal. But it can cause significant disability. This disability can be very difficult to deal with for both the individuals who have the stroke and those that provide support. The exact nature of the brain damage will depend on where the stroke happens in the brain. Fortunately, 80% of strokes can be prevented, with proper lifestyle modifications such as maintaining a healthy weight and not smoking as well as medical management and monitoring for conditions such as high blood pressure and elevated cholesterol. For those in the right target age group of 50 and over, vascular screening can also be helpful by identifying underlying atherosclerotic disease (fatty plaque buildup in the arteries) at an early stage. These steps can identify risk factors for stroke before a stroke happens.

Not all ischemic strokes are fatal. The symptoms related to an ischemic stroke will depend on the size and the location of the stroke. 

Small strokes can be asymptomatic or devastating depending on the location (the strokes of the brainstem have the worse prognosis for recovery). The larger the stroke, the more symptomatic the person will be. 

Strokes related to the larger arteries of the brain are related to a worse prognosis (ie. basilar and carotid arteries). An ischemic stroke can potentially be fatal if there is significant swelling that displaces vital parts of the brain (called herniation). 

After suffering a stroke, even if it is asymptomatic, an appropriate work up should be conducted to prevent a recurrent stroke from happening.

An ischemic stroke can be fatal. 

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.