How Many Types Of Strokes Are There?

There are two main types of stroke: ischaemic stroke and haemorrhagic stroke. An ischaemic stroke happens when a blood clot blocks the flow of blood to part of the brain, while a haemorrhagic stroke happens when a blood vessel in or around the brain bursts and causes bleeding.

You may also hear about a transient ischaemic attack (TIA), often called a mini-stroke. A TIA causes stroke-like symptoms because the blood supply to part of the brain is temporarily interrupted, but the symptoms resolve within 24 hours. It is still a medical emergency and can be a warning sign of a future stroke.

This guide explains the main types of stroke, the different subtypes, rarer causes and what the type of stroke can mean for treatment and recovery.

Important: If you or someone else develops sudden facial weakness, arm weakness or speech problems, call 999 immediately. Do not wait to see whether the symptoms improve.

Key Takeaways

• The two main types of stroke are ischaemic stroke and haemorrhagic stroke.
• Ischaemic strokes are caused by a blockage in a blood vessel supplying the brain.
• Haemorrhagic strokes are caused by bleeding in or around the brain.
• A TIA causes temporary stroke-like symptoms and requires urgent medical assessment.
• There are several subtypes and rarer causes of stroke, so diagnosis usually involves brain scans and other tests.
• Recovery differs from person to person and depends on the area of the brain affected, the severity of the stroke and other individual factors.

What Are the Main Types of Stroke?

The two main types of stroke are:

1. Ischaemic stroke – caused by a blockage that reduces or stops blood flow to part of the brain.
2. Haemorrhagic stroke – caused by bleeding in or around the brain after a blood vessel ruptures.

Ischaemic stroke is the most common type. NHS sources estimate that around 85% of strokes are ischaemic, while the remainder are mainly haemorrhagic strokes.

A TIA is often discussed alongside strokes because it produces similar symptoms and has a similar underlying cause to an ischaemic stroke, but the interruption in blood flow is temporary.

1. Ischaemic Stroke

An ischaemic stroke occurs when a blood vessel supplying the brain becomes blocked. This prevents oxygen-rich blood from reaching part of the brain and can damage brain cells.

The blockage is usually caused by a blood clot. Depending on how and where the clot develops, an ischaemic stroke may be described in different ways.

Thrombotic Stroke

A thrombotic stroke occurs when a blood clot forms within an artery supplying the brain.

This can happen where an artery has become narrowed by fatty deposits known as atherosclerosis. If a clot forms in the narrowed area and blocks blood flow, the brain tissue supplied by that artery may be damaged.

Embolic Stroke

An embolic stroke happens when a clot or other material forms elsewhere in the body and travels through the bloodstream until it blocks an artery in the brain.

One common source of these clots is the heart. Atrial fibrillation, an irregular heart rhythm, can increase the risk of blood clots forming in the heart and travelling to the brain.

Lacunar Stroke

A lacunar stroke affects one of the small blood vessels deep within the brain.

These strokes may affect areas involved in movement, sensation or coordination. Although the damaged area may be relatively small, the effects can still be significant depending on its location.

2. Haemorrhagic Stroke

A haemorrhagic stroke occurs when a blood vessel bursts and causes bleeding within or around the brain.

The bleeding can damage nearby brain tissue and increase pressure within the skull.

There are two important types of haemorrhagic stroke.

Intracerebral Haemorrhage

An intracerebral haemorrhage occurs when a blood vessel bursts and causes bleeding directly into the brain tissue.

High blood pressure is one factor that can increase the risk of this type of stroke, although there can be other causes.

Subarachnoid Haemorrhage

A subarachnoid haemorrhage is bleeding into the space surrounding the brain.

It can occur when an aneurysm, which is a weakened area in the wall of a blood vessel, ruptures.

A subarachnoid haemorrhage can cause a sudden and extremely severe headache and requires immediate emergency treatment.

What Is a TIA or Mini-Stroke?

A transient ischaemic attack, or TIA, occurs when the blood supply to part of the brain is temporarily interrupted.

The symptoms are similar to those of a stroke and may include:

• facial weakness or drooping
• weakness or numbness in one arm
• slurred or unclear speech
• difficulty understanding speech
• sudden changes in vision
• loss of balance or coordination

The symptoms of a TIA usually last for a few minutes or hours and fully resolve within 24 hours.

However, you should never wait for symptoms to disappear. In the early stages, it is not possible to know whether someone is experiencing a TIA or a full stroke.

Call 999 immediately if stroke symptoms appear, even if they begin to improve.

Are There Other Types of Stroke?

The terms ischaemic and haemorrhagic describe the two main mechanisms of stroke, but you may encounter other names describing where a stroke occurs, its cause or the blood vessels involved.

These are usually subtypes or descriptions of stroke rather than completely separate categories.

Brainstem Stroke

A brainstem stroke affects the part of the brain connecting the brain to the spinal cord.

The brainstem is involved in functions such as movement, balance, swallowing, breathing and eye movements, so the effects can vary considerably depending on the area involved.

Cerebellar Stroke

A cerebellar stroke affects the cerebellum, which plays an important role in balance, coordination and controlled movement.

Possible effects can include dizziness, difficulty walking, problems with coordination and changes in balance.

Posterior Circulation Stroke

A posterior circulation stroke affects the blood vessels supplying the back part of the brain, including areas such as the brainstem, cerebellum and occipital lobes.

Symptoms may differ from the classic FAST signs and can include sudden dizziness, balance problems, visual disturbance and coordination difficulties.

New neurological symptoms should always be assessed urgently.

Cryptogenic Stroke

A stroke may be described as cryptogenic when doctors cannot identify a clear cause after investigation.

Further tests may sometimes be carried out to look for possible causes such as intermittent heart rhythm abnormalities or other cardiovascular problems.

What Are Rare Types of Stroke?

Some strokes occur through less common mechanisms or affect less frequently involved blood vessels.

Examples can include:

• strokes associated with cerebral venous sinus thrombosis
• strokes caused by arterial dissection
• strokes linked to rare blood-clotting disorders
• strokes associated with certain inflammatory or vascular conditions
• strokes occurring in younger adults without the usual cardiovascular risk factors

These causes require specialist medical investigation. The symptoms can overlap with more common forms of stroke, so the type cannot be reliably identified from symptoms alone.

How Do Doctors Determine Which Type of Stroke You Have Had?

Doctors need to identify the type of stroke quickly because treatment differs between an ischaemic stroke and a haemorrhagic stroke.

Assessment may include:

• CT scans
• MRI scans
• blood tests
• an electrocardiogram (ECG)
• ultrasound scans
• other cardiovascular or neurological tests where appropriate

Brain imaging can help doctors identify whether symptoms are caused by a blockage or bleeding and determine which parts of the brain have been affected.

Do Different Types of Stroke Cause Different Symptoms?

Stroke symptoms depend heavily on which part of the brain is affected rather than simply whether the stroke is ischaemic or haemorrhagic.

Possible effects include:

• weakness or paralysis on one side of the body
• changes in sensation
• speech and communication difficulties
• problems with vision
• changes in balance and coordination
• difficulty swallowing
• memory or concentration difficulties
• fatigue
• emotional or behavioural changes

Two people who have experienced the same broad type of stroke can therefore have very different symptoms and rehabilitation needs.

What Are the Signs of a Stroke?

The main signs of stroke can be remembered using FAST:

• Face: one side of the face may droop, or the person may be unable to smile normally.
• Arms: they may be unable to raise both arms and keep them raised because of weakness or numbness.
• Speech: speech may become slurred, unclear or difficult to understand.
• Time: call 999 immediately if you notice any of these signs.

Other sudden neurological symptoms can also occur, including changes in vision, balance, coordination or awareness.

If you think someone may be having a stroke, do not try to determine the type yourself. Call 999 for emergency medical help.

Does the Type of Stroke Affect Recovery?

The type of stroke is one factor that doctors consider, but it does not determine recovery on its own.

Recovery can also depend on:

• which area of the brain was affected
• the size and severity of the stroke
• how quickly treatment was received
• the person’s previous health and mobility
• other medical conditions
• the effects caused by the stroke
• access to appropriate rehabilitation and support

Recovery is different for every person. Some abilities may improve relatively quickly, while others can require longer-term rehabilitation and adaptation.

For a more detailed explanation, read our guide to recovery after a stroke.

What Are Signs of Recovery After a Stroke?

Progress after a stroke can appear in different ways depending on the difficulties caused by the stroke.

Examples may include improvements in:

• strength and movement
• balance
• walking
• coordination
• speech or communication
• ability to complete everyday activities
• confidence and independence

Recovery is rarely identical from one person to another, and progress may not happen at a constant rate.

You can read more about signs of recovery after a stroke and what changes may indicate progress during rehabilitation.

How Can Physiotherapy Help After a Stroke?

Physiotherapy can form an important part of rehabilitation when a stroke affects movement, strength, balance or mobility.

A neurological physiotherapist may assess areas such as:

• muscle strength
• balance and coordination
• walking and gait
• transfers, such as standing from a chair
• joint movement and flexibility
• posture
• confidence with everyday movement

Treatment should reflect the individual’s specific difficulties and goals rather than rely on the type of stroke alone.

For example, one person may need support with walking and balance, while another may be working on transferring safely from a bed or chair.

Neurological Physiotherapy After Stroke in Birmingham

Miranda’s Physio Steps provides specialist neurological physiotherapy in Birmingham for adults following stroke and other neurological conditions.

Rehabilitation is tailored to the individual and may include work on strength, balance, coordination, walking and everyday movement depending on the effects of the stroke.

If you would like to discuss rehabilitation following a stroke, contact Miranda’s Physio Steps to discuss your needs.

Summary

There are two main types of stroke: ischaemic stroke, caused by a blockage in the blood supply to the brain, and haemorrhagic stroke, caused by bleeding in or around the brain.

A transient ischaemic attack, or TIA, causes temporary stroke-like symptoms and is often discussed alongside the main stroke types because it requires urgent assessment and can be a warning sign of a future stroke.

There are also several subtypes and rarer causes of stroke, including lacunar strokes, brainstem strokes, cerebellar strokes and strokes associated with less common vascular conditions.

The effects and recovery needs vary considerably from person to person. If stroke has affected movement, strength, walking or balance, neurological rehabilitation can help identify appropriate goals and support recovery.

If you notice sudden signs of stroke, call 999 immediately.