Sepsis is a life-threatening condition where the body’s response to an infection causes widespread inflammation, potentially leading to organ damage. A stroke involves an interruption of blood supply to the brain, depriving brain cells of oxygen and nutrients. While distinct, sepsis can significantly increase an individual’s risk of experiencing a stroke.
How Sepsis Can Lead to Stroke
Sepsis triggers a systemic inflammatory response throughout the body. This widespread inflammation can damage the delicate inner lining of blood vessels, known as the endothelium. When compromised, the endothelium becomes a rougher surface where blood components are more likely to adhere and initiate clot formation.
The inflammatory process in sepsis activates platelets, making them hyperactive and “stickier.” This heightened platelet activity, combined with endothelial damage, promotes the widespread formation of tiny blood clots, or microthrombi. These small clots can dislodge and travel to the brain, blocking blood vessels and causing an ischemic stroke by cutting off oxygen supply.
In severe stages, sepsis can progress to septic shock, characterized by a drop in blood pressure. When systemic blood pressure falls too low, the brain may not receive adequate blood supply, even without physical blockages. This insufficient blood flow, known as hypoperfusion, can lead to widespread brain tissue damage due to lack of oxygen and vital nutrients, causing a type of ischemic stroke.
Sepsis can also stress the heart, leading to cardiac complications that heighten stroke risk. It can cause heart muscle dysfunction or irregular heart rhythms, such as atrial fibrillation. These heart issues contribute to stroke risk by allowing blood to pool and form clots within the heart chambers, which can then travel to the brain.
Furthermore, severe dysregulation of the body’s clotting and anti-clotting systems during sepsis poses dual risks. While excessive clot formation is a concern, this dysregulation can also impair the body’s ability to stop bleeding. In some instances, this can increase the risk of blood vessels rupturing within the brain, leading to a hemorrhagic stroke, though ischemic strokes are more common in the context of sepsis.
Recognizing the Warning Signs
Recognizing the warning signs of both sepsis and a potential stroke is important for timely intervention. Sepsis can manifest with general signs of infection combined with symptoms like fever or low body temperature, shivering, confusion or disorientation, extreme pain or discomfort, clammy or sweaty skin, and rapid breathing or heart rate.
If someone with an infection or suspected sepsis begins to show neurological changes, it could signal a stroke. The most recognized signs of stroke are remembered by the acronym FAST:
Face drooping: One side of the face may droop or feel numb.
Arm weakness: One arm might feel weak or numb, or drift downward when raised.
Speech difficulty: Slurred speech or trouble understanding what others are saying.
Time to call emergency services immediately if any of these signs are observed.
Other stroke symptoms include:
Sudden severe headache with no known cause.
Sudden trouble seeing in one or both eyes.
Sudden trouble walking, dizziness, or loss of balance or coordination.
Sudden numbness on one side of the body.
Any of these symptoms, especially in someone with an active infection or suspected sepsis, require immediate emergency medical attention. Prompt action can significantly improve outcomes for both sepsis and stroke.
Medical Response and Recovery
When a person experiences both sepsis and stroke, the medical response demands rapid, coordinated efforts. Emergency care prioritizes stabilizing the patient and initiating immediate diagnostic tests to confirm both conditions, guiding appropriate and timely treatment.
For sepsis, treatment involves rapid administration of broad-spectrum antibiotics to combat the underlying infection. Intravenous fluids support blood pressure and organ function, often alongside medications if blood pressure remains low. Supportive care for failing organs, such as mechanical ventilation or kidney dialysis, might also be necessary.
Stroke treatment depends on the type of stroke identified. For an ischemic stroke, caused by a blood clot, clot-busting medications like tissue plasminogen activator (tPA) may be administered within a specific time window. In some cases, mechanical thrombectomy, physically removing the clot, might be performed. If the stroke is hemorrhagic, caused by bleeding, treatment focuses on controlling the bleeding and managing intracranial pressure.
Following acute medical management, rehabilitation becomes a significant part of the recovery process, often beginning early. Patients engage in physical therapy to regain movement, occupational therapy to relearn daily activities, and speech therapy to address communication or swallowing difficulties. Recovery from stroke can be complex, and underlying sepsis can complicate rehabilitation, necessitating individualized approaches.
Reducing Your Risk
Reducing the risk of sepsis, and consequently sepsis-induced stroke, involves proactive health measures. A fundamental step is preventing infections, including practicing good hand hygiene, getting recommended vaccinations like the flu shot and pneumonia vaccine, and ensuring proper care for any wounds or cuts.
Managing existing chronic medical conditions effectively also plays a significant role in lowering risk. Conditions such as diabetes, heart disease, and kidney disease can increase susceptibility to severe infections and sepsis. Controlling these conditions helps bolster the body’s overall resilience.
Recognizing the early signs of infection and seeking prompt medical attention remains important. If an infection does not improve or worsens, or if symptoms suggestive of sepsis appear, immediate medical evaluation is necessary. Early treatment of sepsis can prevent its progression and reduce the likelihood of severe complications, including stroke.