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HomeHealth A-Z Stroke
Stroke
Risk of Stroke
Strokes should always be considered a medical emergency and treatment should be sought immediately.

Stroke

(stROKE)

Definition of Stroke

A stroke is a disease that affects the blood vessels that supply blood to the brain. Other names for stroke are "brain attack," cerebral infarction, cerebral hemorrhage, cerebral accident, cerebrovascular accident (CVA), and cerebrovascular disease.

Description of Stroke

Strokes are the third leading cause of death and the leading cause of disability in adults in the US.

A stroke occurs when blood flow to any portion of the brain is interrupted causing a sudden loss of brain function.   If the interruption is caused by a blood clot that stops blood flow to the brain it is called an ischemic stroke.  There are two types of ischemic strokes: cerebral thrombosis and cerebral embolism.  If the interruption is caused by a ruptured blood vessel and bleeding occurs in the brain it is called a hemorrhagic stoke.  There are two types of hemorrhagic strokes: subarachnoid hemorrhage and cerebral hemorrhage.

When a stroke occurs, the brain does not get the oxygen (from the blood) that it needs. Without oxygen, nerve cells in the affected area can't function and die within minutes.  Once the nerve cells die, the part of the body they control no longer function either.  The effects of a stroke can be devastating and irreversible because dead brain cells cannot be replaced.

The most common type of stroke is a cerebral thrombosis.  It is usually caused by atherosclerosis, a condition in which arteries become clogged from plaque that builds up over time on the blood vessel walls until it blocks blood flow to the brain.  With cerebral thrombosis, the clot does not travel.

A cerebral embolism occurs when a wandering clot or other particle is carried by the bloodstream until it gets stuck in a blood vessel that blocks the blood to the brain.  Strokes caused by embolism are usually caused by heart disorders.

While hemorrhagic strokes do not occur as often as ischemic strokes, they have a higher fatality rate.  A subarachnoid hemorrhage is when there is bleeding in the space between the brain and the skull, but not into the brain itself.  A cerebral hemorrhage is when a blood vessel bursts in the brain filling it with blood.  Hemorrhagic strokes can be caused by weak blood vessels or injury to the brain.

Causes and Risk Factors of Stroke

The primary risk factor of stroke is high blood pressure (hypertension).  Other risk factors include age (risk doubles each decade after age 35), family history of stroke, high cholesterol, diabetes, heart disease, and smoking.  Certain medications and birth control pills (especially if over 35 and smoke) can cause blood clots which in turn can increase the risk of stroke.  Men have more strokes than women, but a woman's risk increases during pregnancy and in the weeks immediately following pregnancy.

Strokes caused by bleeding into the brain are increased with cocaine use, alcohol abuse, bleeding disorders, and head injury.

Symptoms of Stroke

The symptoms of stroke vary based on what part of the brain is damaged and the severity of the damage.  A stroke is often characterized by a sudden development of one or more of the following symptoms: weakness or paralysis of any part of the body; numbness, tingling, or decreased sensation; loss of speech; vision changes; loss of muscular control, balance, or coordination; dizziness; memory loss; personality or mood changes; drowsiness or loss of consciousness.

All too often people don't recognize the symptoms of a stroke and delay seeking treatment because they are not aware that a stroke has occurred.  If the symptoms of stroke occur for less than twenty-four hours it may be a transient ischemic attack (TIA).  A TIA causes a temporary loss of brain function and warns of a possible future stroke.

Diagnosis of Stroke

Exams and tests are performed to determine the type, location, and cause of the stroke as well as to rule out other conditions that may be causing the symptoms.  A doctor will also want to know how the symptoms developed and will look for specific neurologic, motor, and sensory changes.

Treatment of Stroke

Treatment varies based on the severity and cause of the stroke, but strokes should always be considered a medical emergency. Hospitalization is almost always necessary and may include intensive care and life support.  The best way to reduce disability and remain alive is to seek immediate care so that the cause of the stroke can be determined and therapy started within three hours of when the stroke began.

Immediate treatment may include thrombolytic medicine to break up blood clots (only if treated within three hours of when the symptoms start), blood thinners, pain killers, high blood pressure medication, nutrients and fluids, or surgery.

Long term treatment focuses on preventing future strokes and recovering as much function as possible.  Therapy, rehabilitation, and recovery differs from person to person depending on a persons overall health and extent of brain damage. Unfortunately, most stroke survivors have long-term disabilities.  About fifty percent are able to live at home if they have medical assistance and about forty percent ten percent end up in a long-term facility such as a nursing home.  Only about ten percent of stroke survivors are able to recover all or most function.

Prevention of Stroke

While a person is unable to control age or heredity, there are many lifestyle choices that will help prevent or reduce the risk of having a stroke.  These choices are to follow a healthy low-fat diet, exercise regularly, lose weight if overweight, limit alcohol consumption (no more than 1 to 2 drinks a day), and (very important) to quit smoking.  It is also important to get screened for high blood pressure, have cholesterol levels checked and follow the doctor's recommended treatment for any contributing conditions that are present such as high blood pressure, diabetes, high cholesterol, and heart disease.  In order to help prevent strokes caused by bleeding in the brain, take appropriate safety measures to avoid falls and minimize injuries.

External Resources

National Stroke Association

National Institute of Neurological Disorders and Stroke

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