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Stroke
Stroke
is a cardiovascular disease. It affects the blood
vessels that supply blood to the brain.
When blood flow to the brain is
impaired, oxygen and important nutrients cannot be
delivered. The result is abnormal brain function.
Blood flow to the brain can be disrupted by either a
blockage or rupture of an artery to the brain. There
are many causes for a stroke.
This is a medical emergency. Prompt treatment
could mean the difference between life and death.
Early treatment can also minimize damage to your
brain and potential disability.
Stroke is the third leading
cause of death and the leading cause of adult
disability; only cardiovascular disease and cancer
cause more deaths annually.
Signs and symptoms
It's important to know the signs and symptoms of a stroke so that you or
someone you know can get prompt treatment. The most common signs and
symptoms include:
-
Sudden numbness,
weakness, or paralysis of the face, arm or leg usually on one side
of the body
-
Loss
of speech, or trouble talking or understanding speech (aphasia)
-
Sudden blurred,
double or decreased vision
-
Dizziness, loss of
balance or loss of coordination
-
A sudden, severe
"bolt out of the blue" headache or an unusual headache, which may be
accompanied by a stiff neck, facial pain, pain between the eyes,
vomiting or altered consciousness
-
Confusion, or
problems with memory, spatial orientation or perception
For most people, a stroke gives no warning. But one possible sign of an
impending stroke is a transient ischemic attack (TIA). A TIA is a
temporary interruption of blood flow to a part of your brain. The signs
and symptoms of TIA are the same as for a stroke, but they appear for a
shorter period several minutes to 24 hours and then disappear,
without leaving apparent permanent effects. You may have more than one
TIA, and the recurrent signs and symptoms may be similar or different. A
TIA indicates a serious underlying risk that a full-blown stroke may
follow. People who have had a TIA are nine times as likely to have a
stroke as are those who haven't had a TIA.
Causes
A
stroke is sometimes called a brain attack. It's caused by a problem with
the amount of blood in the brain. One type of stroke ischemic stroke
is caused by too little blood in the brain. The other main type of
stroke hemorrhagic stroke is caused by too much blood within the
brain cavity.
Ischemic stroke
About 80 percent of strokes are ischemic strokes. They occur when blood
clots or other particles block arteries to your brain and cause severely
reduced blood flow (ischemia). This deprives your brain cells of oxygen
and nutrients, and cells may begin to die within minutes. The most
common ischemic strokes are:
-
Thrombotic
stroke.
This type of stroke occurs when a blood clot (thrombus) forms in one
of the arteries that supply blood to your brain. A clot usually
forms in areas damaged by atherosclerosis a disease in which the
arteries are clogged by an accumulation of cholesterol-containing
fatty deposits (plaques). This process can occur within one of the
two carotid arteries of your neck that carry blood to
your brain, as well as in other arteries. An ischemic stroke may
also be caused by plaques that completely clog or markedly narrow an
artery. This narrowing is called stenosis.
-
Embolic stroke.
This type of stroke occurs when a blood clot or other particle forms
in a blood vessel away from the brain, but is swept through your
bloodstream to lodge in narrower brain arteries. This type of blood
clot is called an embolus. It's commonly caused by atrial
fibrillation, an abnormal heart rhythm caused by irregular beating
in the heart's two upper chambers.
Hemorrhagic stroke
Hemorrhage is the medical word for bleeding. Hemorrhagic stroke
occurs when a blood vessel in your brain leaks or ruptures. Hemorrhages
can result from a number of conditions that affect your blood vessels,
including uncontrolled high blood pressure (hypertension) and weak spots
in your blood vessel walls (aneurysms). A less common cause of
hemorrhage is the rupture of an arteriovenous malformation (AVM) a
malformed tangle of thin-walled blood vessels, present at birth. There
are two types of hemorrhagic stroke:
-
Intracerebral
hemorrhage.
In this type of stroke, a blood vessel in the brain bursts and
spills into the surrounding brain tissue and damages cells. Brain
cells beyond the leak are deprived of blood and are also damaged.
High blood pressure is the most common cause of this type of
hemorrhagic stroke. High blood pressure can cause small arteries
inside your brain to become brittle and susceptible to cracking and
rupture.
-
Subarachnoid
hemorrhage.
In this type of stroke, bleeding starts in a large artery on or near
the membrane surrounding the brain and spills into the space between
the surface of your brain and your skull. A subarachnoid hemorrhage
is often signaled by a sudden, severe "thunderclap" headache. This
type of stroke is commonly caused by the rupture of an aneurysm,
which can develop with age or result from a genetic predisposition.
After a subarachnoid hemorrhage, vessels may go into vasospasm, a
condition where arteries near the hemorrhage constrict erratically,
causing brain cell damage by further restricting or blocking blood
flow to portions of the brain.
Risk factors
Many factors can increase your risk of a stroke. A number of these
factors can also increase your chances of having a heart attack. They
include:
-
Family history.
Your risk of stroke is slightly greater if one of your parents or a
brother or sister has had a stroke or TIA.
-
Age.
Your risk of stroke increases as you get older.
-
Sex.
Stroke affects men and women about equally. But women are more
likely to die of stroke than are men.
-
Race.
Blacks are at greater risk of stroke than are people of other races.
This is partly due to a higher prevalence of high blood pressure and
diabetes.
-
High blood
pressure (hypertension).
High blood pressure is a risk factor for both ischemic and
hemorrhagic strokes. It can weaken and damage blood vessels in and
around your brain, leaving them vulnerable to atherosclerosis and
hemorrhage.
-
Undesirable
levels of blood cholesterol.
High levels of low-density lipoprotein (LDL) cholesterol, the "bad"
cholesterol, may increase your risk of atherosclerosis. In excess, LDLs and other materials build up on the lining of artery walls,
where they may harden into plaques. High levels of triglycerides,
another blood fat, also may increase your atherosclerosis risk. In
contrast, high levels of high-density lipoprotein (HDL) cholesterol,
the "good" cholesterol, reduce your risk of atherosclerosis by
escorting cholesterol out of your body through the liver.
-
Cigarette
smoking.
Smokers have a much higher risk of stroke than do nonsmokers.
Smoking contributes to plaques in your arteries. Nicotine makes your
heart work harder by increasing your heart rate and blood pressure.
The carbon monoxide in cigarette smoke replaces oxygen in your
blood, decreasing the amount of oxygen delivered to the walls of
your arteries and your tissues, including the tissues in your brain.
-
Diabetes.
Diabetes is a major risk factor for stroke. When you have diabetes,
your body not only can't handle sugar appropriately but also can't
process fats efficiently, and you're at greater risk of high blood
pressure. These diabetes-related effects increase your risk of
developing atherosclerosis. Diabetes also interferes with your
body's ability to break down blood clots, increasing your risk of
ischemic stroke.
-
Obesity.
Being overweight increases your chance of developing high blood
pressure, heart disease, atherosclerosis and diabetes all of which
increase stroke risk.
-
Cardiovascular
disease.
Several cardiovascular diseases can increase your risk of a stroke,
including congestive heart failure, a previous heart attack, an
infection of a heart valve (endocarditis), a particular type of
abnormal heart rhythm (atrial fibrillation), aortic or mitral valve
disease, valve replacement, or a hole in the upper chambers of the
heart known as patent foramen ovale. Atrial fibrillation is the most
common condition associated with strokes caused by embolic clots. In
addition, atherosclerosis in blood vessels near your heart may
indicate that you have atherosclerosis in other blood vessels
including those in and around your brain.
-
Previous stroke
or TIA.
If you've already had a stroke, your risk of having another one
increases. In addition, people who have had a TIA are nine times as
likely to have a stroke as are those who haven't had a TIA.
-
Elevated
homocysteine level.
This amino acid, a building block of proteins, occurs naturally in
your blood. But people with elevated levels of homocysteine have a
higher risk of heart and blood vessel damage.
-
Use of birth
control pills.
The risk of stroke is higher among women who take birth control
pills, especially among smokers and women older than 35. However,
today's low-dose pills carry a much lower risk than their earlier
counterparts.
Other factors that can increase your risk of stroke include heavy or
binge drinking, the use of illicit drugs such as cocaine, and
uncontrolled stress.
When to seek medical advice
If you notice any signs of a stroke or TIA, get medical help right away.
A TIA may seem like a passing event. But it can be an important warning
sign and a chance to take steps that may prevent a stroke.
If someone appears to be having a stroke, watch the person carefully
while waiting for an ambulance. You may need to take additional actions
in the following situations:
-
If breathing
ceases, begin resuscitation.
-
If vomiting
occurs, turn the person's head to the side. This can prevent
choking.
-
Don't
let the person eat or drink anything.
Every minute counts when it comes to treating a stroke. The longer a
stroke goes untreated, the greater the damage and potential disability.
The success of most treatments depends on how soon a person is seen by a
doctor in a hospital emergency room after signs and symptoms begin.
Stroke
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Disclaimer
This information is
provided for general medical education purposes only and
is not meant to substitute for the independent medical
judgment of a physician relative to diagnostic and
treatment options of a specific patient's medical
condition.
In no event will The DrEddyClinic.com be liable for any
decision made or action taken in reliance upon the
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