A stroke occurs when blood flow to the brain is blocked, either by blood clots or narrowed blood vessels, or when there is bleeding in the brain. Deprived of nutrients, brain nerve cells begin to die within a few minutes. As a result, a stroke can cause sensory and vision loss, problems with talking and walking, or difficulty in thinking clearly. In many cases, the effects of stroke are irreversible.
There are 2 broad categories of stroke:
Diseased arteries can clog up completely as the plaque accumulates or can be shut down by clotting conditions called "embolism" and "thrombosis". When the arteries become plugged, the blood is no longer able to reach the brain and stroke results.
Thrombotic strokes are caused by fatty deposits (plaque) which have built up in the arteries carrying blood to the brain. This slows blood-flow and can cause clots to form on the plaque that narrows or blocks the flow of nutrients and oxygen to the brain.
An embolic stroke is caused by a blood clot formed in another part of the body which breaks loose, travels through the bloodstream, and then blocks an artery carrying nutrients and oxygen to the brain.
A hemorrhagic stroke takes place when an artery supplying blood bleeds into the brain. The ruptured blood vessel prevents needed oxygen and nutrients from reaching brain cells. One type of hemorrhagic stroke is caused when an artery which has weakened over time, bulges (called an aneurysm) and suddenly bursts.
Strokes are the 3rd leading cause of death in the U.S
Some people are more at risk for stroke than others. Chronic health conditions such as high blood pressure and diabetes can increase your risk, as well as lifestyle choices such as being overweight, smoking cigarettes, or drinking excessively. Men, African Americans, and people with a family history of stroke have a higher risk as well. If you have already had a stroke or a transient ischemic attack (referred to as a TIA or "mini-stroke"), you are also at highest risk. Warning signs include sudden unexplained numbness or tingling sensation especially on one side), blurred vision, slurred speech, clumsiness or stumbling.
What is a Transient Ischemic Attack (TIA)?
A TIA, or mini stroke, is a kind of ischemic stroke. Symptoms last a few minutes to a few hours and then disappear. Always report a TIA to your doctor. A TIA is often a sign that a more damaging stroke is on its way. Seek treatment right away, even if symptoms go away quickly.
Are you at risk for a stroke?
Having many risk factors does not automatically mean you will have a stroke and those with no or few risk factors may not necessarily avoid a stroke.
The National Stroke Association "Stroke Prevention Guidelines" advise patients to:
High blood pressure is the leading cause of stroke.
Signs and Symptoms of a Stroke
These symptoms signal a medical emergency! It is vital to seek emergency medical care at once. Call 911. Every minute counts! The majority of patients do not report to the emergency room until 24 hours after the onset of stroke symptoms. The longer a stroke victim waits before showing up at the emergency room, the more damage a stroke can do and the less recovery can be achieved.
Your goal is to show up at the emergency room less than 3 hours after the onset of stroke symptoms.
If you report to your doctor that you suffered a Transient Ischemic Attack (TIA), he or she will perform some tests.
A neurological and general physical examination will be taken first. As part of the history, the doctor will want to know which, if any, risk factors for stroke you have: high blood pressure, diabetes, irregular heartbeat, oral contraceptive use, heredity, other heart diseases, smoking, diet (especially high sodium and high cholesterol), obesity, lack of exercise, blood disorders, and heavy alcohol consumption.
Your doctor should then perform a detailed physical examination evaluating the heart, the blood vessels, and the nervous system in addition to specialized tests which will help determine whether other conditions might be causing the symptoms. One of those specialized tests is the non-invasive duplex evaluation of the carotid arteries.
Both of these tests are completely painless. No needles, x-rays, or dyes are used. They can be performed quickly, in about 10 minutes, and hospitalization is unnecessary.
The tests are performed using ultrasound equipment. This is the same safe technology used by doctors to look at unborn fetuses in pregnant women.
In a recent study published in The New England Journal of Medicine, it was concluded that ultrasound scanning of the carotid arteries is the single best predictor of stroke and heart disease.(2)
If the test results and symptoms point to carotid artery disease, the patient may have an angiogram, an x-ray test in which dye is injected into the arteries which lead to the brain. This shows the exact location of any narrowing, blockage, or other defect.
So what steps can you take to help prevent a stroke?
Aspirin for stroke prevention?
The investigators, all part of a team known as the Anti-thrombotic Trialists' Collaboration (ATC), looked at whether or not the anti-platelets cut patients' risk of heart attack, stroke and death from a cardiovascular cause.
They found that, overall, any anti-platelet therapy led to a 1/3 drop in heart attack risk, while the risk of non-fatal stroke fell by 25% and cardiovascular death risk declined by 16%.
Aspirin was the most widely studied anti-platelet. Based on this review, the evidence "supports daily doses of aspirin in the range of 75-150 mg for the long-term prevention of serious vascular events in high risk patients.
However the risks and benefits of aspirin therapy vary for each person. While the benefits may be significant for people who are at higher risk, healthy individuals should weigh the pros and cons of aspirin therapy carefully, in my opinion.
First, if you're going to start an aspirin regimen, I would recommend you take the baby aspirin - 81 mgs - not the adult aspirin. Whatever benefits aspirin offers can be derived from the 81 mgs dosage. Even then, unless you are in the high-risk category, I would advise you not to take aspirin more often than every other day. The problem with aspirin is the risk of bleeding, gastrointestinal hemorrhage and a possible increased risk of renal failure.
Taking aspirin isnít advised during a stroke, because not all strokes are caused by blood clots. Most strokes are caused by clots, but some are caused by ruptured blood vessels. Taking aspirin could actually make these bleeding strokes more severe.
If youre taking aspirin and you must undergo even a simple surgical procedure or dental extraction, you must tell the surgeon or dentist your aspirin dosage.
Vitamin E to reduce the risk of stroke?
Vitamin E may have a protective effect against ischemic strokes, researchers reported on April 20 2000 at the annual meeting of the American Academy of Neurology in Toronto, Canada. Their study showed that vitamin E supplements can reduce stroke risk by 53%.
Also, researchers from Columbia Presbyterian Medical Center (CPMC) of New York Presbyterian Hospital found a person's risk of stroke is reduced by 50% if he or she takes a vitamin E supplement each day.
So there appears to be some protective effect offered by vitamin E, although it must be said that not all the evidence is conclusive in this regard. In my opinion the best price for high quality vitamin E on the internet can be found here.
Gum disease leads to higher stroke risk
Common, chronic bacterial infections, including gum disease, urinary tract and lung infections, may increase the risk of atherosclerosis, a build-up of fatty plaques in the arteries that could lead to heart attack, study findings suggest.
Periodontal, or gum, disease is caused by a chronic, low-grade infection that is often not linked by physicians to other conditions such as conditions causing stroke. However, gum disease involves a large amount of bone and there is a lot of tissue in contact with that bone. From this contact, bacteria and inflammatory, toxic compounds can gain access to the blood stream, where they may have a detrimental effect on the lining of blood vessels. It is believed that inflammation plays an important role in stroke and heart disease.
Fish oil reduces the risk of stroke?
A study released in the January 17, 2001 issue of the "Journal of the American Medical Association" (4)suggests that fatty fish and omega-3 polyunsaturated fatty acid, such as that found in fish oil and flaxseed oil, may be as effective as daily aspirin therapy at reducing the risk of thrombotic stroke, but without the side effects of aspirin therapy.
Investigators tracked 79,839 female nurses from 1980 to 1994. At the beginning of the study, the subjects ranged in age from 34 to 59 years. Food frequency questionnaires were used to determine the women's intake of fish and omega-3 oil.
for various risk factors of cardiovascular
applied primarily to thrombotic strokes. The study found no
With increasing scientific evidence on the benefits of omega-3 fish oil, even the prestigious American Heart Association (AHA) has finally recommended the use of omega-3 fatty acids in the prevention of strokes and heart diseases. This was announced in the AHA meeting in Chicago, Illinois in December 2002.
Based on its review of all available scientific evidence, the AHA announced that omega-3 fatty acids benefit healthy people, people at high risk of cardiovascular disease as well as patients with cardiovascular disease.
Since omega-3 helps make the blood thinner to prevent it from clotting, it should not be taken by people on "blood thinners", as well as people on aspirin therapy.
There is an enormous amount of medical literature which testifies to the fact that omega-3 fish oils prevent and may help to ameliorate or reverse atherosclerosis, angina, heart attack, stroke, arrhythmias, congestive heart failure, and peripheral vascular disease. Fish oils help maintain the elasticity of artery walls, prevent blood clotting, reduce blood pressure and stabilize heart rhythm. (5-12)
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(1) Lavenson, George S. Jr., MD, RVT, FACS. Carotid Screening Preparing for the Future. Vascular Ultrasound Today 1997, 2 (5), pg. 64.
(2) O'Leary, D.H., MD, Polak, J.F., MD, Kronmal, R.A., Ph.D., Manolio, T.A., MD, Burke, G.L., MD., MS, Wolfson Jr., S.K., MD, Carotid-Artery Intima and Media Thickness as a Risk Factor For Myocardial Infarction and Stroke in Older Adults. The New England Journal of Medicine, 1999; 340:14-22.
(3) British Medical Journal January 12, 2002;324:71-86, 59-60
(4) JAMA, 2001; 285: 304-312. "Intake of Fish and Omega-3 Fatty Acids and Risk of Stroke in Women"
(5).Simopoulos, Artemis. Omega-3 fatty acids in health and disease and
in growth and development. American Journal of Clinical Nutrition, Vol.
54, 1991, pp. 438-63
(9). Daviglus, Martha L., et al. Fish consumption and the 30-year risk
of fatal myocardial infarction. New England Journal of Medicine, Vol.
336, April 10, 1997, pp. 1046-53
© 2002 Healing Daily