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Stroke: Prevention and Treatment

Thanks to new tests that help predict stroke, treatments that help control high blood pressure, and good health habits that many Americans are practicing, the death rate from stroke is down as much as 50 percent since 1970. Still, stroke is the third leading cause of death in the United States and the leading cause of disability among adults.



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What Is a Stroke?

A stroke is a sudden partial loss of brain function usually caused by a clot that stops the flow of blood to an area of the brain. Without oxygen and important nutrients, the affected brain cells are either damaged or die within a few minutes.

While cell damage can be repaired and the lost function regained, the death of brain cells is permanent. Most strokes are caused by a blood clot or narrowing of a blood vessel (artery) leading to the brain. Other strokes are caused by a hemorrhage (bleeding) from an artery. There are three major types of strokes:

Thrombotic strokes are caused by fatty deposits (plaques) that have built up in the arteries carrying blood to the brain. This slows the blood flow until a blood clot completely blocks the artery and the flow of oxygen and nutrients to the brain.

An embolic stroke is caused by a blood clot formed in another part of the body that breaks loose, travels through the bloodstream, and blocks an artery carrying oxygen and nutrients to the brain. When traveling through the body the blood clot is called an embolus.

A hemorrhagic stroke is caused when an artery supplying blood bleeds into the brain. The broken blood vessel prevents needed oxygen and nutrients from reaching the brain cells. One type of hemorrhagic stroke is caused when an artery that has weakened over time bulges (called an aneurysm) and suddenly breaks.

Diagnosis and Treatment

A stroke requires immediate medical care. Research shows that treatment during the first hours after symptoms appear can be important for the best possible recovery. An emergency doctor or neurologist (a doctor who diagnoses and treats disorders of the brain and nervous system) will provide emergency treatment. Then a family doctor, internist, or geriatrician can step in and provide longer term care.

Doctors make an early diagnosis by looking at symptoms, reviewing the patientís medical history, and performing tests such as a computerized tomography scan--a 3-dimensional

x-ray technique to take pictures of the brain.

What You Can Do to Prevent a Stroke

A stroke was once viewed as a single damaging attack, but we now know it develops over many years. The risk factors or conditions that may lead to stroke include high blood pressure, smoking, heart disease, and diabetes. The risk of stroke increases with age and is higher in African Americans and Hispanics than in whites.

You can reduce your stroke risk by taking the following steps:

  • Control your blood pressure. Have your blood pressure checked often, and, if it is high, follow your doctorís advice on how to lower it. Treating high blood pressure reduces the risk for both stroke and heart disease.
  • Stop smoking. Cigarette smoking is linked to increased risk for stroke. Research shows that the risk of stroke for people who have quit smoking for 2-5 years is lower than for smokers.

Exercise regularly. Researchers think that exercise may make the heart stronger and improve circulation. It also helps control weight. Being overweight increases the chance of high blood pressure, atherosclerosis, heart disease, and adult-onset (type II) diabetes.

Physical activities like brisk walking, cycling, swimming, and yard work lower the risk of both stroke and heart disease. Talk with your doctor before starting an exercise program.

  • Eat a healthy diet. Choose, prepare, and eat foods low in fats, saturated fatty acids, and cholesterol. Eat a variety of fruits and vegetables.
  • Control diabetes. If untreated, diabetes can damage the blood vessels throughout the body and lead to atherosclerosis.
  • Promptly report warning signs or symptoms to your doctor. The warning signs for stroke are a sudden, unexplained tingling and/or numbness on one side of the body, a sudden severe headache, blurred vision, difficulty talking, stumbling and/or sudden clumsiness. Sometimes a mini-stroke, lasting only a few moments and called a transient ischemic attack (TIA), comes before a stroke.

Rehabilitation for Stroke

Rehabilitation should begin as soon as possible after the patient is stable. It often continues after the patient has gone home. Stroke rehabilitation includes many kinds of therapies: physical therapy to strengthen muscles and improve balance and coordination; speech and language therapy; and occupational therapy to improve eye-hand coordination and skills needed for tasks such as bathing and cooking. A team of health care experts (physicians, physical and occupational therapists, nurses, social workers, and speech and language specialists) coordinates activities for the patient and family.

Rehabilitation progress varies from person to person. For some, recovery is completed within weeks following a stroke; for others, it may take many months or years.

Where to Get Help

National Institute of Neurological Disorders and Stroke
Information Office
P.O. Box 5801
Bethesda, MD 20824

National High Blood Pressure Education Program
P.O. Box 30105 Bethesda, MD 20824

The National Stroke Association
96 Inverness Drive East
Suite I
Englewood, CO 80112-5112

American Heart Association
7272 Greenville Avenue
Dallas, TX 75231



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