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