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Each year over 700,000 people in the United States suffer a stroke. On average, someone in the United States suffers a stroke every 45 seconds; every 3.1 minutes someone dies of a stroke. It is the number one cause of adult disability and the third leading cause of death in the United States today.
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A stroke, also known as a "brain attack," occurs when a blood clot blocks a blood vessel or artery, or when a blood vessel breaks, interrupting blood flow to the brain, depriving the brain of oxygen. When someone suffers from a stroke, the brain cells in the immediate area usually die within minutes to a few hours after the stroke starts. The dead brain cells release chemicals that set off a chain reaction that endangers brain cells in a larger, surrounding area of brain tissue. When part of the brain dies from lack of blood flow, the part of the body it controls is affected. Strokes can cause paralysis, affect language and vision, and can cause loss of independence and depression.
Ischemic (is-KEM-ik) stroke: This is the most common type of stroke, accounting for approximately 83 percent of all strokes. An ischemic stroke is caused by clots that block an artery and keep the brain from receiving oxygen and vital nutrients.
Hemorrhagic (hem-o-RAJ-ik) stroke: A hemorrhagic stroke, also known as a bleeding stroke, is caused by ruptured blood vessels which bleed into the brain. The sudden increase in pressure within the brain can cause damage to the brain cells surrounding the blood.
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If you or someone you know experience one ore more of the signs listed below, CALL 911 IMMEDIATELY! These changes may last more than a few minutes or may start, briefly subside, and then return.
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Sudden numbness or weakness of the face, arm, or leg, especially on one side of the body |
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Sudden confusion, trouble speaking or understanding |
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Sudden trouble seeing in one or both eyes |
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Sudden trouble walking, dizziness, loss of balance or coordination |
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Sudden, severe headache with no known cause |
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Sudden problems doing simple things like brushing teeth or tying a knot |
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There are several medical conditions that can increase your risk for stroke, as well as controllable lifestyle choices and uncontrollable factors.
Medical Conditions
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High blood pressure (140/90 mm Hg or higher) is the most important risk factor for stroke. It is important to have your blood pressure checked regularly since high blood pressure usually doesn't have specific symptoms or early warning signs. |
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Diabetes mellitus, defined as a fasting plasma glucose (blood sugar) of 126 mg/dL or more measured on two occasions, increases a person's risk of stroke. Many people with diabetes also have high blood pressure, high blood cholesterol and are overweight, which increases the risk of stroke even more. While diabetes is treatable, it should be monitored closely and managed by your doctor. |
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Carotid or other artery disease results when plaque builds up and the artery walls become narrowed by fatty deposits. The carotid arteries in your neck supply blood to your brain and if they become blocked by a blood clot a stroke may occur. |
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Peripheral artery disease is the narrowing of blood vessels carrying blood to leg and arm muscles. It is also caused by fatty buildups of plaque in artery walls. People with peripheral artery disease have a higher risk of carotid artery disease, which raises their risk of stroke. |
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Atrial fibrillation, a heart rhythm disorder where the heart's upper chambers quiver instead of beating effectively, can let the blood pool and clot. If a clot breaks off, enters the bloodstream and lodges in an artery leading to the brain, a stroke results. |
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Coronary heart disease or heart failure raises the risk of stroke. Dilated cardiomyopathy (an enlarged heart), heart valve disease and some types of congenital heart defects also raise the risk of stroke. |
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High blood cholesterol, 240 mg/dL or higher, is a major risk factor for heart disease, which raises the risk of stroke. Recent studies show that high levels of LDL ("bad") cholesterol (greater than 100 mg/dL) and triglycerides (blood fats, 150 mg/dL or higher) increase the risk of stroke in people with previous coronary heart disease, ischemic stroke or transient ischemic attack (TIA). Low levels (less than 40 mg/dL) of HDL ("good") cholesterol also may raise stroke risk. |
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A high red blood cell count thickens the blood and makes clots more likely, increaing the risk of stroke. Blood disorders such as this may be treated by removing blood cells or prescribing "blood thinners." |
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Sickle cell disease (also called sickle cell anemia) is a genetic disorder that mainly affects African Americans. "Sickled" red blood cells are less able to carry oxygen to the body's tissues and organs and they tend to stick to blood vessel walls, which can block arteries to the brain and cause a stroke. |
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Transient ischemic attacks or TIAs are "warning strokes" that produce stroke-like symptoms but do not result in lasting damage. Recognizing the sign of a TIA and properly treating it can reduce your risk of a major stroke. |
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Cigarette smoking is a major, preventable risk factor for stroke. The nicotine and carbon monoxide in tobacco smoke reduce the amount of oxygen in your blood and damage the walls of blood vessels, making clots more likely to form. Using some kinds of birth control pills combined with smoking cigarettes greatly increases stroke risk. |
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Being inactive, obese or both can increase your risk of high blood pressure, high blood cholesterol, diabetes, heart disease and stroke. |
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Drinking an average of more than one alcoholic drink a day for women or more than two drinks a day for men can raise blood pressure and may increase the risk for stroke. |
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Intravenous drug abuse carries a high risk of stroke. Cocaine use has been linked to strokes and heart attacks and has even been fatal first-time users. |
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Increasing age. Stroke is more common in people over 60. |
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Male sex. Men and women both have strokes, although stroke is more common at younger ages in men. |
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Heredity and ethnicity. Stroke is more common in people whose close relatives have had stroke at an early age. African-Americans and Hispanic Americans are at higher risk than white Americans. This may be due in part to high blood pressure and dietary differences. |
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Treatments for the two types of stroke are different because their mechanisms are different.
Ischemic stroke is treated by removing obstruction and restoring blood flow to the brain.
| ACUTE TREATMENT |
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Clot-busters, e.g., tPA
The most promising treatment for ischemic stroke is the FDA-approved clot-busting drug tPA, which must be administered within a three-hour window from the onset of symptoms to work best. tPA is effective only if given promptly, that's why it's extremely important to determine the type of stroke very quickly and why it's so critical that medical professionals and the public recognize stroke as a medical emergency and respond immediately.
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| PREVENTATIVE TREATMENT |
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Anticoagulants/Antiplatelets
Antiplatelet agents such as aspirin, and anticoagulants such as warfarin interfere with the blood's ability to clot and can play an important role in preventing stroke. |
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Carotid Endarterectomy
Carotid endarterectomy is a procedure in which blood vessel blockage is surgically removed from the carotid artery. |
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Angioplasty/Stents
Doctors sometimes use balloon angioplasty and implantable steel screens called stents to treat cardiovascular disease in which mechanical devices are used to remedy fatty buildup clogging the vessel. |
In hemorrhagic stroke, doctors introduce an obstruction to prevent rupture and bleeding of aneurysms and arteriovenous malformations.
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Surgical Intervention
For hemorrhagic stroke, surgical treatment is often recommended to either place a metal clip at the base, called the neck, of the aneurysm or to remove the abnormal vessels comprising an Arteriovenous Malformation (AVM). |
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Endovascular Procedures, e.g., "coils"
Endovascular procedures are less invasive and involve the use of a catheter introduced through a major artery in the leg or arm, guided to the aneurysm or AVM where it deposits a mechanical agent, such as a coil, to prevent rupture. |
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