How to prevent a stroke?
Prevention is an important public health concern. Identification of patients with treatable risk factors for stroke is paramount. Treatment of risk factors in patients who have already had strokes (secondary prevention) is also very important as they are at high risk of subsequent events compared with those who have never had a stroke. Medication or drug therapy is the most common method of stroke prevention. Surgery such as Carotid endarterectomy can be used to remove significant narrowing
of the neck (internal) carotid artery which supplies blood to the brain and this operation has been shown to be an effective way to prevent stroke in particular groups of patients.
Some brain damage that results from stroke may be secondary to the initial death of brain cells caused by the lack of blood flow to the brain tissue. This brain damage is a result of a toxic reaction to the primary damage. Researchers are studying the mechanisms of this toxic reaction and ways to prevent this secondary injury to the brain. Scientists hope to develop neuroprotective agents to prevent this damage. Another area of research involves experiments with vasodilators, medications that expand or dilate blood vessels and thus increase the blood flow to the brain. Basic research has also focused on the genetics of stroke and stroke risk factors. One area of research involving genetics is gene therapy. One promising area of stroke animal research involves hibernation. The dramatic decrease of blood flow to the brain in hibernating animals is extensive enough that it would kill a non-hibernating animal. If scientists can discover how animals hibernate without experiencing brain damage, then maybe they can discover ways to stop the brain damage associated with decreased blood flow in stroke patients. Other studies are looking at the role of hypothermia, or decreased body temperature, on metabolism and neuroprotection. Scientists are working to develop new and better ways to help the brain repair itself and restore important functions to the stroke patients. Some evidence suggests that transcranial magnetic stimulation (TMS), in which a small magnetic current is delivered to an area of the brain, may possibly increase brain plasticity and speed up recovery of function after stroke.
The possibility of suffering a stroke can be markedly decreased by controlling the risk factors. The most important risk factor for stroke is high blood pressure. When a person's blood pressure is persistently too high, roughly greater than 140/90, the risk of a stroke increases in proportion to the degree by which the blood pressure is elevated. Controlling blood pressure in the normal range decreases the chances of a stroke. Another important risk factor is cigarette or other tobacco use. Cigarettes cause the carotid arteries to develop severe atherosclerosis, which can lead to their closure and block the blood flow to the brain. Atherosclerosis in general, including involvement of the arteries that supply blood to the heart, is accelerated by smoking. So, when an individual smokes, the main question becomes - which will occur first; a stroke, heart attack, or lung cancer?
Another risk factor for developing a stroke is diabetes mellitus. Diabetes causes the small vessels to close prematurely. When these blood vessels close in the brain, small (lacunar) strokes may occur. Good control of blood sugar is important in decreasing the risk of stroke in diabetic patients. An elevated level of blood cholesterol is also a risk factor for a stroke due to the eventual blockage of blood vessels (atherosclerosis). A low cholesterol diet and medications can help normalize an elevated blood cholesterol level.
An irregular heart beat (atrial fibrillation in particular) is associated with an increased risk of an embolic stroke, in which the blood clot travels from the heart, through the bloodstream, and into the brain. Warfarin (Coumadin) is a blood "thinner" that prevents the blood from clotting. This medication is often used in patients with atrial fibrillation to decrease this risk. For more information, please see the Atrial Fibrillation article. Warfarin is also sometimes used to prevent the recurrence of a stroke in other situations, such as with certain other heart conditions and conditions in which the blood has a tendency to clot on its own (hypercoagulable states). Patients taking warfarin need to have periodic blood checks to make sure that their current dose is producing the desired effect. Patients on warfarin also need to know that they are at increased risk for bleeding, either externally or internally.
More information on the stroke
What is a stroke? - Stroke (cerebrovascular accident) is a sudden loss of consciousness resulting when the rupture or occlusion of a blood vessel leads to oxygen lack in the brain.
What're the different types of strokes? - There are two main types of stroke. Ischemic stroke is the most common type of stroke. Hemorrhagic stroke is caused by bleeding.
What is ischemic stroke? - Ischemic stroke is the most common type. Ischemic stroke can further be divided into two main types: thrombotic and embolic.
What is a thrombotic stroke? - Thrombotic strokes are strokes caused by a thrombus (blood clot) that develops in the arteries supplying blood to the brain.
What is an embolic stroke? - Embolic strokes often result from heart disease or heart surgery and occur rapidly and without any warning signs.
What's transient ischemic attack (TIA) or mini stroke? - A transient ischemic attack (TIA) is often called a mini stroke. A transient ischemic attack (TIA) is a transient stroke that lasts only a few minutes.
What is hemorrhagic stroke? - In hemorrhagic stroke, bleeding in the brain itself or between the brain and the skull (subarachnoid hemorrhage) disrupts brain function.
What is an intracerebral hemorrhage? - Intracerebral hemorrhage is usually caused by hypertension (high blood pressure), and bleeding occurs suddenly and rapidly.
What is a subarachnoid hemorrhage? - Subarachnoid hemorrhage results when bleeding occurs between the brain and the meninges in the subarachnoid space.
What causes a stroke? - Stroke caused by damage to blood vessels in the brain. The ischemic stroke is usually caused by atherosclerosis (hardening) of blood vessels.
What are the symptoms of a stroke? - The symptoms of a stroke depend on what part of the brain and how much of the brain tissue is affected. Stroke symptoms usually come on suddenly.
What are the risk factors for a stroke? - Risk factors for a stroke include high blood pressure (hypertension), atherosclerosis, cigarette smoking, atrial fibrillation, diabetes.
How is a stroke diagnosed? - Stroke is diagnosed through several techniques: a short neurological examination, blood tests, CT scans or MRI scans, Doppler ultrasound, and arteriography.
What's the treatment for a stroke? - The aim of the therapy is to minimise the size of the stroke and therefore minimise subsequent disability by restoring blood flow to the area of the brain affected quickly.
What medications can be used for stroke treatment? - Intravenous thrombolytics. clot-busting, or thrombolytic drugs are now administered intravenously for ischemic (not hemorrhagic) stroke.
What can be done to prevent a stroke? - Prevention of stoke is an important public health concern. Medication or drug therapy is the most common method of stroke prevention.
What're the surgical treatments for stroke? - Surgical treatments for stroke include carotid endarterectomy, angioplasty, clipping. Clipping involves clamping off the aneurysm.
How to recover from a stroke? - Spontaneous recovery accounts for most improvements in the first month after a stroke. Successful recovery after a stroke depends on the extent of brain damage.
What is stroke rehabilitation? - Stroke rehabilitation is the process by which patients with disabling strokes undergo treatment to help them return to normal life.