About Stroke
Each year in the United States, there are more than 700,000 new strokes. Stroke is the third leading cause of death in the country, after heart disease and cancer. And stroke causes more serious long-term disabilities than any other disease. Nearly three-quarters of all strokes occur in people over the age of 65. And the risk of having a stroke more than doubles each decade after the age of 55.
About Stroke - What is Stroke?
Stroke occurs in all age groups, in both sexes, and in all races in every country. It can even occur before birth, when the fetus is still in the womb.
Learning about stroke can help you act in time to save a relative, neighbor, or friend. And making changes in your lifestyle can help you prevent stroke.
A stroke is serious, just like a heart attack. A stroke is sometimes called a "brain attack." Most often, stroke occurs when blood flow to the brain stops because it is blocked by a clot. When this happens, the brain cells in the immediate area begin to die.
Some brain cells die because they stop getting the oxygen and nutrients they need to function. Other brain cells die because they are damaged by sudden bleeding into or around the brain. The brain cells that don't die immediately remain at risk for death. These cells can linger in a compromised or weakened state for several hours. With timely treatment, these cells can be saved.
New treatments are available that greatly reduce the damage caused by a stroke. But you need to arrive at the hospital as soon as possible after symptoms start to prevent disability. Knowing stroke symptoms, calling 911 immediately, and getting to a hospital as quickly as possible are critical.
There are two kinds of stroke. The most common kind of stroke is called ischemic stroke. It accounts for approximately 80 percent of all strokes. An ischemic stroke is caused by a blood clot that blocks or plugs a blood vessel in the brain.
Blockages that cause ischemic strokes stem from three conditions:
- the formation of a clot within a blood vessel of the brain or neck, called thrombosis
- the movement of a clot from another part of the body, such as from the heart to the neck or brain, called an embolism
- a severe narrowing of an artery in or leading to the brain, called stenosis
The other kind of stroke is called hemorrhagic stroke. A hemorrhagic stroke is caused by a blood vessel that breaks and bleeds into the brain.
One common cause of a hemorrhagic stroke is a bleeding aneurysm. An aneurysm is a weak or thin spot on an artery wall. Over time, these weak spots stretch or balloon out due to high blood pressure. The thin walls of these ballooning aneurysms can rupture and spill blood into the space surrounding brain cells.
Artery walls can also break open because they become encrusted, or covered with fatty deposits called plaque, eventually lose their elasticity and become brittle, thin, and prone to cracking. Hypertension, or high blood pressure, increases the risk that a brittle artery wall will give way and release blood into the surrounding brain tissue.
Quiz
1. A stroke is sometimes called a brain attack.
TRUE is the correct answer. A stroke is sometimes called a brain attack. It is serious, just like a heart attack. Most often, stroke occurs when blood flow to the brain stops because it is blocked by a clot.
2. The two types of stroke are ischemic and hemorrhagic.
TRUE is the correct answer. The two kinds of stroke are ischemic and hemorrhagic. An ischemic stroke is caused by a blood clot that blocks or plugs a blood vessel in the brain. A hemorrhagic stroke is caused by a blood vessel that breaks and bleeds into the brain.
3. The most common kind of stroke is hemorrhagic.
FALSE is the correct answer. Ischemic strokes are more common than hemorrhagic strokes. Ischemic strokes account for approximately 80 percent of all strokes.
4. An embolism occurs when a blood clot moves from one part of the body to another, such as from the heart to the neck or brain.
TRUE is the correct answer. The movement of a blood clot from one part of the body to another is called an embolism.
About Stroke - Effects of a Stroke
Stroke damage in the brain can affect the entire body -- resulting in mild to severe disabilities. These include paralysis, problems with thinking, trouble speaking, and emotional problems.
A common disability that results from stroke is complete paralysis on one side of the body, called hemiplegia. A related disability that is not as debilitating as paralysis is one-sided weakness, or hemiparesis. The paralysis or weakness may affect only the face, an arm, or a leg, or it may affect one entire side of the body and face.
A stroke patient may have problems with the simplest of daily activities, such as walking, dressing, eating, and using the bathroom. Movement problems can result from damage to the part of the brain that controls balance and coordination. Some stroke patients also have trouble swallowing, called dysphagia.
Stroke may cause problems with thinking, awareness, attention, learning, judgment, and memory.
In some cases of stroke, the patient suffers a neglect syndrome. The neglect syndrome means that the stroke patient has no knowledge of one side of his or her body, or one side of the visual field, and is unaware of the problem. A stroke patient may be unaware of his or her surroundings, or may be unaware of the mental problems that resulted from the stroke.
Stroke victims often have a problem forming or understanding speech. This problem is called aphasia. Aphasia usually occurs along with similar problems in reading and writing. In most people, language problems result from damage to the left hemisphere of the brain.
Slurred speech due to weakness or incoordination of the muscles involved in speaking is called dysarthria, and is not a problem with language. Because it can result from any weakness or incoordination of the speech muscles, dysarthria can arise from damage to either side of the brain.
A stroke can also lead to emotional problems. Stroke patients may have difficulty controlling their emotions or may express inappropriate emotions in certain situations. One common disability that occurs with many stroke patients is depression.
Post-stroke depression may be more than a general sadness resulting from the stroke incident. It is a serious behavioral problem that can hamper recovery and rehabilitation and may even lead to suicide. Post-stroke depression is treated as any depression is treated, with antidepressant medications and therapy.
Stroke patients may experience pain, uncomfortable numbness, or strange sensations after a stroke. These sensations may be due to many factors, including damage to the sensory regions of the brain, stiff joints, or a disabled limb.
An uncommon type of pain resulting from stroke is called central stroke pain or central pain syndrome or CPS. CPS results from damage to an area called the thalamus. The pain is a mixture of sensations, including heat and cold, burning, tingling, numbness, and sharp stabbing and underlying aching pain.
The pain is often worse in the hands and feet and is made worse by movement and temperature changes, especially cold temperatures. Unfortunately, since most pain medications provide little relief from these sensations, very few treatments or therapies exist to combat CPS.
Quiz
1. A common disability that results from stroke is paralysis on one side of the body, called
A. hemiparesis
B. dysarthria
C. hemiplegia
C is the correct answer. A common disability that results from stroke is paralysis on one side of the body, called hemiplegia. A related disability that is not as debilitating as paralysis is one-sided weakness or hemiparesis. The paralysis or weakness may affect one entire side of the body and face.
2. A problem forming or understanding speech is called
A. dysarthria
B. aphasia
C. dysphagia
B is the correct answer. A deficit in forming or understanding speech is called aphasia. Slurred speech due to weakness or incoordination of the muscles involved in speaking is called dysarthria. Trouble swallowing is called dysphagia.
3. One common disability that occurs with many stroke patients is
A. depression
B. hearing loss
C. arthritis
A is the correct answer. One common disability that occurs with many stroke patients is depression. Post-stroke depression may be more than a general sadness resulting from the stroke incident. It is a serious behavioral problem that can hamper recovery and rehabilitation and may even lead to suicide.
4. An uncommon type of pain resulting from stroke is called
A. central nervous system pain, or CNS
B. central stroke pain or central pain syndrome or CPS
C. mid-brain pain, or MBP
B is the correct answer. An uncommon type of pain resulting from stroke is called central stroke pain or central pain syndrome or CPS. CPS results from damage to an area called the thalamus. The pain is a mixture of sensations, including heat and cold, burning, tingling, numbness, and sharp stabbing and underlying aching pain.
Warning Signs and Risk Factors
Two key steps you can take will lower your risk of death or disability from stroke. These are knowing stroke's warning signs and controlling stroke's risk factors.
Warning Signs and Risk Factors - Warning Signs
If you suffer a stroke, you may not realize it at first. The people around you might not know it, either. Your family, friends, or neighbors may think you are unaware or confused. You may not be able to call 911 on your own. That's why everyone should know the signs of stroke and know how to act fast.
Warning signs are clues your body sends to tell you that your brain is not receiving enough oxygen. If you observe one or more of the following signs of a stroke or "brain attack," don't wait. Call a doctor or 911 right away!
These are warning signs of a stroke:
- sudden numbness or weakness of the face, arm, or leg, especially on one side of the body
- sudden confusion, trouble speaking or understanding
- sudden trouble seeing in one or both eyes
Warning signs of a stroke:
- sudden trouble walking, dizziness, loss of balance or coordination
- sudden severe headache with no known cause
Other danger signs that may occur include double vision, drowsiness, and nausea or vomiting. Sometimes the warning signs may last only a few moments and then disappear. These brief episodes, known as transient ischemic attacks, or TIAs, are sometimes called "mini-strokes."
Although brief, TIAs identify an underlying serious condition that isn't going away without medical help. Unfortunately, since they clear up, many people ignore them. Don't ignore them. Heeding them can save your life.
What should you do? Dont wait for the symptoms to improve or worsen. If you believe you are having a stroke or someone you know is having a stroke, call 911 immediately. Making the decision to call for medical help can make the difference in avoiding a lifelong disability.
Quiz
1. A warning sign is a clue your body sends to tell you that your brain is not receiving enough oxygen.
TRUE is the correct answer. A warning sign is a clue your body sends to tell you that your brain is not receiving enough oxygen. If you observe one or more of the warning signs of a stroke or "brain attack," don't wait, call a doctor or 911 right away!
2. A transient ischemic attack, or TIA, is another name for a full-blown stroke.
FALSE is the correct answer. A transient ischemic attack, or TIA, is a brief episode sometimes called a mini-stroke. Although brief, TIAs identify an underlying serious condition that isn't going away without medical help. A TIA is a stroke and should not be ignored.
3. Sudden confusion, trouble speaking or understanding, and sudden numbness or weakness of face, arm, or leg are warning signs of a stroke.
TRUE is the correct answer. Sudden confusion, trouble speaking or understanding, and sudden numbness or weakness of face, arm, or leg, especially on one side of the body, are warning signs of a stroke. Other warning signs of a stroke are sudden trouble seeing in one or both eyes, sudden trouble walking, dizziness, loss of balance or coordination, and sudden severe headache with no known cause.
4. If you think you are having a stroke, you should wait to see if the symptoms get worse.
FALSE is the correct answer. If you believe you are having a stroke or someone you know is having a stroke, don't wait for the symptoms to improve or worsen. Call 911 immediately! Making the decision to call for medical help can make the difference in avoiding a lifelong disability.
Warning Signs and Risk Factors - Risk Factors
A risk factor is a condition or behavior that increases your chances of getting a disease. Having a risk factor for stroke doesn't mean you'll have a stroke. On the other hand, not having a risk factor doesn't mean you'll avoid a stroke. But your risk of stroke grows as the number and severity of risk factors increase.
High blood pressure, also called hypertension, is by far the most potent risk factor for stroke. If your blood pressure is high, you and your doctor need to work out an individual strategy to bring it down to the normal range. Here are some ways to reduce blood pressure:
- Maintain proper weight.
- Avoid drugs known to raise blood pressure.
Ways to reduce blood pressure:
- Cut down on salt.
- Eat fruits and vegetables to increase potassium in your diet.
- Exercise more.
Your doctor may prescribe medicines that help lower blood pressure. Controlling blood pressure will also help you avoid heart disease, diabetes, and kidney failure.
Cigarette smoking has been linked to the buildup of fatty substances in the carotid artery, the main neck artery supplying blood to the brain. Blockage of this artery is the leading cause of stroke in Americans. Also, nicotine raises blood pressure, carbon monoxide reduces the amount of oxygen your blood can carry to the brain, and cigarette smoke makes your blood thicker and more likely to clot.
Your doctor can recommend programs and medications that may help you quit smoking. By quitting -- at any age -- you also reduce your risk of lung disease, heart disease, and a number of cancers including lung cancer.
Heart disease, including common heart disorders such as coronary artery disease, valve defects, irregular heart beat, and enlargement of one of the heart's chambers, can result in blood clots that may break loose and block vessels in or leading to the brain. The most common blood vessel disease, caused by the buildup of fatty deposits in the arteries, is called atherosclerosis, also known as hardening of the arteries.
Your doctor will treat your heart disease and may also prescribe medication, such as aspirin, to help prevent the formation of clots. Your doctor may recommend surgery to clean out a clogged neck artery if you match a particular risk profile. A high level of total cholesterol in the blood is a major risk factor for heart disease, which raises your risk of stroke. Your doctor may recommend changes in your diet or medicines to lower your cholesterol.
Experiencing warning signs and having a history of stroke are also risk factors for stroke. Transient ischemic attacks, or TIAs, are brief episodes of stroke warning signs that may last only a few moments and then go away. If you experience a TIA, get help at once. Most communities encourage those with stroke's warning signs to dial 911 for emergency medical assistance.
If you have had a stroke in the past, it's important to reduce your risk of a second stroke. Your brain helps you recover from a stroke by drawing on body systems that now do double duty. That means a second stroke can be twice as bad.
Having diabetes is another risk factor for stroke. You may think this disorder affects only the body's ability to use sugar, or glucose. But it also causes destructive changes in the blood vessels throughout the body, including the brain.
Also, if blood glucose levels are high at the time of a stroke, then brain damage is usually more severe and extensive than when blood glucose is well-controlled. Treating diabetes can delay the onset of complications that increase the risk of stroke.
Quiz
1. Having a risk factor for stroke means you will have a stroke.
FALSE is the correct answer. Having a risk factor for stroke does not mean you will have a stroke. However, not having a risk factor does not mean you will avoid a stroke. Your risk of stroke grows as the number and severity of risk factors increase.
2. Cigarette smoking has been linked to the buildup of fatty substances in the carotid artery.
TRUE is the correct answer. Cigarette smoking has been linked to the buildup of fatty substances in the carotid artery, the main artery supplying blood to the brain. Blockage of this artery is the leading cause of stroke in Americans.
3. The most common blood vessel disease is diabetes.
FALSE is the correct answer. Atherosclerosis, or hardening of the arteries, is the most common blood vessel disease. It is caused by the buildup of fatty deposits in the arteries.
4. Diabetes can cause destructive changes in the blood vessels throughout the body, including the brain.
TRUE is the correct answer. Although diabetes affects the body's ability to use sugar, or glucose, it also causes destructive changes in the blood vessels throughout the body, including the brain. Also, if blood glucose levels are high at the time of a stroke, the brain damage is usually more severe and extensive than when blood glucose is well-controlled.
