Stroke is a brain injury. It occurs when the brain's blood supply is interrupted. Without oxygen and nutrients from blood, brain tissue dies quickly (in less than 10 minutes). This causes a sudden function loss.
A stroke occurs when blood flow to the brain is blocked (called ischemic stroke). This is caused by one of the following:
A stroke may also occur if a blood vessel breaks and bleeds into or around the brain. This is called hemorrhagic stroke.
These risk factors increase your chance of developing a stroke. Tell your doctor if you have any of these risk factors.
Risk factors you can affect:
Risk factors you cannot affect:
Symptoms occur suddenly. They differ depending on the part of the brain affected. Also, multiple symptoms can happen at the same time. If you notice any of the symptoms below, call emergency help right away. Getting help immediately is important, because brain tissue dies quickly when deprived of oxygen.
Having a stroke is an emergency situation. Diagnosis includes:
Some tests may include:
Immediate treatment is needed to:
Other treatment aims to:
Other drugs are used to:
Other interventions during an acute stroke:
Some procedures can be done to prevent damage or allow blood flow back into the affected area after a stroke:
Other surgeries may be performed following a stroke or TIA to prevent a recurrence. Surgical techniques:
A study was done to compare endarterectomy to stenting. Even though endarterectomy is more invasive, it led to fewer deaths. It also had fewer repeat strokes than stenting within the first six months.
To help reduce your chance of getting a stroke, take the following steps:
RESOURCES:
American Heart Association
http://www.americanheart.org/
National Stroke Association
http://www.stroke.org/
CANADIAN RESOURCES:
Heart and Stroke Foundation of Canada
http://ww2.heartandstroke.ca/splash/
Prevent Stroke
http://www.preventstroke.ca/
References:
Adams H, Adams R, Del Zoppo G, Goldstein LB. Guidelines for the early management of patients with ischemic stroke: 2005 guidelines update: a scientific statement from the Stroke Council of the American Heart Association/American Stroke Association. Stroke. 2005;36:916-923.
Cerebrovascular disease, occlusive. Quick Answers to Medical Diagnosis and Therapy: http://www.accessmedicine.com.ezp-prod1.hul.harvard.edu/quickam.aspx.
Duncan PW, Zorowitz R, Bates B, et al. Stroke Council of the American Heart Association/American Stroke Association. Management of adult stroke rehabilitation care: a clinical practice guideline. Stroke. 2005;36:100-143.
Grau AJ, Barth C, Geletneky B, et al. Association between recent sports activity, sports activity in young adulthood, and stroke. Stroke. 2009;40:426-431. Epub 2008 Dec 24.
He K, Song Y, Daviglus ML, Liu K, Van Horn L, Dyer AR, Goldbourt U, Greenland P. Fish consumption and incidence of stroke: a meta-analysis of cohort studies. Stroke. 2004; 35(7):1538-1542.
Rowland LP, Merritt HH. Merritt's Neurology. 11th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2005.
Sacco RL, Adams R, Albers G, et al. Guidelines for prevention of stroke in patients with ischemic stroke or transient ischemic attack: a statement for healthcare professionals from the AHA/ASA Council on Stroke: co-sponsored by the Council on Cardiovascular Radiology and Intervention. Stroke. 2006;37:577-617.
Silver B. Ischemic stroke. In: Gilman S, ed. MedLink Neurology website. Available at: http://www.medlink.com. Accessed February 23, 2008.
Stroke. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/stroke/stroke.htm. Accessed June 25, 2008.
Stroke (acute management). EBSCO Publishing DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated October 27, 2009. Accessed November 8, 2009.
Stroke symptoms. National Stroke Association website. Available at: http://www.stroke.org/site/PageServer?pagename=SYMP. Accessed January 25, 2010.
Stroke treatment. American Heart Association website. Available at: http://www.americanheart.org/presenter.jhtml?identifier=4724. Accessed June 25, 2008.
What is stroke? National Stroke Association website. Available at: http://www.stroke.org/site/PageServer?pagename=STROKE. Accessed January 25, 2010.
11/20/06 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: Mas JL, Chatellier G, Beyssen B, et al. Endarterectomy versus stenting in patients with symptomatic severe carotid stenosis. N Engl J Med. 2006;355:1726-1729.
12/16/2008 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: Farquhar C, Marjoribanks J, Lethaby A, Suckling J, Lamberts Q. Long term hormone therapy for perimenopausal and postmenopausal women. Cochrane Database Syst Rev. 2008;CD004143.
10/9/2009 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: Mitchell PH, Veith RC, Becker KJ, et al. Brief psychosocial-behavioral intervention with antidepressant reduces poststroke depression significantly more than usual care with antidepressant: living well with stroke: randomized, controlled trial. Stroke. 2009;40:3073-3078.
Last reviewed November 2009 by J. Thomas Megerian, MD, PhD, FAAP
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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