What is a stroke?
A stroke occurs when blood flow to the brain is blocked, either
by narrowed blood vessels or blood clots or when there is bleeding in the
brain. Deprived of nutrients, brain nerve cells begin to die within a few
minutes. As a result, stroke can cause vision and sensory loss, problems with
walking and talking, or difficulty in thinking clearly. In many cases, the
effects of stroke are irreversible.
Some people are more at risk for stroke than others. Chronic health
conditions such as high blood pressure and diabetes can increase your risk,
as well as lifestyle choices such as smoking cigarettes, being overweight,
or drinking excessively. Men, African Americans, and people with a family
history of stroke have a higher risk as well. Warning signs include sudden
unexplained numbness, tingling or odd sensations (especially on one side),
slurred speech, blurred vision, weakness or problems with balance or coordination.
Atrial Fibrillation
If you have atrial fibrillation, the upper left chamber of your
heart beats rapidly and unpredictably, making it hard for all the blood in
the chamber to empty. The remaining blood tends to form clots that can travel
to any part of your body. If they travel to the brain, these clots can cause
a stroke. Treatment with anticoagulants (or blood-thinners) can prevent these
clots from forming. Aspirin also is used to reduce the risk of stroke. Current
studies show that treatment with anticoagulants can prevent over half of the
80,000 strokes that are caused annually by atrial fibrillation.
If you have atrial fibrillation, your health care provider may
recommend that you take an anticoagulant. If you do, you need to know:
- They may increase the risk of bleeding. Careful regular monitoring of blood
levels and proper dosage should keep this risk in check. Your health care
provider will tell you where to go for monitoring.
- When properly administered, they can prevent 20 strokes for every major
bleeding complication caused by the medicine.
- Most bleeding incidents are preventable and treatable.
- Certain drugs can interfere with proper anticoagulation. Antibiotics and
anticonvulsants are examples of drugs that can cause problems. Talk to your
physician or pharmacist for more complete information.
Preventing Stroke
It is now believed that stroke is as preventable as heart attack. In addition
to primary prevention tactics such as quitting smoking, drinking only in moderation,
and exercising, there are medical interventions that can decrease your risk
of stroke if you are in a high-risk group. Recent studies show that if you have
conditions known as atrial fibrillation or carotid artery disease, there are
interventions that can dramatically lower your risk of stroke.
Carotid Artery Disease
The carotid arteries run through the neck and supply blood to the brain. When
the walls of the carotid arteries are narrowed by fatty deposits known as plaque,
small clots in the blood can cut off blood supply to the brain and cause a stroke.
A surgical procedure known as a carotid endarterectomy clears arteries of plaque.
If you have had a minor stroke or symptoms that suggest you are at high risk
for a stroke, and there is evidence of severe blockage in your carotid arteries,
your health care provider may suggest you consider carotid endarterectomy as
a preventive procedure.
If you are considering this surgery, you should know:
- Certain tests may be required to confirm the diagnosis of carotid artery
disease. With angiography, a dye is injected into the artery, followed by
an x-ray to check for blockage. Magnetic resonance imaging (MRI) and ultrasonic
scans also can test for blockage without entering the arteries.
- Carotid endarterectomy carries some risks. There can be complications if
parts of the plaque break away during the procedure and block an artery to
the brain or if artery incisions leak.
It is much easier to prevent a stroke than to treat a patient who has had one.
Since strokes are preventable, by following the simple prevention tactics, being
aware of the symptoms and working with your healthcare professional, you can
greatly minimize your risk of stroke.
