Preventing a Stroke
A cardiologist is often asked about signs and symptoms of heart disease and warnings of heart attacks and early death. Some patients do recognize that though a heart attack can be a setback in life, most survive the episode and return to normal function, but even a small stroke will alter a whole life style. One of the questions that I am frequently asked is what can be done to prevent or recognize signs of a stroke. Unfortunately, this often comes after a family member is stricken, and is associated with guilt for not having known. Along with the sorrow over loss of bodily function comes anger, often misdirected at family, treating physicians, and employers who are perceived as not doing enough to accommodate the loss, or who are misperceived as being responsible. In the past I have heard stroke blamed on the stress caused by family, or job, and in a recent malpractice case blamed on failure of the doctors to prevent it.
What is a stroke?
A stroke is also called a cerebrovascular accident. There is a sudden problem in a blood vessel of the brain causing either leakage of blood into the brain, or clotting of blood in the vessels to the brain. In the case of leakage, it occurs because there is a weak spot in the blood vessel (such as an inherited aneurysm). In the case of clotting (also called thrombosis) it occurs because there is a clot that has gotten into the brain either from the heart, one of the great blood vessels (the aorta, carotid, or vertebrobasilar arteries), or because of arteriosclerosis or plaque that forms in the brain’s blood vessels just as it can form in blood vessels in the heart or rest of the body. The interruption of blood supply, or blood seeping into the brain causes damage. Depending upon the area in the brain that is damaged, the signs may be different. A problem in the speech area will disturb speech; in the motor area, paralysis. The larger the area affected, the more the deficit.
Risk factors for stroke can be broken into those that are non-modifiable such as age (strokes occur more frequently as we age), gender (not sexual orientation, surgeries don’t change the chromosomes), and family history (such as strokes, aneurysms or brain hemorrhages in near relatives) and those that we can modify to some extent such as smoking, obesity, hypertension, diabetes, high blood cholesterol and fats, or level of exercise. The best way to decrease the chance of having a stroke is to avoid exposure to cigarettes, to control our penchant to eat more and exercise less than we need, and to control our blood pressure, blood sugar and cholesterol. In those at highest risk for stroke the addition of medications to lower the risk such as cholesterol or blood pressure lowering drugs, aspirin, clopidogrel or sodium warfarin may help, and sometimes even surgical intervention may be needed
Common warning signs that should alert you to get to a hospital or doctor immediately include:
Sudden loss of vision in either eye, or both, even if it only lasts for a few seconds
Sudden onset of double vision
Sudden “unevenness” of the face, with one side that doesn’t move when smiling
Sudden loss of strength or power in an arm or leg (does the arm drift down if you lift it?)
Difficulty speaking, garbled speech
Sudden loss of consciousness
If you, a relative, a neighbor, a coworker, or anyone else suffers from one of these warning signs, please alert and get to the nearest medical facility right away. Unless you can’t tolerate aspirin, it would be a good idea to take two adult aspirins on the way.
Published On: October 20, 2006