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Everyone should know the basics about strokes. Given the evidence that having Migraine disease increases our risk of stroke, it is especially important for Migraineurs to know the warning signs of stroke AND how to reduce our modifiable stroke risks.

Quick facts about stroke:

  • Stroke is the third leading cause of death in the United States. In 2006, 137,119 people died from stroke in the United States.
  • Stroke is a leading cause of serious long-term disability.
  • About 795,000 strokes occur in the United States each year. About 610,000 of these are first or new strokes. About 185,000 occur in people who have already had a stroke before.
  • Nearly three-quarters of all strokes occur in people aged 65 years or older. The risk of having a stroke doubles each decade after the age of 55.
  • Strokes can--and do--occur at ANY age. Nearly 25% of strokes occur in people younger than age 65.
  • Stroke death rates are higher for African Americans than for whites, even at younger ages.
  • According to the American Heart Association, stroke will cost almost $73.7 billion in both direct and indirect costs in 2010.
  • It has been noted for several decades that the southeastern United States has the highest stroke mortality rates in the country. It is not completely clear what factors might contribute to the higher incidence of and mortality from stroke in this region.
  • People with a family history of stroke have a higher risk.

What is stroke?

A stroke occurs when the blood supply to part of the brain is suddenly interrupted or when a blood vessel in the brain bursts, spilling blood into the spaces surrounding brain cells. Brain cells die when they no longer receive oxygen and nutrients from the blood or there is sudden bleeding into or around the brain. The symptoms of a stroke include:

  • sudden numbness or weakness, especially on one side of the body;
  • sudden confusion or trouble speaking or understanding speech;
  • sudden trouble seeing in one or both eyes;
  • sudden trouble with walking, dizziness, or loss of balance or coordination;
  • or sudden severe headache with no known cause.

There are two forms of stroke: ischemic - blockage of a blood vessel supplying the brain, and hemorrhagic - bleeding into or around the brain.

Treating stroke

Generally there are three treatment stages for stroke:

  • Prevention: Therapies to prevent a first or recurrent stroke are based on treating an individual's underlying risk factors for stroke, such as hypertension, atrial fibrillation, and diabetes.
  • Therapy immediately after the stroke (acute therapy): Acute stroke therapies try to stop a stroke while it is happening by quickly dissolving the blood clot causing an ischemic stroke or by stopping the bleeding of a hemorrhagic stroke.
  • Post-stroke rehabilitation: Post-stroke rehabilitation helps individuals overcome disabilities that result from stroke damage.

Medication or drug therapy is the most common treatment for stroke. The most popular classes of drugs used to prevent or treat stroke are antithrombotics (antiplatelet agents and anticoagulants) and thrombolytics.

Prognosis after stroke:

Although stroke is a disease of the brain, it can affect the entire body. A common disability that results from stroke is hemiplegia. A related disability that is not as debilitating as paralysis hemiparesis. Stroke may cause problems with thinking, awareness, attention, learning, judgment, and memory. Stroke survivors often have problems understanding or forming speech (aphasia). A stroke can lead to emotional problems. Stroke patients may have difficulty controlling their emotions or may express inappropriate emotions. Many stroke patients experience depression. Stroke survivors may also have numbness or strange sensations. The pain is often worse in the hands and feet and is made worse by movement and temperature changes, especially cold temperatures.

Lifestyle choices to lower stroke risk:

Knowing your risk of stroke and doing what you can to decrease or control your risk is the best approach to preventing stroke and stroke-related disability. All people can take steps to lower their risk for stroke, whether they have had a stroke or not. Things you can do to lower the risk of stroke include steps to prevent and control high blood pressure, heart disease, and other chronic conditions, eating a healthy diet, maintaining a healthy weight, exercise, not smoking, and not drinking too much alcohol (drinking more than two drinks per day on average for men or more than one drink per day on average for women).

  • Prevent and control high blood pressure.
  • Prevent and control diabetes.
  • Abstain from tobacco use.
  • Treat atrial fibrillation.
  • Prevent and control high blood cholesterol.
  • Maintain a healthy weight.
  • Keep regular physical activity.
  • East healthy food.

Recurrence

Recurrent stroke is frequent; about 25% of people who recover from their first stroke will have another stroke within five years.

For more information on stroke, stroke prevention, and Migraines, please see Stroke Awareness: Essential for Migraineurs.

These articles outline the various risks presented by Migraine disease:

_ __*More Research Links Migraine With Aura and Stroke in Women__

*   [**When to See a Doctor for a Migraine or Headache**](http://www.healthcentral.com/migraine/check%20a%20symptom-39090-5.html)_

For information on types of Migraines and headaches, please see:


Resources:

NIH: NINDS. "Stroke Information Page." May 10, 2010. NINDS.NIN.gov

Centers for Disease Control (CDC). "May is National Stroke Awareness Month." CDC.gov. May, 2010.

Medical review by John Claude Krusz, PhD, MD

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