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Download American Stroke Association / American Society of Neuroradiology Pamphlet on Stroke
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Home Page > Specific Conditions > Stroke Download American Stroke Association / American Society of Neuroradiology Pamphlet on Stroke |
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Stroke According to the American Heart Association, stroke affects 600,000 Americans each year, and approximately 160,000 people die from this disease. Stroke is the third leading cause of death in the United States. What is stroke? What is a transient ischemic attack? A stroke is a true medical emergency that occurs when the brain is deprived of the oxygen and nutrients it requires to function properly. Strokes are classified as ischemic and hemorrhagic. In the ischemic type, an artery is blocked as a result of a clot or atherosclerosis, and blood cannot flow to where it is needed. In the hemorrhagic type, a cerebral vessel ruptures and bleeds, damaging the surrounding brain cells. Ischemic strokes are much more common. Other names for this disease include cerebrovascular accident (CVA) and brain attack. Strokes occurring in children and adolescents are called pediatric strokes. Transient ischemic attacks (TIAs) are also known as mini-strokes. TIAs are temporary events, and their symptoms often appear and disappear within minutes. Most people who have a TIA fully recover within a day. Because TIAs are so short, permanent damage is rare. However, TIAs can recur and lead to a full stroke. Therefore, people who experience a TIA should seek medical care immediately. What are the risk factors for stroke? Can stroke be prevented? Some risk factors can be modified or treated to help prevent the occurrence of stroke. Examples of these include the following:
Some risk factors cannot be modified.
The risk of stroke is increased in people with a family history of the disease, and although strokes can occur in children, most patients are older than 65 years. The incidence of stroke is higher in men than in women; however, more women die from stroke. Also, stroke affects more African Americans than people of other races, partly because of their higher risk of hypertension, obesity, and diabetes. A person who has had a heart attack is at risk for a stroke. In addition to treating any controllable risk factors, individuals can make lifestyle changes, such as the following, to decrease their risk.
In some patients, physicians may prescribe drug therapy with antiplatelet agents or anticoagulants such as aspirin. What are the signs and symptoms of a stroke? When a stroke occurs, brain cells die, causing various signs and symptoms depending on the area of the brain involved. Common findings include the following:
Occasionally, TIAs and strokes do not cause any recognizable symptoms. With TIAs, symptoms can be intermittent. What tests are used to diagnose a stroke? Neuroradiologists traditionally use computed tomography (CT) or magnetic resonance imaging (MRI) as the primary tests for diagnosing a stroke. With recent technological advances in MRI, neuroradiologists have new tools such as diffusion imaging, perfusion imaging, and spectroscopy. One or more of the following procedures may be performed.
After a stroke is diagnosed, the neuroradiologist may order additional tests to further evaluate the location and extent of the stroke so that the best treatment can be administered. What treatments are available? Most of the damage caused by a stroke occurs in the first few hours. Therefore, the sooner a person receives treatment, the better his or her chances for a good outcome. Oxygen-deprived or damaged brain cells can often be saved, but after about 6 hours, the damage may be irreversible, and therapy may not be effective. The goal of early treatment is to stop the progression of a stroke and limit its effects. Medications once used to treat heart attacks are now being used to treat strokes. Drugs helpful in the emergency treatment of stroke include thrombolytic agents such as tissue plasminogen activator (tPA) and neuroprotective agents. Thrombolytic drugs dissolve clots, and neuroprotective drugs make the brain more resistant to stroke and its effects. In some patients, surgical procedures are appropriate. Interventional neuroradiologists may perform operations such as carotid endarterectomy, carotid angioplasty and stent placement, and aneurysm clipping, among others, to treat a stroke or prevent future strokes. Is recovery possible? Patients can undergo rehabilitation to overcome residual disabilities and to resume their previous lifestyle to the extent possible. Depending on the patient's needs, rehabilitation may be conducted on an inpatient or an outpatient basis. The consequences of a stroke can be limited or widespread, depending on the area of the brain affected. Common effects include the following:
Rehabilitation usually involves physical therapy and occupational therapy. Patients can often relearn activities of daily living, such as eating and drinking, dressing, bathing, and reading and writing. Speech therapy enables some patients to regain their ability to speak or understand words. Patients often experience the greatest improvements in the first few months of rehabilitation. The success of the program depends not only on degree of brain damage but also on the attitude and cooperation of the patient and his or her caretakers. For many patients and families, participation in a support group is helpful.
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