Stroke

Brain cells need a constant supply of oxygen and nutrients. They are delivered by a network of blood vessels that reach every part of the brain. When something cuts off that supply, brain cells downstream begin to die. The injury that follows is called a stroke.

Most strokes strike when a blood clot becomes lodged in one of the brain's arteries, blocking blood flow. In some cases, the clot forms inside the artery, usually because a cholesterol-filled plaque inside the artery breaks open. This is called a thrombotic stroke. In other cases, a blood clot or a solid mass of debris that originates elsewhere travels to the brain, where it blocks a brain artery. This is called an embolic stroke. A third type of stroke, hemorrhagic stroke, occurs when a blood vessel in the brain bursts.

Since different areas of the brain are responsible for different functions, symptoms of stroke vary. They can be changes in sensation, movement, sight, speech, balance, and coordination. Sometimes a stroke is preceded by one or more transient ischemic attacks (TIAs). These are brief episodes of stroke-like symptoms that last for a few minutes — or possibly up to 24 hours — but that go away on their own.

If you think that you, or someone you are with, is having a stroke, call 911 right away. The sooner you call, the sooner treatment can begin — "time is brain," as emergency room doctors say. The type of treatment depends on the type of stroke that has occurred. If the brain's blood supply is restored quickly and completely, a full recovery with little or no disability is possible. The more widespread the damage, and the greater delay of treatment, the more severe and long-lasting the damage.

Recovery after a stroke depends on how well healthy areas of the brain take over duties that had been performed by the damaged brain tissue. To some extent, especially in children and young adults, recovery is possible because of the brain's ability to compensate for damage in one area by working harder in another — by relying on alternate wiring for some functions or by rewiring around the injured site. When such rewiring isn't possible, rehabilitation techniques can help the brain recover function.

Stroke Articles

Hot baths and saunas: Beneficial for your heart?

Taking baths or saunas on a regular basis may help lower the risk of heart attack and stroke. Evidence for these benefits comes from studies in Japan (where hot tub use in ingrained in the culture) and Finland, where saunas are popular. Both habits seem to be safe for people with stable heart disease and even mild heart failure. But people with unstable chest pain (angina), poorly controlled high blood pressure, or other serious heart issues should avoid them. Because high temperatures can lower blood pressure, older people with low blood pressure should be extra careful in hot baths and saunas. (Locked) More »

Telemedicine: A good fit for cardiovascular care?

Virtual doctor visits—when a person talks to a physician on a video call instead of during an in-person office exam—became popular early on in the coronavirus pandemic. The technology may be a good option for managing cardiovascular disease even after in-person visits become more common again. In the future, remote monitoring of health data using Wi-Fi–enabled devices that measure a person’s weight, blood pressure, blood sugar, pulse, and heart rhythm could further advance telehealth’s promise. (Locked) More »

Does alcohol help protect the brain?

An observational study published online June 29, 2020, by Jama Network Open found a potential link between low-to-moderate alcohol drinking in middle age and better cognitive skills in older age. More »

FDA approves broader use of clot-prevention drug

Ticagrelor (Brilinta), a drug that prevents dangerous blood clots, was granted an expanded approval by the FDA. Doctors can now prescribe the drug in people at high risk of a heart attack as well as those who have already had one. More »

New advice about a common heart variation: Patent foramen ovale (PFO)

About 25% of people have a patent foramen ovale or PFO, a flaplike opening between the heart’s upper chambers. Most people never know they have it, because a PFO doesn’t cause any signs or symptoms. For the most part, the condition is harmless. But it may allow small amounts of blood to leak across the heart from the right atrium to the left atrium without getting filtered by the lungs. PFOs may be responsible for up to 10% of strokes among people younger than 60. Guidelines now recommend a procedure to close a PFO for young stroke survivors with no other obvious risk factors for stroke. (Locked) More »

Midlife isn’t too late for stroke prevention

Strokes can be prevented through lifestyle changes, such as exercising more, quitting smoking, losing weight, or eating a healthy diet, even if changes aren’t made until midlife, according to a study by Harvard researchers. Compared with women who didn’t make beneficial lifestyle changes, women who quit smoking, lost weight, or exercised for 30 minutes or more each day had an estimated 25% reduction in stroke risk, and women who ate a healthier diet had an estimated 23% reduction in risk. (Locked) More »