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

Niacin trial stopped early: Now what?

A clinical trial of niacin in combination with a statin to lower cholesterol was stopped early because of concerns that the combined medication could be associated with an increased risk of stroke. The editors of the Health Letter will wait until the complete results are published in a peer-reviewed journal before weighing in fully on the AIM-HIGH trial and high doses of niacin. But there's no reason to get panicky about niacin — or Niaspan, for that matter. The FDA issued a statement the same day the end of the trial was announced that emphasized that its recommendations for extended-release niacin weren't changing. The agency's statement noted that nine of the 28 strokes in the Niaspan group occurred well after people stopped taking the prescription niacin. More »

The crucial, controversial carotid artery Part I: The artery in health and disease

The carotid arteries supply the brain with blood. Carotid artery disease occurs when these arteries are narrowed and blood flow can be interrupted. Brief interruptions of blood flow to the brain cause transient ischemic attacks (TIAs); prolonged or complete blockages are the major cause of cerebrovascular accidents — strokes. TIA or "mini-strokes" are often a warning sign of a major stroke, the fourth leading cause of death in the United States. Detecting and treating a narrowed carotid artery is the best way to prevent TIAs and strokes. (Locked) More »

Trial clouds use of niacin with a statin

A large clinical trial dubbed AIM-HIGH was designed to gauge whether adding a prescription form of niacin (Niaspan) to a cholesterol-lowering statin makes sense for people with low HDL. When the trial's safety panel analyzed preliminary results, niacin didn't offer any additional benefit. A small and highly unexpected difference in the rate of ischemic (clot-caused) stroke — 1.6% in the niacin group versus 0.7% in the statin-only group — contributed to the panel's decision to halt AIM-HIGH early. (Locked) More »

With rising, a fall in blood pressure

With age, the heart and blood vessels weaken, leading to lower blood pressure when standing up, a condition known as orthostatic hypotension. Insufficient blood to the brain can cause dizziness and blurred vision, and an increased risk of falls. But there are often simple ways to counter the problem. Here are eight things you can do to counter orthostatic hypotension: (Locked) More »

Specialized care improves stroke survival

Care at a specialized center may provide a better chance of surviving a stroke, even if it requires extra travel time to reach. A study of almost 31,000 New York State residents treated for ischemic stroke suggests that those who received care at a primary stroke center were 2.5% more likely to survive than those who received care at other hospitals.  (Locked) More »

Ask the doctor: Headache and stroke

I have heard that one symptom of a stroke is "the worst headache you can imagine." I recently had a migraine that was so much more painful than previous ones that I worried it was a stroke. Is there any way to tell a migraine from a "stroke headache"? (Locked) More »

Gloomy forecast on heart disease

The American Heart Association is predicting significant increases in heart disease among baby boomers, along with associated health care costs. Following better health habits can help prevent heart disease. In a report, the AHA offers a gloomy forecast for cardiovascular disease in 2030: high blood pressure, up 10%; heart disease, up 17%; heart failure and stroke, each up 25%. If the projections are accurate, today's 81 million American adults with cardio vascular disease will swell to 110 million by 2030; the cost of treating them will balloon to $818 billion. Here are proven strategies for protecting the heart and arteries: (Locked) More »

Study suggests caution on statins after a bleeding stroke

People who take a statin after a hemorrhagic stroke may be at a slightly higher risk of having another stroke, but this potential risk may be outweighed by the protection against heart attack provided by a statin. Talk with your doctor to find out where you stand. (Locked) More »