Stroke Archive

Q. My lower legs tend to swell when I take long plane trips. Would compression stockings help?

A. Compression stockings are elastic, below-the-knee socks that gently squeeze your calves. They can help prevent swelling in the foot, ankle, and lower leg that often occurs during any period of prolonged sitting—not just in planes but also in buses, trains, and cars. Your leg muscles don't contract, which normally helps push blood back toward the heart. As a result, blood and fluid tend to pool in the lower legs.

Think F.A.S.T. and check the face, arms, speech, and time.

Every second counts when it comes to getting treatment for a stroke, the interruption of blood flow to the brain that occurs when a blood vessel is blocked or ruptures. "From the time symptoms begin, we have only three—or in rarer cases, four-and-a-half—hours to give someone a clot-busting drug that can restore blood flow and keep brain cells from dying," says Dr. Natalia Rost, director of acute stroke services at Harvard-affiliated Massachusetts General Hospital.

The body needs adequate protein for many reasons, but could stroke protection be one of them? Researchers in China analyzed the results of seven studies, which together included about 250,000 people ranging in age from their 30s to their 80s. For every extra 20 grams of protein the participants ate each day, their stroke risk dropped by an impressive-sounding 26%, according to results published online June 11 in the journal Neurology.

"If everyone's protein intake were at this level, that would translate to more than 1.4 million fewer deaths from stroke each year worldwide, plus a decreased level of disability from stroke," study author Dr. Xinfeng Liu, of Nanjing University School of Medicine in China, said in a statement.

Q. My family doctor heard a heart murmur and sent me to a cardiologist, who diagnosed aortic valve sclerosis after doing an echocardiogram. Should I worry?

Updated recommendations can help people who have had a stroke or TIA lessen their chances of another "brain attack."

A first stroke often sneaks up unexpectedly. But for stroke survivors, the probability of a subsequent clot or brain bleed looms large. Nearly a quarter of the 795,000 annual strokes in the United States are recurrences. Likewise, about a third of people who experience a transient ischemic attack (TIA), often called a mini-stroke, can go on to have a major stroke within a year.

Having a glass of wine with dinner might help you avoid a stroke, but pouring a couple more could have the opposite effect, according to a study reported in the International Journal of Cardiology. Researchers analyzed the results of 27 studies from around the world (11 of them in the United States), which included a total of 1.4 million participants. People in the study who were light drinkers—having one drink per day—had a lower risk of strokes and death from strokes compared with those who didn't drink at all.

However, heavier drinkers—those who imbibed about three drinks or more a day—increased their stroke risk. The authors say heavy alcohol intake may contribute to stroke by raising blood pressure and by encouraging the development and growth of blood clots that can block blood vessels supplying the brain. The current recommendation for women is to have no more than one drink a day, but check with your doctor to make sure it's healthy for you to drink.

Q. What's the difference between atrial flutter and atrial fibrillation?

A. Both of these heart-rhythm disorders arise from electrical misfires in the heart's upper chambers, or atria. The symptoms are often similar—mainly palpitations and lightheadedness. The conditions can occur together, and both are treated with either drugs or procedures that restore the heart's normal rhythm. But there are a few key differences.

Changes include adding new clot-preventing drugs and using less aspirin.

If you have atrial fibrillation (also called afib), your doctor may recommend changes to your treatment based on recently updated guidelines for managing this common heart disorder.

If a clot blocks blood flow to the brain, causing an ischemic stroke, the sooner a person receives the clot-busting drug known as tPA, the better. In an effort to cut "door-to-needle time" (the time it takes a person to get the drug after arriving at the hospital), researchers launched the Target: Stroke initiative. Started in 2010, the initiative pushed 10 strategies to streamline and speed treatment in the hospital, such as early notification from emergency medical workers and a single-call system for alerting the stroke team.

An analysis of the three-year data, which involved more than 70,000 people in 1,030 hospitals, appeared in The Journal of the American Medical Association. The initiative boosted the percentage of eligible people with door-to-needle times of an hour or less, from just under 30% to just over 53%. The faster treatment was also associated with fewer complications and better outcomes. Under the new processes, more people were able to return home after treatment rather than to a rehabilitation facility, and fewer people died in the hospital.

When it comes to preventing strokes, women and men are definitely not on equal footing. In recognition of our gender's unique stroke risk factors, in February 2014, the American Heart Association and American Stroke Association released the first-ever guidelines for stroke prevention in women. The recommendations, which were published in the journal Stroke, recognize that a woman's risk is strongly influenced by hormones, reproductive history, and other gender-specific factors. We also face a bigger uphill recovery after a stroke than do men.

Many of the new guidelines are targeted to women of childbearing age. For example, they suggest women with a history of high blood pressure take low-dose aspirin starting in the 12th week of pregnancy to lower their risk of preeclampsia—high blood pressure during pregnancy. And, they recommend that women be screened for high blood pressure before they start taking birth control pills (oral contraceptives increase stroke risk). But there are also a few important pieces of advice for older women. Those who are over age 75 should get screened for atrial fibrillation, an irregular heart rhythm that is a leading cause of stroke. And women between the ages of 65 and 79 should consider taking a daily baby aspirin (81 mg) to prevent stroke.