What is a Stroke?A stroke, or “brain attack,” occurs when blood circulation to the brain fails. Brain cells can die from decreased blood flow and the resulting lack of oxygen. There are two broad categories of stroke: those caused by a blockage of blood flow and those caused by bleeding. While not usually fatal, a blockage of a blood vessel in the brain or neck, called an ischemic stroke, is the most frequent cause of stroke and is responsible for about 80 percent of strokes. These blockages stem from three conditions: the formation of a clot within a blood vessel of the brain or neck, called thrombosis; the movement of a clot from another part of the body such as the heart to the neck or brain, called embolism; or a severe narrowing of an artery in or leading to the brain, called stenosis. Bleeding into the brain or the spaces surrounding the brain causes the second type of stroke, called hemorrhagic stroke. Many communities encourage those with stroke’s warning signs to dial 911 for emergency medical assistance. |
Common heart disorders such as coronary artery disease, valve defects, irregular heart beat, and enlargement of one of the heart’s chambers can result in blood clots that may break loose and block vessels in or leading to the brain. The most common blood vessel disease, caused by the buildup of fatty deposits in the arteries, is called atherosclerosis. Your doctor will treat your heart disease and may also prescribe medication, such as aspirin, to help prevent the formation of clots. Your doctor may recommend surgery to clean out a clogged neck artery if you match a particular risk profile. If you are over 50, NINDS scientists believe you and your doctor should make a decision about aspirin therapy. A doctor can evaluate your risk factors and help you decide if you will benefit from aspirin or other blood-thinning therapy.
o Warning signs or history of stroke.
If you experience a TIA, get help at once. If you have had a stroke in the past, it’s important to reduce your risk of a second stroke. Your brain helps you recover from a stroke by drawing on body systems that now must do double duty. That means a second stroke can be twice as bad.
If you notice one or more of these signs, don’t wait. Stroke is a medical emergency. Call 911 or your emergency medical services. Get to a hospital right away!
The American Stroke Association wants you to learn the warning signs of stroke:
* Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
* Sudden confusion, trouble speaking or understanding
* Sudden trouble seeing in one or both eyes
* Sudden trouble walking, dizziness, loss of balance or coordination
* Sudden, severe headache with no known cause
o Be prepared for an emergency.
* Keep a list of emergency rescue service numbers next to the telephone and in your pocket, wallet or purse.
* Find out which area hospitals are primary stroke centers that have 24-hour emergency stroke care.
* Know (in advance) which hospital or medical facility is nearest your home or office.
o Diabetes.
You may think this disorder affects only the body’s ability to use sugar, or glucose. But it also causes destructive changes in the blood vessels throughout the body, including the brain. Also, if blood glucose levels are high at the time of a stroke, then brain damage is usually more severe and extensive than when blood glucose is well-controlled. Treating diabetes can delay the onset of complications that increase the risk of stroke.
Americans should be able to prevent 80 percent of all strokes by the end of the decade.
Do You Know Your Stroke Risk?
Some of the most important risk factors for stroke can be determined during a physical exam at your doctor’s office. If you are over 55 years old, the worksheet in this pamphlet can help you estimate your risk of stroke and show the benefit of risk factor control.
The worksheet was developed from NINDS-supported work in the well-known Framingham Study. Working with your doctor, you can develop a strategy to lower your risk to average or even below average for your age.
Many risk factors for stroke can be managed, some very successfully. Although risk is never zero at any age, by starting early and controlling your risk factors you can lower your risk of death or disability from stroke. With good control, the risk of stroke in most age groups can be kept below that for accidental injury or death.
Americans have shown that stroke is preventable and treatable. A better understanding of the causes of stroke has helped Americans make lifestyle changes that have cut the stroke death rate nearly in half in the last two decades.
More than a million stroke survivors suffer little or no long lasting disability from their strokes. Another two million, however, live with the crippling and lifelong disabilities of paralysis, loss of speech, and poor memory. Scientists at the NINDS predict that, with continued attention to reducing the risks of stroke and by using currently available therapies and developing new ones, Americans should be able to prevent 80 percent of all strokes by the end of the decade.
Recommended Stroke Books
- My Stroke of Insight: A Brain Scientist’s Personal Journey
- The Diving Bell and the Butterfly: A Memoir of Life in Death
- NO More Heart Disease: How Nitric Oxide Can Prevent–Even Reverse–Heart Disease and Strokes
- Stronger After Stroke: Your Roadmap to Recovery
- Never Give Up: My Stroke, My Recovery, and My Return to the NFL
- Brain, Heal Thyself: A Caregiver’s New Approach to Recovery from Stroke, Aneurysm, And Traumatic Brain Injuries
Score your stroke risk for the next 10 years-MEN
Key:
SBP = systolic blood pressure (score one line only, untreated or treated);
Diabetes = history of diabetes; Cigarettes = smokes cigarettes;
CVD (cardiovascular disease) = history of heart disease;
AF = history of atrial fibrillation;
LVH = diagnosis of left ventricular hypertrophy
Box A
Points 0 +1 +2 +3 +4 +5 +6 +7 +8 +9 +10
Age 55- 57- 60- 63- 66- 69- 73- 76- 79- 83- 85
56 59 62 65 68 72 75 78 81 84
SBP- untrtd
97- 106- 116- 126- 136- 146- 156- 166- 176- 186- 196-
105 115 125 135 145 155 165 175 185 195 205
or SBP-trtd
97- 106- 113- 118- 124- 130- 136- 143- 151- 162- 177-
105 112 117 123 129 135 142 150 161 176 205
Diabetes No Yes
Cigarettes No Yes
CVD No Yes
AF No Yes
LVH No Yes
Box B
Your 10-Year Your 10-Year Your 10-Year
Points Probability Points Probability Points Probability
1 3% 11 11% 21 42%
2 3% 12 13% 22 47%
3 4% 13 15% 23 52%
4 4% 14 17% 24 57%
5 5% 15 20% 25 63%
6 5% 16 22% 26 68%
7 6% 17 26% 27 74%
8 7% 18 29% 28 79%
9 8% 19 33% 29 84%
10 10% 20 37% 30 88%
Box C
Compare with Your Age Group Average 10-Year Probability of Stroke
55-59 5.9%
60-64 7.8%
65-69 11.0%
70-74 13.7%
75-79 18.0%
80-84 22.3%
Score your stroke risk for the next 10 years-WOMEN
Key:
SBP = systolic blood pressure (score one line only, untreated or treated);
Diabetes = history of diabetes; Cigarettes = smokes cigarettes;
CVD (cardiovascular disease) = history of heart disease;
AF = history of atrial fibrillation;
LVH = diagnosis of left ventricular hypertrophy
Box A
Points 0 +1 +2 +3 +4 +5 +6 +7 +8 +9 +10
Age 55- 57- 60- 63- 65- 68- 71- 74- 77- 79- 82-
56 59 62 64 67 70 73 76 78 81 84
SBP- untrtd 95- 107- 119- 131- 144- 156- 168- 181- 193- 205-
106 118 130 143 155 167 180 192 204 216
or SBP- 95- 107- 114- 120- 126- 132- 140- 149- 161- 205-
trtd 106 113 119 125 131 139 148 160 204 216
Diabetes No Yes
Cigarettes No Yes
CVD No Yes
AF No Yes
LVH No Yes
Box B
Your 10-Year Your 10-Year Your 10-Year
Points Probability Points Probability Points Probability
1 1% 10 6% 19 32%
2 1% 11 8% 20 37%
3 2% 12 9% 21 43%
4 2% 13 11% 22 50%
5 2% 14 13% 23 57%
6 3% 15 16% 24 64%
7 4% 16 19% 25 71%
8 4% 17 23% 26 78%
9 5% 18 27% 27 84%
Box C
Compare with Your Age Group Average 10-Year Probability of Stroke
55-59 3.0%
60-64 4.7%
65-69 7.2%
70-74 10.9%
75-79 15.5%
80-84 23.9%Source: D’Agostino, R.B.; Wolf, P.A.; Belanger, A.J.; Kannel, W.B. “Stroke Risk Profile: The Framingham Study.” Stroke, Vol. 25,, No. 1, pp.40-43, January 1994.
The National Institute of Neurological Disorders and Stroke
Since its creation by Congress in 1950, the NINDS has grown to become the leading supporter of neurological research in the United States. Most research funded by the NINDS is conducted by scientists in public and private institutions such as universities, medical schools, and hospitals. Government scientists also conduct a wide variety of neurological research in the 21 laboratories and branches of the NINDS itself. This research ranges from studies on the structure and function of single brain cells to tests of new diagnostic tools and treatments for those with neurological disorders. For more information, write or call:
NIH Neurological Institute P.O. Box 5801 Bethesda, MD 20824
Phone: (301) 496-5751 Toll-free number: (800) 352-9424 Fax number: (301) 402-2186
U.S. Department of Health and Human Services – Public Health Service
NIH Publication No. 94-3440-b
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