Stroke Is A Dreaded Disease And Alters Daily Life

April 13, 2021 at 10:02 p.m.


There are a number of diseases or conditions that result in death or disability, but the one I fear most is  having a stroke.  Strokes, also called brain attacks, result from an injury to a blood vessel that limits blood flow to part of the brain and without a constant supply of oxygen and nutrients, brain cells begin to die. The resulting damage leaves the victim unable to speak, feel, think, see or even recognize other people. Strokes alter daily life together with a sense of self and there is strong possibility that the patient must rely on others for nursing care including speech, occupational and physical therapy.  

Major Types

There are two major kinds of strokes, which in turn can be divided into various subtypes. The first is an ischemic stroke which is caused by a blocked blood vessel. This type accounts for 87% of strokes and occurs when an artery supplying the brain is blocked by a blood clot.  Usually the clot forms in an already-clogged artery, choking off the flow of blood.

The clot may break off from somewhere else in the body and travel through the circulatory system until it lodges in an otherwise normal blood vessel that supplies the brain.  The second type, a hemorrhagic stroke, is caused by a burst blood vessel.  This occurs when a blood vessel in the brain leaks or ruptures.  No matter whether ischemic or hemorrhagic, the effects will depend upon which blood vessels are blocked and thus what part of the brain is deprived of the vital nutrients and oxygen. In either case, immediate treatment is crucial in order to minimize brain damage.

Ministrokes (TIAs)

A transient ischemic attack or TIA is a blood vessel blockage that usually comes and goes quickly. TIAs have the same causes as ischemic strokes and if not treated usually lead to a full-blown stroke.  As many as 20% of people with a TIA will suffer a full-blown ischemic stroke within the next 90 days.

Strokes Among Women

Women have more strokes than men and part of the reason is that women live much longer than men. Age is a key element in stroke risk.  Other reasons include the use of birth control pills.  

Hormone replacement therapy has been linked to a slightly higher risk of strokes.  Women who have had more than one miscarriage may also be a higher risk of blood clots which can increase the risk of strokes.  

The link between pregnancy and complications and later-life stroke risk can be traced to blood vessel abnormalities.  Strokes are up to 10 times more common in women who suffer from migraines with auras. Auras are  visual or sensory changes such as blind spots, flashing lights, silver zigzag lines in the field of vision or prickly sensations that occur about 10 to 30 minutes before the headache.  Irregular heart rhythm (atrial fibrillation) is more common in women than in men, but women with AF have higher rates of stroke related deaths.  Women also tend to suffer more disability after a stroke.              

Risk Factors

Some factors that increase the risk of stroke are things that can be changed.  Other risk factors can not. Simply knowing the difference can make an individual more diligent and more likely to take other risk reducing steps within control.  

Age is one example. The odds of having a stroke more than double every 10 years after age 55. More than two-thirds of strokes involve people over age 65 and 88% of deaths from stroke are in people 65 and older.  As mentioned above, women have more strokes than men, and women are more likely to die from a stroke.

African Americans and Latino Americans have a higher risk of strokes and are also more likely to die from a stroke compared to whites.  Family history also plays a role.  If someone in the immediate family has had a stroke, the risk is about 30% higher compared to people who have no such family history.  If you have a strong family history of strokes, you should discuss preventive measures with your doctor.

Risk Factors

Fortunately, you can take steps to reduce certain risk factors for strokes, especially ischemic types, by managing medical conditions and behaviors that increase risk.  The most common risk factors for both ischemic strokes and TIAs include:  high blood pressure, diabetes, unhealthy cholesterol levels, obesity, cigarette smoking and a sedentary life style combined with a poor diet.   

Prevention

Based on risk factors, the most important steps to take for stroke prevention, include lowering blood pressure, keeping cholesterol and blood sugar in healthy range, not smoking, regular exercise and losing weight. Consult your physician.

Important Information

If you are at risk of having a stroke, prepare for an emergency by having important phone numbers (hospitals, doctors, close friends of relatives) featured prominently next to the phone.  Understand and learn stroke warning signs and symptoms, they can occur anywhere from a few minutes to a few days before a stroke.

See www.strokeassociation.org for more information.

Max Sherman is a medical writer and pharmacist retired from the medical device industry.  His new book “Science Snippets” is available from Amazon and other book sellers. It contains a number of previously published columns.  He can be reached by email at  [email protected]

There are a number of diseases or conditions that result in death or disability, but the one I fear most is  having a stroke.  Strokes, also called brain attacks, result from an injury to a blood vessel that limits blood flow to part of the brain and without a constant supply of oxygen and nutrients, brain cells begin to die. The resulting damage leaves the victim unable to speak, feel, think, see or even recognize other people. Strokes alter daily life together with a sense of self and there is strong possibility that the patient must rely on others for nursing care including speech, occupational and physical therapy.  

Major Types

There are two major kinds of strokes, which in turn can be divided into various subtypes. The first is an ischemic stroke which is caused by a blocked blood vessel. This type accounts for 87% of strokes and occurs when an artery supplying the brain is blocked by a blood clot.  Usually the clot forms in an already-clogged artery, choking off the flow of blood.

The clot may break off from somewhere else in the body and travel through the circulatory system until it lodges in an otherwise normal blood vessel that supplies the brain.  The second type, a hemorrhagic stroke, is caused by a burst blood vessel.  This occurs when a blood vessel in the brain leaks or ruptures.  No matter whether ischemic or hemorrhagic, the effects will depend upon which blood vessels are blocked and thus what part of the brain is deprived of the vital nutrients and oxygen. In either case, immediate treatment is crucial in order to minimize brain damage.

Ministrokes (TIAs)

A transient ischemic attack or TIA is a blood vessel blockage that usually comes and goes quickly. TIAs have the same causes as ischemic strokes and if not treated usually lead to a full-blown stroke.  As many as 20% of people with a TIA will suffer a full-blown ischemic stroke within the next 90 days.

Strokes Among Women

Women have more strokes than men and part of the reason is that women live much longer than men. Age is a key element in stroke risk.  Other reasons include the use of birth control pills.  

Hormone replacement therapy has been linked to a slightly higher risk of strokes.  Women who have had more than one miscarriage may also be a higher risk of blood clots which can increase the risk of strokes.  

The link between pregnancy and complications and later-life stroke risk can be traced to blood vessel abnormalities.  Strokes are up to 10 times more common in women who suffer from migraines with auras. Auras are  visual or sensory changes such as blind spots, flashing lights, silver zigzag lines in the field of vision or prickly sensations that occur about 10 to 30 minutes before the headache.  Irregular heart rhythm (atrial fibrillation) is more common in women than in men, but women with AF have higher rates of stroke related deaths.  Women also tend to suffer more disability after a stroke.              

Risk Factors

Some factors that increase the risk of stroke are things that can be changed.  Other risk factors can not. Simply knowing the difference can make an individual more diligent and more likely to take other risk reducing steps within control.  

Age is one example. The odds of having a stroke more than double every 10 years after age 55. More than two-thirds of strokes involve people over age 65 and 88% of deaths from stroke are in people 65 and older.  As mentioned above, women have more strokes than men, and women are more likely to die from a stroke.

African Americans and Latino Americans have a higher risk of strokes and are also more likely to die from a stroke compared to whites.  Family history also plays a role.  If someone in the immediate family has had a stroke, the risk is about 30% higher compared to people who have no such family history.  If you have a strong family history of strokes, you should discuss preventive measures with your doctor.

Risk Factors

Fortunately, you can take steps to reduce certain risk factors for strokes, especially ischemic types, by managing medical conditions and behaviors that increase risk.  The most common risk factors for both ischemic strokes and TIAs include:  high blood pressure, diabetes, unhealthy cholesterol levels, obesity, cigarette smoking and a sedentary life style combined with a poor diet.   

Prevention

Based on risk factors, the most important steps to take for stroke prevention, include lowering blood pressure, keeping cholesterol and blood sugar in healthy range, not smoking, regular exercise and losing weight. Consult your physician.

Important Information

If you are at risk of having a stroke, prepare for an emergency by having important phone numbers (hospitals, doctors, close friends of relatives) featured prominently next to the phone.  Understand and learn stroke warning signs and symptoms, they can occur anywhere from a few minutes to a few days before a stroke.

See www.strokeassociation.org for more information.

Max Sherman is a medical writer and pharmacist retired from the medical device industry.  His new book “Science Snippets” is available from Amazon and other book sellers. It contains a number of previously published columns.  He can be reached by email at  [email protected]

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