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Stroke: Prevention and Treatment
Thanks to new tests that help predict stroke, treatments that help control high blood pressure, and good
health habits that many Americans are practicing, the death rate from stroke is down as much as 50 percent
since 1970. Still, stroke is the third leading cause of death in the United States and the leading cause of
disability among adults.
What Is a Stroke?
A stroke is a sudden partial loss of brain function usually caused by a clot that stops the flow of blood to an
area of the brain. Without oxygen and important nutrients, the affected brain cells are either damaged or die
within a few minutes.
While cell damage can be repaired and the lost function regained, the death of brain cells is permanent.
Most strokes are caused by a blood clot or narrowing of a blood vessel (artery) leading to the brain. Other
strokes are caused by a hemorrhage (bleeding) from an artery. There are three major types of strokes:
Thrombotic strokes are caused by fatty deposits (plaques) that have built up in the arteries carrying blood
to the brain. This slows the blood flow until a blood clot completely blocks the artery and the flow of
oxygen and nutrients to the brain.
An embolic stroke is caused by a blood clot formed in another part of the body that breaks loose, travels
through the bloodstream, and blocks an artery carrying oxygen and nutrients to the brain. When traveling
through the body the blood clot is called an embolus.
A hemorrhagic stroke is caused when an artery supplying blood bleeds into the brain. The broken blood
vessel prevents needed oxygen and nutrients from reaching the brain cells. One type of hemorrhagic stroke
is caused when an artery that has weakened over time bulges (called an aneurysm) and suddenly breaks.
Diagnosis and Treatment
A stroke requires immediate medical care. Research shows that treatment during the first hours after
symptoms appear can be important for the best possible recovery. An emergency doctor or neurologist (a
doctor who diagnoses and treats disorders of the brain and nervous system) will provide emergency
treatment. Then a family doctor, internist, or geriatrician can step in and provide longer term care.
Doctors make an early diagnosis by looking at symptoms, reviewing the patient's medical history, and
performing tests such as a computerized tomography scan--a 3-dimensional
x-ray technique to take pictures of the brain.
What You Can Do to Prevent a Stroke
A stroke was once viewed as a single damaging attack, but we now know it develops over many years.
The risk factors or conditions that may lead to stroke include high blood pressure, smoking, heart disease,
and diabetes. The risk of stroke increases with age and is higher in African Americans and Hispanics than in
You can reduce your stroke risk by taking the following steps:
Control your blood pressure. Have your blood pressure checked often, and, if it is high, follow your
doctor's advice on how to lower it. Treating high blood pressure reduces the risk for both stroke
and heart disease.
Stop smoking. Cigarette smoking is linked to increased risk for stroke. Research shows that the risk
of stroke for people who have quit smoking for 2-5 years is lower than for smokers.
Exercise regularly. Researchers think that exercise may make the heart stronger and improve circulation. It
also helps control weight. Being overweight increases the chance of high blood pressure, atherosclerosis,
heart disease, and adult-onset (type II) diabetes.
Physical activities like brisk walking, cycling, swimming, and yard work lower the risk of both stroke and
heart disease. Talk with your doctor before starting an exercise program.
Eat a healthy diet. Choose, prepare, and eat foods low in fats, saturated fatty acids, and cholesterol.
Eat a variety of fruits and vegetables.
Control diabetes. If untreated, diabetes can damage the blood vessels throughout the body and lead
Promptly report warning signs or symptoms to your doctor. The warning signs for stroke are a
sudden, unexplained tingling and/or numbness on one side of the body, a sudden severe headache,
blurred vision, difficulty talking, stumbling and/or sudden clumsiness. Sometimes a mini-stroke,
lasting only a few moments and called a transient ischemic attack (TIA), comes before a stroke.
Rehabilitation for Stroke
Rehabilitation should begin as soon as possible after the patient is stable. It often continues after the patient
has gone home. Stroke rehabilitation includes many kinds of therapies: physical therapy to strengthen
muscles and improve balance and coordination; speech and language therapy; and occupational therapy to
improve eye-hand coordination and skills needed for tasks such as bathing and cooking. A team of health
care experts (physicians, physical and occupational therapists, nurses, social workers, and speech and
language specialists) coordinates activities for the patient and family.
Rehabilitation progress varies from person to person. For some, recovery is completed within weeks
following a stroke; for others, it may take many months or years.
Where to Get Help
National Institute of Neurological Disorders and Stroke
P.O. Box 58014
Bethesda, MD 20824
National High Blood Pressure Education Program
P.O. Box 30105 Bethesda, MD 20824
The National Stroke Association
96 Inverness Drive East
Englewood, CO 80112-5112
American Heart Association
7272 Greenville Avenue
Dallas, TX 75231
For a list of free publications from the National Institute on Aging (NIA), contact:
NIA Information Center
P.O. Box 8057
Gaithersburg, MD 20898-8057