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Stroke (cont.)

Stroke Prevention

Strokes are preventable! The most important thing you can do is to get your blood pressure checked and treated if it is high.

  • Have your blood pressure checked and monitored by a doctor. Even moderately high blood pressure over years can lead to a stroke.
  • Treat high cholesterol with diet and exercise and then medication to reduce the risk of stroke. High levels of blood cholesterol known as LDL (low-density lipoprotein) increase risk for stroke and may cause the formation of artery-narrowing plaque.
  • In people with certain irregular heart rhythms, such as atrial fibrillation, the use of blood thinners such as warfarin (Coumadin) has been shown to reduce the risk of stroke.
  • For the general population, aspirin has not been shown to reduce stroke risk. It may be useful if prescribed by a doctor for people who have an increased risk of stroke.
  • Control diabetes.
  • Stop smoking or never smoke.
  • Know the symptoms of stroke. Act quickly when someone exhibits the signs of a stroke. Stroke is a medical emergency.
  • Surgically, some brain aneurysms can be treated if found before they bleed into the brain tissue.

Stroke Prognosis

Many people recover completely after a stroke. For others, it can take many months to recover from a stroke. Physical therapy and other retraining methods are greatly improving rehabilitation and recovery.

Despite clot-busting medications that help during an ischemic stroke, overall, about 30% of people die from stroke. In general, the more deficits or loss of ability (in walking or talking) individuals have when they arrive in the emergency department, the worse the outcome.

Stroke Images

CT scan taken some time after a large stroke. The black area is where the stroke was and now the brain tissue has died and left a large hole.
CT scan taken some time after a large stroke. The black area is where the stroke was and now the brain tissue has died and left a large hole. Click to view larger image.

This MRI scan of a new stroke shows some of the new tools available for diagnosing stroke. The left scan shows the severely injured tissue (in white). 
The picture on the right is of the same person but shows the amount of blood flow to the brain. 
The dark area on the right side of the brain indicates low blood flow and is much bigger than the white area in the other picture. 
This suggests that part of the brain is at risk but hasn't been severely injured yet.
This MRI scan of a new stroke shows some of the new tools available for diagnosing stroke. The left scan shows the severely injured tissue (in white). The picture on the right is of the same person but shows the amount of blood flow to the brain. The dark area on the right side of the brain indicates low blood flow and is much bigger than the white area in the other picture. This suggests that part of the brain is at risk but hasn't been severely injured yet. Click to view larger image.

This slide illustrates the potential benefits of treating stokes with tPA. 
For every 16 people with acute stroke (light blue people on top), if you do nothing, they will have the outcomes shown in the second row.
 Four will do well (green); four will do okay (yellow); five will have severe deficits (gray); and three will die (white). 
 If all of them had received tPA, now more of them have great outcomes (green), fewer have severe outcomes (gray), and the same number die (white). 
 One of those who died had bleeding in the brain caused by the tPA.
This slide illustrates the potential benefits of treating stokes with tPA. For every 16 people with acute stroke (light blue people on top), if you do nothing, they will have the outcomes shown in the second row. Four will do well (green); four will do okay (yellow); five will have severe deficits (gray); and three will die (white). If all of them had received tPA, now more of them have great outcomes (green), fewer have severe outcomes (gray), and the same number die (white). One of those who died had bleeding in the brain caused by the tPA. Click to view larger image.

REFERENCE:

Jaunch, C. E., et al. "Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association." Stroke 44.3 (2013): 870-947.

Powers, W., et al., 2015 AHA/ASA focused update of the 2013 guidelines for the early management of patients with acute ischemic stroke regarding endovascular treatment. Stroke, June 29, 2015.


Medically Reviewed by a Doctor on 7/13/2015

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Read What Your Physician is Reading on Medscape

Stroke, Ischemic »

Stroke is characterized by the sudden loss of blood circulation to an area of the brain, resulting in a corresponding loss of neurologic function.

Read More on Medscape Reference »


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