What Causes a Stroke?
A common cause of stroke is atherosclerosis — hardening of the arteries. Plaque made of fat, cholesterol, calcium, and other substances builds up in the arteries, leaving less space for blood to flow. A blood clot may lodge in this narrow space and cause an ischemic stroke. Atherosclerosis also makes it easier for a clot to form. Hemorrhagic strokes often result from uncontrolled high blood pressure that causes a weakened artery to burst.
Common risk factors include chronic conditions (such as high blood pressure, diabetes and obesity) unhealthy behaviors (such as smoking and not exercising enough), and a poor diet. Uncontrollable factors include aging, having a family history of strokes, being a male, and race (African-Americans, Native Americans, and Alaskan Natives are at greater risk compared to people of other ethnicities).
For an ischemic stroke, emergency treatment focuses on medicine to restore blood flow. A clot-busting medication is highly effective at dissolving clots and minimizing long-term damage, but it must be given within three hours of the onset of symptoms. Hemorrhagic strokes are more difficult to manage. Treatment usually involves attempting to control high blood pressure, bleeding, and brain swelling.
Stroke Prevention: Lifestyle
People who have had a stroke or TIA can take steps to prevent a recurrence:
• Quit smoking.
• Exercise and maintain a healthy weight.
• Limit alcohol and salt intake.
• Eat a healthier diet with more veggies, fish, and whole grains.
Stroke Prevention: Medication
For people with a high risk of stroke, doctors often recommend medications to lower this risk. Anti-platelet medicines, including aspirin, keep platelets in the blood from sticking together and forming clots. Anti-clotting drugs, such as warfarin, may be needed to help ward off stroke in some patients. Finally, if you have high blood pressure, your doctor will prescribe medication to lower it.
Stroke Prevention: Surgery
In some cases, a stroke results from a narrowed carotid artery — the blood vessels that travel up each side of the neck to bring blood to the brain. People who have had a mild stroke or TIA due to this problem may benefit from surgery known as carotid endarterectomy. This procedure removes plaque from the lining of the carotid arteries and can prevent additional strokes.
Stroke Prevention: Balloon and Stent
Doctors can also treat a clogged carotid artery without major surgery in some cases. The procedure, called angioplasty, involves temporarily inserting a catheter into the artery and inflating a tiny balloon to widen the area that is narrowed by plaque. A metal tube, called a stent, can be inserted and left in place to keep the artery open.
Life After a Stroke
More than half of people who have a stroke regain the ability to take care of themselves. Those who get clot-busting drugs soon enough may recover completely. And those who experience disability can often learn to function independently through therapy. While the risk of a second stroke is higher at first, this risk drops off over time.