Heart Information Center


Stroke is the third leading cause of death and the leading cause of disability in the United States. More than 500,000 Americans suffer a stroke each year; of these nearly 20% will die within a year. Persons surviving a stroke often end up financially impoverished and socially isolated, losing the ability to walk, talk or care for themselves.

Top


What is a stroke?

Stroke is a disease that affects the blood vessels supplying blood to the brain. It is also sometimes called brain attack. Blood containing oxygen and nutrients is delivered to the brain via 4 arteries and their branches: left and right internal carotid arteries; left and right vertebral arteries. The two vertebral arteries join together in the brainstem to form the basilar artery.

When deprived of oxygen, nerve cells in the affected area of the brain can't function and die within minutes. When nerve cells can't function, the part of the body controlled by these cells can't function either. The devastating effects of stroke are often permanent.

Top


What are the different types of stroke?

A stroke occurs when blood flow (and thus oxygen delivery) to a certain part of the brain is interrupted. This can occur by two mechanisms:

  1. Ischemic stroke can happen when a blood vessel in the brain is clogged by a blood clot or some other particle. Because of blockage part of the brain doesn't receive the blood it needs. Deprived of oxygen (ischemia), affected brain cells can't function and die within minutes. When brain cells can't function, the part of the body controlled by these cells can't function either. Stroke effects are often permanent because dead brain cells aren't replaced.

  2. Hemorrhagic stroke is caused by a ruptured (burst) brain blood vessel. When hemorrhage occurs, the loss of a constant blood supply means some brain cells can no longer function. Another problem is that accumulated blood from the burst artery may put pressure on surrounding brain tissue and interfere with how the brain functions. Severe or mild symptoms can result, depending on the amount of pressure.

Approximately 80-85% of strokes are ischemic in nature while 15-20% are due to hemorrhage.

Top


Ischemic stroke is divided into 3 main categories:
  1. Thrombotic strokes occur when a clot (thrombus) forms within a brain blood vessel and blocks blood flow to that area of the brain. Clots are more likely to form on the inside of a brain artery that is injured or narrowed. Atherosclerosis is by far the most common cause of thrombotic stroke in the United States. Much less frequent causes may include dissection, vasculitis, conditions that cause blood to clot too easily. Thrombotic strokes cause about 70-80% of ishemic strokes (about 60% of all strokes).

  2. Embolic strokes occur when a blood clot breaks loose in some other part of the body, such as the heart, travels to and lodges in a brain artery. Most embolic strokes originate from the heart, aorta,carotid or vertebral arteries. Conditions such as atrial fibrillation or valvular heart disease increase the risk of emboli. Embolic strokes account for about 15-20% of all strokes.

  3. Systemic hypoperfusion, occurring during a severe heart attack,heart arrhythmias or extreme blood loss, is failure of the heart to pump enough blood to the brain and can cause stroke. Hypoperfusion is less common than thrombosis or embolism as a cause of stroke.

Top


Hemorrhagic Stroke is divided into 2 categories:
  1. Intracerebral hemorrhage (ICH) accounts for about two thirds of hemorrhagic strokes (10-15% of all strokes). Bleeding occurs directly into the brain tissue, usually from small arteries (arterioles). Most ICH are associated with chronic high blood pressure.

  2. Subarachnoid hemorrhage (SAH) occurs when a blood vessel on the surface of the brain ruptures and bleeds into the space between the brain and the skull (but not into the brain itself). SAH is usually due to an aneurysm in the brain.

Aneurysms are blood-filled pouches that balloon out from weak spots in the artery wall. They're often caused or aggravated by high blood pressure. Aneurysms aren't always dangerous, but if one bursts in the brain, a stroke results.

Brain aneurysms (called berry aneurysms) usually occur at points where the brain arteries branch or are just about to enter brain tissue in an area known as the subarachnoid space. Rupture in this area is often very serious because the blood pressure is higher in this area than in smaller arteries that have already entered the brain tissue.

SAH occurs half as frequently as ICH. Ruptured subarachnoid aneurysms cause about 10% of all strokes but cause a higher percent of strokes in younger people (under 40 years).
They're often caused or aggravated by high blood pressure but may occur in young otherwise healthy people.
Cerebral and subarachnoid hemorrhages have a much higher fatality rate than strokes caused by clots. The amount of bleeding determines the severity of cerebral hemorrhages. In 50 percent of the cases, people with cerebral hemorrhages die within the first month due to increased pressure on their brains. Those who live, however, tend to recover much more than those who've had strokes caused by a clot.

Top


What are risk factors for having a stroke?

Risk factors are things that increase the chance of having a stroke. Certain risk factors are important contributors to all types of strokes while other factors may favor a specific type of stroke.

  • High blood pressure - High blood pressure is the most important risk factor for stroke . In fact, stroke risk varies directly with blood pressure. Effective treatment of high blood pressure may be the reason that death rates for stroke have greatly decreased in recent years.

  • Increasing age - The chance of having a stroke more than doubles for each decade of life after age 55.
  • Prior stroke - The risk of stroke for someone who has already had one is many times that of a person who has not.

  • Cigarette smoking - Cigarette smoking is an important risk factor for stroke . The nicotine and carbon monoxide in cigarette smoke damage the heart and blood vessels in many ways. The use of birth control pills combined with cigarette smoking greatly increases stroke risk.

  • Male sex - Overall, men have about a 20 percent greater chance of stroke than women. Among people under age 65, the risk for men is even greater when compared to that of women.
  • Heredity (family history) and race - The chance of stroke is greater in people who have a family history of stroke. African Americans have a much higher risk of death and disability from a stroke than whites, in part because blacks have a greater incidence of high blood pressure.
  • Diabetes mellitus - Diabetes is an independent risk factor for stroke and is strongly correlated with high blood pressure. While diabetes is treatable, having it still increases a person's risk of stroke.
  • Carotid artery disease - The carotid arteries in your neck supply blood to your brain. A carotid artery damaged by atherosclerosis (a fatty buildup of plaque in the artery wall) may become blocked by a blood clot and cause a stroke.
  • Heart disease - A diseased heart increases the risk of stroke. People with heart problems have greater than twice the risk of stroke as those without heart problems. Heart attack is also the major cause of death among survivors of stroke.

  • Atrial fibrillation (the rapid, uncoordinated beating of the heart's upper chambers) raises the risk for embolic stroke.

  • Transient ischemic attacks (TIA's) - TIA's are "mini strokes" that produce stroke-like symptoms but no lasting damage. They are strong predictors of stroke. A person who's had one or more TIA's is almost 10 times more likely to have a stroke than someone of the same age and sex who hasn't.
  • High red blood cell count - An increase in the red blood cell count is a risk factor for stroke. Excess red blood cells thicken the blood and make clots more likely to form.

  • Cerebral Aneurysms- Aneurysms are blood-filled pouches that balloon out from weak spots in the artery wall. They're often caused or aggravated by high blood pressure but can be congenital. Aneurysms aren't always dangerous, but if one bursts in the brain, a hemorrhagic stroke results. More common cause of stroke in those under 40 years.

  • Drug abuse - Intravenous drug users are at risk of stroke from cerebral embolisms . Cocaine use has been closely related to strokes and heart attacks. Some have been fatal even in first-time cocaine users.

Secondary risk factors that indirectly increase the risk of stroke by increasing the risk of heart disease include:

    • High cholesterol
    • Lack of exercise
    • Obesity

Other factors affecting the risk of stroke

  • Geographic location - Strokes are more common in the southeastern United States than in other areas.
  • Season and climate - Stroke deaths occur more often during extremes (hot or cold) of temperature.
  • Excessive alcohol intake - Excessive drinking ( average of greater than one drink per day for women and more than two drinks per day for men) and binge drinking can indirectly lead to a stroke by raising blood pressure, contributing to obesity, and causing heart failure.

Top


What are symptoms of a stroke?

Strokes affect different people in different ways depending on the type of stroke, the part of the brain affected and the amount of the brain injury. Stroke symptoms may include:

  • Sudden numbness or weakness of face, arm or leg, especially on one side of the body.
  • Sudden confusion, trouble speaking or understanding speech.
  • Sudden trouble seeing in one or both eyes.
  • Sudden trouble walking, dizziness, loss of balance or coordination.
  • Sudden, severe headache with no known cause. Often described as "feeling like my head is going to explode" or the worst headache of my life.

It is often not possible to tell what type of stroke (bleeding, thrombotic, or embolic) is occurring based on the symptoms a person is having.

Bleeding strokes are more likely to occur in younger people (under 40 years), be preceded by severe headaches and cause decreased consciousness or coma.

Embolic strokes are more likely in persons with existing heart valve disease, congenital heart defects, atrial fibrillation and other heart arrhythmias.

Thrombotic strokes are more likely in persons with known narrowing of neck or brain arteries (carotid artery stenosis) and prior stroke or TIA's with the similar symptoms.

Top


What is a TIA or transient ischemic attack?

If blood flow is restored quickly any of the above signs may be only temporary and last from a few minutes upto half an hour. This may be due to a "little stroke" or "mini-stroke" called a transient ischemic attack or TIA

About 10 percent of strokes are preceded by TIA's. About a third of people who have had one or more TIA's will later have a stroke. A person who has had one or more TIA's is almost 10 times more likely to have a stroke than someone of the same age and sex who has not. Increasing frequency of TIA's may indicate an impending stroke. See your doctor immediately if TIA's are occurring more frequently.

Top


What to do if having stroke symptoms!

IF YOU NOTICE ONE OR MORE OF THESE SIGNS, DON'T WAIT!

CALL YOUR EMERGENCY MEDICAL SERVICES.
GET TO A HOSPITAL RIGHT AWAY!

 

 

 

 

 

Top


How is a stroke diagnosed?

At the hospital, the emergency department staff or your doctor will check to see if you are having a stroke by:

  1. Asking you about your symptoms;
  2. Testing the muscles of your body for strength, coordination and sensation.
  3. Performing a CT scan to determine what type of stroke you might be having;
  4. Taking a blood samples to test for red blood cell count, blood sugar, electrolyte concentration, and how your blood clotting system works.
  5. Perform an EKG to see if a heart problem might be causing a stoke.

These tests should be performed as quickly as possible so optimal stroke treatment may be given.

If the emergency department staff suspects you are having a stroke they will hook you up to a heart monitor, place a catheter(s) in your vein(s), and give you additional oxygen through a tube attached under your nose.

Symptoms

Your doctor will want to know how long symptoms have been present and whether or not you have had a previous stroke or similar symptoms. If symptoms have been brief (less than several hours) and your stroke is not due to bleeding (hemorrhage) in the brain, clot dissolving medicine may be considered. Your doctor will want to know if you have a severe headache.

Physical exam

Strokes may produce certain patterns depending on the part of the brain involved. Knowing the severity of stroke symptoms is very important in deciding how aggressively to treat the stroke because certain treatments have serious side effects.

For example, treating a severely disabling ischemic stroke in an otherwise healthy person with a clot dissolving medication would likely be worth the increased risk of severe brain hemorrhage associated with the use of this medication. However, in a patient having a mild stroke with relatively little disability the risk of severe brain hemorrhage would outweigh possible mild benefits gained from use of clot dissolving medication.

CT scan the most important test in majority of stroke patients because it can accurately tell whether or not a stroke is due to bleeding in the brain.

  • Should be performed in all patients suspected of having a stroke.
  • CT scan does not detect most ischemic strokes for at least 6 hours. However, it is excellent at detecting bleeding in the brain from hemorrhagic (burst blood vessel)strokes.

It is extremely important to determine what type of stroke (hemorrhagic or ischemic) you are having because treatment is different for each type. Blood thinners or clot dissolving medications used in ischemic strokes will make a hemorrhagic stroke worse!

Lab tests

  • Abnormally low blood sugar may mimic certain stroke symptoms.
  • Abnormally low or high electrolytes (sodium) may also mimic stroke symptoms.
  • Drugs, such as methamphetamine (speed) or cocaine, may cause stroke.
  • Blood cell count may indicate if blood is "thick", increasing risk of thrombotic stroke.
  • Blood of patients taking blood thinners may not clot normally, increasing the risk of hemorrhagic stroke.

EKG

  • Atrial fibrillation and heart attack cause a majority of embolic strokes. If either are detected on EKG it is much more likely that a stroke is from heart emboli. Treating the underlying heart problem will be important in both treatment and future stroke prevention.

Top


Stroke Treatment

Surgery, drugs, acute hospital care and rehabilitation are all accepted ways to treat stroke. Treatment will depend on both type and severity of stroke. When a neck artery has become partially blocked, surgery might be used to remove the buildup of atherosclerotic plaque. This is called carotid endarterectomy . Cerebral angioplasty is a new experimental technique. Balloons, stents and coils are used to treat some types of brain blood vessel problems. Widespread use of these experimental techniques will require further study of safety and effectiveness.

Initial treatment of ischemic (thrombotic and embolic) strokes

Thrombotic and embolic strokes are due to blockage of blood flow from blood clots. Once it has been determined that a person is not having a bleeding stroke they may be given anticoagulant (blood thinning) or thrombolytic (clot dissolving) medications. These medications may include aspirin, heparin, or tissue plasminogen activator (TPA).

Aspirin

Low dose aspirin (1-4 baby aspirin) are given to almost all patients suffering from a nonbleeding stroke. Aspirin prevents platelets (part of the blood clotting system) from sticking together. Aspirin may decrease the severity of stroke and definitely decreases the risk of having another stroke. Aspirin is very safe for people not allergic to it.

Anticoagulants

Anticoagulant (blood thinners) work by preventing certain blood clotting factors from working. Anticoagulants prevent new clots from forming but do not dissolve preexisting clots. Use of anticoagulants increases the risk of internal bleeding. There are two anticoagulants used in stroke patients.

Heparin is given intravenously for the first 3- 5 days for certain stroke patients. Heparin works very quickly and its blood thinning effects stop a few hours after being discontinued.

Coumadin is taken by mouth once a day and may be started the second or third day after a stroke. Coumadin takes several days to become effective. Heparin is stopped once the desired level of blood thinning with coumadin has been reached. Certain blood tests can tell how well both heparin and coumadin are working.

Anticoagulants are indicated for embolic stroke, particularly emboli arising from the heart. Heparin is still used by many doctors for all cases of ischemic stroke. It is unclear whether it actually improves stroke outcome for thrombotic strokes. It is sometimes difficult to determine whether an ischemic stroke is thrombotic or embolic. There is an increased risk (about 1%) of converting an ischemic stroke into a bleeding stroke with the use of heparin. This is bad because bleeding strokes have a 30-50% death rate while that of nonbleeding (ischemic) strokes is 10-15%.

Long term use of coumadin has not been shown to be any more effective than aspirin in preventing recurrent stroke in patients not having emboli.

Thrombolytics (clot dissolvers)

Tissue plasminogen factor (TPA) is a clot dissolving medicine that has been used for some time in persons having heart attacks and recently approved by the Food and Drug Administration (F.D.A.) for stroke treatment. It has recently shown great promise in treatment of ischemic stroke. Studies have shown that persons receiving TPA are more likely to have improved outcome than those not receiving TPA.

TPA must be used carefully and is not for all patients.

  • TPA may be indicated for patients having ischemic (thrombotic or embolic) stroke who seek treatment within 3 hours of the onset of symptoms.

  • A CT scan must be performed to exclude brain bleeding.

  • TPA can not be used in persons with bleeding strokes, recent major surgery, extremely high blood pressure or in people taking coumadin.

Use of TPA increases the chance of converting an ischemic stroke into a bleeding stroke from 0.6% to 6%( 10 times) even when patients with contraindications are excluded from receiving TPA. About 50% of persons with TPA induced bleed will die or be severely disabled.

It is our opinion persons receiving TPA must fully understand the risks as well as benefits. For example, a person having a mild stroke with minimal loss of function must weigh the relative benefits versus the very real risk (1 in 18) of sustaining a much more severe stroke with TPA. This is a highly personal choice. A person's age, health and prior level of activity are all considerations.

Long term treatment (prevention) of ischemic strokes

The goal of long term treatment is to prevent either an initial or recurrent stroke. Type of treatment will depend on underlying cause.

Aspirin

Use of low dose aspirin on a daily basis has been shown to significantly decrease the frequency of TIA's and the likelihood of all types of ischemic stroke.

Anticoagulants

Long term use of coumadin after stroke has been replaced by aspirin use for most patients. Coumadin is still used in persons at high risk of recurrent embolic stroke. Risk factors include atrial fibrillation, valvular or congenital heart disease.

Surgery

Narrowing of the carotid artery (neck artery) may cause wither TIA's or thrombotic stroke. When the carotid artery is narrowed more than 70-75% a surgical procedure, called carotid endarterecomy, has been shown to greatly decrease the risk of stroke due to carotid artery thrombus. If narrowing is less severe such surgery has not been shown to decrease stroke risk.

Initial treatment of hemorrhagic stroke

Management of hemorrhagic strokes is complex. Hemorrhagic strokes are associated with higher rates of death than ischemic strokes. Most intracerebral bleeds (ICB) are left alone. Accumulated blood from the burst artery puts pressure on surrounding brain tissue and interferes with how the brain functions. Severe or mild symptoms can result, depending on the amount of pressure. Surgery may be done persons with large bleeds who are alert but deteriorating. Doctors will gently lower extremely high blood pressure with medications.

Subarachnoid hemorrhages have the highest risk of rebleeding in the first 24 hours. In hospital management includes carefully controlling blood pressure and using certain medications that reduce spasm of brain arteries after hemorrhage has occurred. Angiography is usually performed to see where bleeding is coming from. In certain cases surgery may be done to "clip" the leaking blood vessel shut.

Top


Stroke effects
  • Emotions - A stroke survivor may cry easily, often for no apparent reason. This is called emotional lability . Laughing uncontrollably may also occur but is not as common as crying. Depression is common, as people who have experienced stroke may feel less than "whole".

  • Depression- is very common after stroke. It more likely in persons living alone and in those having speech/ communication impairment. Your doctor may prescribe low dose antidepressants to help with depression.

  • Bodily awareness- Stroke often causes people to lose mobility and/or feeling in an arm and/or leg, or suffer dimness of sight on one side. The loss of feeling or vision may result in a loss of awareness. Stroke survivors may forget or ignore their weaker side. This problem is called "neglect." As a result, they may ignore items put on their affected side, have trouble reading, or dress only one side of their bodies and think they're completely dressed. Bumping into furniture or door jambs is also common. One-side neglect is most common in those with injury to the right side of the brain.

  • Perception - A stroke can also affect seeing, touching, moving and thinking, so a person's perception of everyday objects may be changed. Stroke survivors may not be able to recognize and understand familiar objects the way they did before. When vision is affected, objects may look closer or farther away than they really are, causing spills at the table or collisions when walking.

  • Speech - Usually stroke doesn't cause hearing loss, although people may have problems understanding speech. They also may have trouble saying what they're thinking. This is called aphasia. It is most common when a stroke weakens the right side of the body (effects the left side of the brain).

    A related problem is that a stroke can affect muscles used in talking (those in the tongue, palate and lips), and speech can be slowed, slurred or distorted. Stroke survivors thus can be hard to understand. This is called dysarthria and may require the help of a speech expert.

  • Swallowing - Stroke can affect chewing and swallowing food. The mouth muscles may be weak, lack feeling or the normally protective gag reflex may be absent. Swallowing difficulty is called dysphagia and increases the risk of choking and inhaling mouth contents into the lungs.

  • Thinking - Stroke can affect the ability to think clearly. Planning and doing simple activities may be hard. Stroke survivors may not know how to start a task, confuse the sequence of logical steps in tasks, or forget how to do tasks they've done many times before.

  • Movement- Stroke can affect the ability to use an arm and/ or leg. This usually occurs on one side of the body. Walking, dressing, or getting on or off the toilet may be difficult or impossible.

  • Bladder- About half of stroke patients have bladder control problems the first several weeks. For a vast majority of patients this improves without treatment.

  • Muscle Pain often occurs for a variety of reasons. It may be from rehabilitation exercises that are too vigorous, in persons who are not active enough, in muscles that are spastic or in persons who have been tugged on to help them up. Nonsteroidal anti-inflammatory medications, muscle relaxants, local anesthetics, or cortisone-like medications may be prescribed.

  • Sexual Dysfunction- Sexual desire remains intact in most people after a stroke! However, many men and women who were previously sexually active experience problems with sexual performance because of physical and/ or psychological difficulties. Physical reasons include decreased movement, pain and medication side effects. Many persons, or their partners, may be inhibited by fear that sex may cause another stroke or the misperception they should not be having sex. This is a myth! Treatment may include counseling, exploration of different sexual techniques, and/ or use of medications (in men without heart problems) for erection.

Top


Recovery after a stroke

Stroke recovery is often the most difficult part for many persons. Stroke can turn independently living persons into disabled ones dependent on others for help. How well a person recovers after a stroke will depend on a number of factors including the type of stroke, severity of stroke, area of the brain effected by the stroke, overall age / health before the stroke, and available family/ social support after a stroke. Most stroke patients (about 70%) are eventually able to perform basic activities and take care of themselves; however, many of these do not have the same level of social interaction they had before the stroke.

Prognosis for recovery

Persons with mild speech or mobility problems generally do better and recover more quickly than those with moderate to severe deficits. Improvement,usually most noticeable in the first 6 weeks, may continue for upto one year.

During a stroke there is often a zone surrounding the area of brain effected that is injured but does not die due to collateral circulation. This area often regains function over time. In addition, other parts of the brain may attempt to do the job of the area that was lost: specialized cells (called glial cells) to "rewire" various brain cells and parts of the brain.

Early rehabilitation goals

The primary care doctor has an important role in early stroke rehabilitation by recognizing, preventing , and treating other medical problems that may worsen a person's health, make recovery more difficult, and make another stroke more likely. This includes paying attention to blood pressure, nutrition, bladder function, blood sugar levels, proper use of medications such as aspirin and anticoagulants, and safety during self-care tasks.

Long term rehabilitation goals

The long term goal of stroke rehabilitation is to decrease disability and handicap. Physical therapists work with patients to improve ability to move and self-care. This includes working with large muscle groups involved in walking, dressing and being able to use a toilet. Occupational therapists focus on integrating muscle movement (coordination), particularly the hands and arms, into purposeful function. They work with patients using assistive devices for daily activities. Speech therapists help with swallowing and language impairments. Social workers, neuropsychologists, orthotists, dietitians and bioengineers may also be involved in after stroke care

Rehabilitation options

  • While still in the hospital persons who have had a stroke should have physical therapy, occupational therapy, and speech / swallowing evaluations to determine the appropriate level of support and rehabilitation they may require. This evaluation typically occurs 2-3 days after a stroke. Typical hospital stay after an uncomplicated stroke is 1-2 weeks.

  • Persons with limited disability and excellent family support are often able to go home and receive outpatient rehabilitation services.

  • Persons with moderate to severe disability ( may not be able to walk and have trouble speaking) may be considered for admission to an inpatient stroke rehabilitation center. Many studies have shown that persons with moderate impairment receiving care in specialized stroke recovery centers have improved recovery and survival compared to those receiving rehabilitative care in a general medical ward.

  • Elderly persons with significant disability (bedridden, having severe dementia, etc..) are usually transferred to a nursing home. Nursing homes are able to provide rehabilitation services.

Top


Can strokes be prevented?

Although not all strokes can be prevented the chance of having one can be reduced for most people. Risk factors were previously listed. Treatable factors include:

  • Controlling blood pressure and not smoking are the two most important things most people can do to decrease their risk of stroke.

  • If you are diabetic controlling blood sugar and regular modest exercise will be important.

  • Lowering cholesterol decreases the risk of heart disease and stroke in persons with high cholesterol. This may be accomplished with diet, exercise, and/ or medication.

  • Daily aspirin has been shown to decrease the risk of both ischemic stroke and heart attack.

  • Persons with valvular heart problems or certain types of irregular heart beats, particularly atrial fibrillation, should be on anticoagulants.

It is important for a person to see their primary care doctor for regular health checkups.

Top


Glossary

Aphasia injury to the language processing center in the brain impairing the ability to talk, listen, read and write or understand speech.
Arrhythmia an irregular heart rate. There are many different types of arrhythmias
Atherosclerosis narrowing (stenosis) and stiffening of an artery due to build up of fatty deposits and calcium inside an artery.
Atrial fibrillation rapid uncontrolled quivering of the upper chambers (atria) of the heart. The atria do not effectively pump blood.
Carotid endarterecomy carotid artery surgically opened and the atherslerotic plaque (blockage) is removed. The artery is then sewn closed.
Cerebral angioplasty a very fine balloon tipped catheter is threaded through an artery to the blockage. The balloon is inflated to expand the blocked artery.
Collateral circulation increased blood flow in small blood vessels indirectly supplying blood to a region of the brain when the blood flow from a main artery to the region is blocked.
Congenital An abnormality occurring before birth. Can be caused by infection, medications, chemical, radiation exposure, or genetic factors.
CT (CAT) scan Computerized axial tomography uses a series of x-rays and computer to generate an image of the brain.
Dementia impairment of a person's ability to remember past events, be aware of current events in their life, or think in an organized and logical manner.
Disability is limitation in activity due to physical or emotional impairments. An example would be a person who has had a stroke paralyzing one leg or arm not being able to walk across a room without assistance or type on a keyboard.
Dysarthria difficulty speaking clearly (slurred speech) due to weakness of tongue and mouth muscles. Language understanding often normal
Dysphagia difficulty swallowing
Embolus a clot (thrombus) that breaks loose from where it is formed and travels via the bloodstream to and lodges in another part of the body.
Handicap is a limitation on participation in an activity or performance of a usual role. An example would be a person unable to walk not being able to climb up the stairs of a building to get to their job if an elevator was not available
Hemorrhagic severe bleeding
Heparin an anticoagulant (blood thinner) that prevents new blood clots from forming or ones already present from getting bigger. Does not dissolve clots already present.
Ischemia lack of sufficient oxygen to an organ or cell. Usually caused by blocked blood flow. Prolonged ischemia causes death of a cell, organ or person.
Rehabilitation after-stroke treatment attempting to improve a person's level of functioning to what it was before the stroke.
Subarachnoid space a space between the inside of the skull and brain surface that is filled with cerebral spinal fluid.
Thrombolytic clot dissolving medication such as TPA
Thrombus a blood clot or other material causing blockage at the place it forms (versus an embolus that travels from where it was formed).
TPA tissue plasminogen activator is a medication that can dissolve blood clots that have already formed.


Top


Other Sources of Information

American Heart Association
American Stroke Association
American Academy of Family Practice

Dobkin, B. H., Disabling Stroke: Managing common symptoms in FAMILY PRACTICE RECERTIFICATION, (vol. 21, #12, October 1999).

Dobkin, B. H., Disabling Stroke: Setting rehabilitation goals in FAMILY PRACTICE RECERTIFICATION, (vol. 21, #12, October 1999).


Top


Doctors Corner INternet Group, Inc. 1997-2004