Stroke prevention essential to controlling the devastating effects of this deadly disease

 Newswise — Stroke is the third leading cause of death in the United States. Preliminary estimates indicate that 150,147 people in the United States died from cerebrovascular disease in 2004; a decrease of nearly 5 percent from the prior year. Of the more than 700,000 people affected every year, about 500,000 of these are first attacks, and 200,000 are recurrent.

About 25 percent of people who recover from their first stroke will have another stroke within five years. Stroke is a leading cause of serious long-term disability, with an estimated 5.4 million stroke survivors currently alive today.

“Prevention is essential to controlling the devastating and far-reaching physical, emotional, and financial repercussions of cerebrovascular disease,” said Donald O. Quest, MD, president of the American Association of Neurological Surgeons (AANS), and a cerebrovascular neurosurgeon at the Neurological Institute, NewYork-Presbyterian Hospital/Columbia University Medical Center.

“Understanding the factors that increase the risk of stroke and recognizing the symptoms help in prevention. If you do suffer a stroke, receiving early diagnosis and treatment improves your chances for complete recovery,” added Dr. Quest.

Prevention Tips

There are some stroke risk factors such as age, gender, heredity/race and a history of heart disease/stroke that are uncontrollable. The good news is that there are controllable or treatable risk factors which may help prevent a stroke.

•If you are a smoker, stop smoking
•Maintain a healthy weight
•Maintain normal blood pressure and if it is high, seek treatment
•Maintain normal blood cholesterol levels through a healthy diet and/or medication if necessary
•If you have diabetes, control your blood pressure, blood sugar and cholesterol levels
•If you have a family history of aneurysm or stroke, screening may be advisable
•If you are diagnosed with carotid arteriosclerosis, seek treatment
•If you are diagnosed with atrial fibrillation, seek treatment
•If you have a history of transient ischemic attacks (TIAs ), seek prompt diagnosis and treatment
•Get 30 minutes of moderate exercise, five days a week. Check with your doctor first before starting any exercise program if you have any health problems or have been inactive.

Stroke Symptoms

The range and severity of early stroke symptoms vary considerably, but they share the common characteristic of being of sudden onset. Call 911 promptly if you experience any of these symptoms. Warning signs may include some or all of the following symptoms:

•Dizziness, nausea or vomiting
•Unusually severe headache
•Confusion, disorientation or memory loss
•Numbness, weakness in an arm, leg or the face, especially on one side
•Abnormal or slurred speech
•Difficulty with comprehension
•Loss of vision or difficulty seeing
•Loss of balance, coordination or the ability to walk

Stroke Treatment

Ischemic stroke, which accounts for about 85 percent of all strokes, is treated by removing the obstruction and restoring blood flow to the brain. One treatment for ischemic stroke is the FDA-approved drug, tissue plasminogen activator (tPA), which is most effective if administered within a three-hour window from the onset of symptoms. After three hours, tPA may in some cases, be injected directly into the site of the clot (intra-arterial therapy). This medication carries a risk for increased intracranial hemorrhage and is not used for hemorrhagic stroke. Anticoagulants or antiplatelet medications may be administered after a stroke to help prevent formation of blood clots.

Hemorrhagic stroke may require surgery to relieve intracranial pressure caused by bleeding. Surgical treatment for hemorrhagic stroke caused by an aneurysm or defective blood vessel can prevent additional strokes. Surgery may be performed to seal off the aneurysmal defect on a blood vessel or to redirect blood flow to other vessels that supply blood to the same region of the brain.

Endovascular treatment involves inserting a long, thin, flexible tube (catheter) into a major artery, usually in the thigh, guiding it to the defective blood vessel, and inserting tiny platinum coils for aneurysms or stents for narrowed blood vessels through the catheter. Stents keep the blood vessel open to prevent further damage and additional strokes. Stents may be used to open blocked arteries in the brain when clot-dissolving drugs have failed.

Some newer stroke treatment innovations include:

•Thrombectomy or clot removal devices are now available for stroke therapy as alternatives to clot dissolving agents or in addition to these agents when they fail to remove the blockage.

•Stents are now available in certain institutions with special approval for the prevention of strokes in patients who have intracranial arteriosclerosis who have had a stroke, minor stroke or TIA, despite being on blood-thinning medications.

The AANS has additional information on stroke at: http://www.NeurosurgeryToday.org, under Conditions & Treatments.

Founded in 1931 as the Harvey Cushing Society, the American Association of Neurological Surgeons (AANS) is a scientific and educational association with more than 6,800 members worldwide. The AANS is dedicated to advancing the specialty of neurological surgery in order to provide the highest quality of neurosurgical care to the public. All active members of the AANS are certified by the American Board of Neurological Surgery, the Royal College of Physicians and Surgeons (Neurosurgery) of Canada or the Mexican Council of Neurological Surgery, AC. Neurological surgery is the medical specialty concerned with the prevention, diagnosis, treatment and rehabilitation of disorders that affect the entire nervous system, including the spinal column, spinal cord, brain, and peripheral nerves.