Stroke now the third leading cause of death in western society

A stroke, or cerebrovascular accident, is a disease involving one or more blood vessels of the brain.

Strokes are a major cause of death and disability and the third leading cause of death in western society. It is estimated 3% to 5% of the population is affected by strokes. Men and women are equally affected.

Strokes are more common than generally realized. It is estimated that by the age of 30 years, one in four people have sufficient change in their cerebral arteries to provide a setting for a stroke at any time. Autopsy studies show nearly half those who die from other causes have had a minor stroke without ever being aware of it.

The impact of stroke is far-reaching. Seventy-five percent of all stroke victims are 65 years of age or older. Increased age is a strong risk factor but other factors include cigarette smoking, lack of physical activity, high blood pressure and a high fat and sugar diet.

There are three main causes of strokes—blood clot, or thrombus, at the site of the artery, an embolus (blood clot) from a distant site and a hemorrhage, or brain bleed.

A thrombus is the most common cause, accounting for 85% of all strokes. It usually is a severe result of atherosclerosis, or hardening of the arteries, in the brain. A thrombus is a collection of fat, cholesterol, fibrin, white blood cells and platelets that develop in a blood vessel. The clot can eventually progress and severely block the blood flow through an artery depriving part of the brain of vital oxygen and nutrients.

An embolus is a small circulating mass that develops in one part of the body but can then travel to another site to cause disruption of blood flow and tissue damage. It can be made up of air, plaque or other material introduced into the circulatory system.

A brain bleed is caused by a rupture in the lining of the artery wall that allows blood to leak out and flood surrounding tissue. High blood pressure and a weakness in the arterial wall contribute to the development of this type of stroke. It deprives brain tissue immediately downstream from the site of the injury of oxygen, leading to tissue damage. About 13% of strokes are hemorrhagic.

Other, less common causes of stroke, include compression of blood vessels near the brain because of the growth of tumours or arterial spasms.

Symptoms of strokes vary according to the type and area of the brain affected. If the left side of the brain is affected, the opposite side of the body is affected and vice versa. Early symptoms of stroke include dizziness, headache, mental confusion, poor coordination and muscle weakness in the arms or legs.

Speech can also be affected and emotional disturbance may occur. There may also be loss of consciousness, paralysis of one or more limbs, convulsions and even sudden death.

Depending on the extent and duration of the injury, damage to the brain can be transient or permanent. Strokes that last from a few minutes to less than 24 hours are called transient ischemic attacks, or TIAs. This is usually a temporary condition that resolves and leaves no permanent damage. These attacks are considered warnings that a more serious episode can occur.

Conventional medical treatment of strokes begins with proper assessment of the type of injury. A medical imaging test of the head, including a CT scan or MRI, is required to make an accurate diagnosis.

TPA, or “clot buster” drugs, may be used in a hospital setting if the diagnosis of ischemic stroke is confirmed within three or four hours after the first onset of symptoms.

Blood thinners and anticoagulant medicine may be prescribed when tests confirm injury is caused by a thrombus or other blood clot. Platelet inhibitors include acetylsalicylic acid (ASA), clopidogrel (Plavix) and ticagrelor (Brilinta).

New oral anticoagulants include apixaban (Eloquis) and rivaroxaban (Xarelto) and dabigatran (Pradaxa). The drugs prevent blood clots from forming by inhibiting the clotting cascade. Unlike warfarin, there is no need to monitor blood clotting times and vitamin K intake.

Medication for high blood pressure and high cholesterol may also be prescribed when warranted.

Stress is a major risk factor in the development of high blood pressure and strokes. Identifying and reducing stressors can help reduce these risk factors.

A poor diet, high in salt (sodium)and refined and processed foods also contributes to the development of high blood pressure and arterial damage.

Supplements can also be helpful in keeping the blood thin, reducing high blood pressure and decreasing fats and cholesterol levels. These can include fish oils, garlic, gingko magnesium, nattokinase, proteolytic enzymes, red yeast rice and turmeric.

Consultation with a licensed medical professional is helpful to determine if there are any interactions between drugs and supplements that may affect blood clotting.

The information provided in this article is not intended to constitute medical advice. All information and content are for general information purposes only.

This article is written by or on behalf of an outsourced columnist and does not necessarily reflect the views of Castanet.