(Cerebrovascular Accident; CVA; Cerebral Infarct)
- An ischemic stroke is caused by a blocked blood vessel. It is the most common cause of stroke.
- A hemorrhagic stroke is caused by a ruptured blood vessel.
|Hemorrhagic vs. Ischemic Stroke|
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- Atherosclerosis—a build-up of fatty substances along the inner lining of the artery that gradually decrease the area the blood can flow through
- A blood clot that has traveled from other parts of the body such as the neck or heart
- Inflammation of the blood vessels
- Race—People of African American, Hispanic, or Asian/Pacific Islander descent are at increased risk.
- Age: Older than 55 years of age
- Family history of stroke
- High blood pressure
- High cholesterol levels—specifically high-LDL bad cholesterol
- Low bone mineral density, especially in women
- Obesity and metabolic syndrome
- High blood homocysteine level
- Diabetes mellitus or impaired glucose tolerance
- Atrial fibrillation
- Blood disorders such as sickle cell disease and polycythemia
- Vascular dementia
- Disease of heart valves, such as mitral stenosis
- Prior stroke or cardiovascular disease, such as heart attack
- Peripheral artery disease
- Transient ischemic attack (TIA) —a warning stroke with stroke-like symptoms that go away shortly after they appear
- Conditions that increase your risk of blood clots such as:
- Certain autoimmune diseases
- Migraine with aura
- Having a blood vessel abnormality
- Previous pre-eclampsia
- Use of birth control pills, especially if you are over 35 years old and smoke
- Long-term use of hormone replacement therapy
- Pregnancy—due to increased risk of blood clots
- Weakness or numbness of face, arm, or leg, especially on one side of the body
- Trouble speaking or understanding
- Trouble seeing in one or both eyes
- Lightheadedness, trouble walking, loss of balance, or coordination
- Severe headache with no known cause
- Reduce the chance of later strokes
- Improve function affected by the stroke
- Overcome disabilities
- Oxygen therapy
- Precautions to prevent choking
- Decrease blood pressure
- Correct irregular heart rhythms
- Extracranial/intracranial bypass—blood vessel from the scalp is used to reroute blood supply around the blocked artery
- Embolectomy—a catheter is threaded through blood vessels to the clot. It can remove the clot or deliver clot-dissolving medication directly to the area
- Physical therapy—to regain as much movement as possible
- Occupational therapy—to assist in everyday tasks and self care
- Speech therapy—to improve swallowing and speech challenges
- Psychological therapy—to improve mood and decrease depression
- Exercise regularly.
- Eat more fruits, vegetables , and whole grains . Limit dietary salt and fat .
- Stop smoking .
- Increase your consumption of fish.
- Drink alcohol only in moderation: no more than 1-2 drinks per day.
- Maintain a healthy weight.
- Check blood pressure frequently . Follow your doctor's recommendations for keeping it in a safe range.
- Take a low dose of aspirin if your doctor says it is safe.
- Keep chronic medical conditions under control. This includes high cholesterol and diabetes.
- Talk to your doctor about the use of a statins. These types of drugs may help prevent certain kinds of strokes in some people.
- Seek medical care if you have symptoms of a stroke, even if symptoms stop.
- If you abuse drugs, talk to your doctor about rehabilitation programs.
American Heart Association http://www.heart.org
National Stroke Association http://www.stroke.org
Heart and Stroke Foundation of Canada http://ww2.heartandstroke.ca
Public Health Agency of Canada http://www.publichealth.gc.ca
Furie KL, Kasner SE, Adams RJ, et al. Guidelines for the Prevention of Stroke in Patients With Stroke or Transient Ischemic Attack: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke. 2010 October 21. Available at: http://stroke.ahajournals.org/cgi/reprint/STR.0b013e3181f7d043v1. Updated October 21, 2010. Accessed November 18, 2013.
Ischemic stroke. American Heart Association American Stroke Association website. Available at: http://www.strokeassociation.org/STROKEORG/AboutStroke/TypesofStroke/IschemicClots/Ischemic-Strokes-Clots%5FUCM%5F310939%5FArticle.jsp. Updated November 7, 2013. Accessed November 18, 2013.
Long term management of stroke. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated October 28, 2013. Accessed November 18, 2013.
Neuroimaging for acute stroke. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated May 15, 2013. Accessed November 18, 2013.
Stroke (acute management). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated October 24, 2013. Accessed November 18, 2013.
What is stroke? National Stroke Association website. Available at: http://www.stroke.org/site/PageServer?pagename=STROKE. Accessed November 18, 2013.
11/20/06 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: Mas JL, Chatellier G, Beyssen B, et al. Endarterectomy versus stenting in patients with symptomatic severe carotid stenosis. N Engl J Med. 2006;355:1726-1729.
12/16/2008 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Farquhar C, Marjoribanks J, Lethaby A, Suckling J, Lamberts Q. Long term hormone therapy for perimenopausal and postmenopausal women. Cochrane Database Syst Rev. 2008;CD004143.
10/9/2009 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Mitchell PH, Veith RC, Becker KJ, et al. Brief psychosocial-behavioral intervention with antidepressant reduces poststroke depression significantly more than usual care with antidepressant: living well with stroke: randomized, controlled trial. Stroke. 2009;40:3073-3078.
3/28/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Park Y, Subar AF, Hollenbeck A, Schatzkin A. Dietary Fiber Intake and Mortality in the NIH-AARP Diet and Health Study. Arch Intern Med. 2011 Feb 14. [Epub ahead of print]
2/7/2014 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: Bushnell C, et al. AHA/ASA Guideline for the Prevention of Stroke in Women. Stroke. 2014 Feb 6. [Epub ahead of print]
6/2/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Myint PK, Cleark AB, et al. Bone mineral density and incidence of stroke: European prospective investigation into cancer-norfolk population-based study, systemic review, and meta-analysis. Stroke. 2014 Feb;45(2):373-82.
6/2/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Imfeld P, Bodmer M, et al. Risk of incident stroke in patients with Alzheimer disease or vascular dementia. Neurology. 2013 Sep 3;81(10):910-919.
- Reviewer: Rimas Lukas, MD
- Review Date: 11/2013 -
- Update Date: 06/02/2014 -