Charles A. Bertrand, M.D., FACP, DIM-CD (Ret.)
Associate Clinical Professor of Medicine at New York Medical College
and at the Medical University of South Carolina


A key question is -- what is a stroke? Well, it's an interference with the circulation in one of the arteries of the brain. This causes damage to the brain substance that is reflected clinically by certain signs and symptoms.

There are two types of stroke: ischemic and hemorrhagic. In the ischemic type a blood clot is formed and the area of the brain supplied by that artery is closed off resulting in brain damage. In the hemorrhagic type blood is actually hemorrhaged into the brain substance causing damage. About 80% of strokes are ischemic.

The clinical expression has been given in prior articles on this site. In brief, there may be weakness or paralysis in the arm, leg , part of the face or all three. Inability to speak, or slurred speech, is common. Weakness, unconsciousness and other symptoms may also occur.

While treatment is important and helpful, it is far better to prevent a stroke -- if that is possible. The key factors in having a stroke may be general or specific. The general factors are similar to those risk factors for a heart attack. These include weight control, low-fat diet and cholesterol control restricted alcohol intake, no smoking and proper exercise. All of these factors-- in one way or another - can form the basis, or substrate, that ultimately leads to a stroke.

* Most of us realize that we should be at a more or less normal weight-- the sad truth is that half of our population in the United States is overweight. We should be on a low fat diet -with statin medicines to lower-cholesterol levels to below 200. We should exercise at least three times a week for 20 to 30 minutes, if not more often. Smoking should be prohibited and, in this regard, smoking is much less prevalent in adults. -- Unfortunately, it is increasing in the age bracket from 15 to 25 years of age. Alcohol can be helpful in reducing the incidence of stroke provided it is taken in small amounts -- no more than one drink a day. Clearly, ingestion of large amounts of alcohol is counter productive and may produce serious medical problems.

* There are two specific factors of great importance - hypertension(high blood pressure) and an irregular heartbeat known as atrial fibrillation. By controlling blood pressure to below 135/85, the incidence of strokes can be reduced by half if not more. This is of crucial importance and we should all have our blood pressure checked at least once or twice each year. The irregular heartbeat is diagnosed by a doctor and, when found, the heart rhythm should be reverted to a regular rhythm (known as sinus rhythm) whenever possible.

All of the above is directed to stroke prevention. But should a stroke occur, then the patient should be brought the hospital right away since the results of treatment are much better if it is initiated within the first three hours of symptom onset. As ever it is wise therefore to seek medical attention as soon as possible when even the suspicion of a stroke arises.

For proper medical attention see your doctor on a regular basis. The above represents a general medical discussion.

The advice provided on this website is intended to be general in nature and should not be relied upon for specific treatment. If you need personal medical attention please contact your physician.

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