Stroke
Cerebral vascular disease often presents either as a transitory
ischemic attack, referred to as TIA, or an infarct, commonly
called a stroke. A TIA is defined as a reversible ischemic
event caused either by an emboli, a clot that comes from the
heart or a large vessel outside the brain, or a thrombosis,
a clot that occurs in the brain. They can last from minutes
to hours, but resolve within less than 24 hours, by definition.
A stroke can either be ischemic or hemorrhagic. Approximately
85 percent of strokes are ischemic and they are either embolic,
primarily a clot that travels from the heart to the brain,
or they can be lacunar, usually a small vessel occludes precipitated
by chronic hypertension and/or diabetes, or atherosclerotic
changes of the vessel, ultimately resulting in an occlusion
and an acute neurologic deficit that does not resolve within
a 24-hour period. The remaining 15 percent of strokes are
hemorrhagic and they can either be intracranial or intracerebral
hemorrhages, or subarachnoid hemorrhages.
Whenever there is an acute neurologic event: a loss of motor,
sensory function, language, or any acute loss of neurologic
brain function, it is imperative that you seek appropriate
medical help from your physician or allied healthcare professional,
or to dial 911 and proceed to the emergency room for assistance.
The most important issue regarding neurovascular health
is to focus on prevention. To do everything we can to prevent
a stroke from ever happening. Some simple approaches are to
control diet, proper exercise, attempt to control weight.
Obviously, appropriate assessments from your physician or
allied healthcare professional to control triglycerides, cholesterol,
homocysteine, monitor your C-reactive protein, are just part
of what is necessary as stroke prevention. It is also important
to do proper exercise and when appropriate to take appropriate
supplements in an effort to help reduce your risk of a potential
stroke or a recurrence of a stroke.
There are various treatment algorithms in the management
of stroke, whether it's acute or preventive, when appropriate
discussions regarding the use of antiplatelet or anticoagulation
therapies will need to be addressed as part of an overall
treatment algorithm. Oftentimes when a neurovascular event
occurs, it's also imperative to address potential cardiovascular
issues as well. Please review these issues with your physician
and/or allied healthcare professional.
While many people suffer from this condition each year, there are simple steps that you can take to improve your quality of life. More information regarding these steps is outlined in Dr. Winner's "The 7 Steps to a Healthy Brain".
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