Causes of stroke: How do you get a stroke?

The most common type of stroke is called an "ischemic stroke" and is caused by a blockage cutting-off the blood supply to, or through, part of the brain.¹

Stroke may also be caused by a bleed from a burst blood vessel, which is called "hemorrhagic stroke"¹

Common^a causes of stroke²

	ISCHEMIC STROKE
Blood flow to/within brain cut-off by	Blood clot
Obstruction forms within	Large artery within or outside the brain	General circulation	In brain
Medical term	Cerebral thrombus	Cerebral embolism	Lacunar stroke

	HEMORRHAGIC STROKE
Blood flow to/within brain cut-off by	Bleed from a burst blood vessel
Obstruction forms within	In brain	Between brain and skull
Medical term	Intracerebral hemorrhage	Subarachnoid hemorrhage

^a there are also other less common causes of stroke, including cerebral hypoperfusion and cerebral venous thrombosis

What happens during stroke?

• Cutting-off the blood supply to brain cells starves the cells ‘downstream’ of the blockage of the essential nutrients and oxygen that are needed for their survival.^2,3
• Without these supplies the brain cells can’t work and die within minutes.^2,3
• Unlike other cells in the body, once brain cells have died they are not usually replaced.^2,3
• The area of dead brain cells caused by the stroke is called an infarct.^2,3
• Cells surrounding the infarct may receive insufficient blood supply. This area of cells is called the penumbra. The cells within the penumbra are starved of their normal oxygen and nutrient supply. This leads to the release of damaging chemicals that have the potential to damage or kill healthy brain cells and thus increase the size of the infarct.⁴
• The size of the infarct will affect a person’s chance of recovery from a stroke and it will keep growing if treatment is delayed.^5,6

To minimise the size of brain injury and to enable patients to achieve their best possible recovery it is essential that they receive medical attention early.^5,6

Why protect yourself against stroke?

• Everyone is at risk of stroke and it attacks many people.
• Worldwide approximately 15 million strokes occur every year.⁷
• Stroke is the leading cause of disability in industrialised countries⁸ and can rob people of their precious quality of life.

Stroke risk factors we can’t change

Some of us have a higher risk of stroke because of our genes, age or medical history.

Stroke risk factor	Who is at higher risk?
Age	The chance of having a stroke more than doubles every decade after the age of 55 years.9
Sex	Stroke is more common in men than women. Almost one in four men and nearly one in five women can expect to have a stroke if they live to their 85th year.10
Family history	People whose relatives have had a stroke.9,11
Ethnic background	People of Asian and African-Caribbean ethinicity.11 The prevalence of stroke is 40-70% higher among African-Caribbean and South Asian men than in the general population.10
History of transient ischemic attack (TIA)	The chance of having a stroke after a TIA is almost 10 times greater than someone of the same age and sex who has not had a TIA.9
Certain medical conditions	Anyone who has already had a stroke or a heart attack or have sickle cell anaemia, high blood pressure, heart disease, diabetes or high cholesterol.9

Although we can’t change these it’s helpful to be aware of them because it can make us think more carefully about how we look after our health.

However, just because someone fulfils a certain criteria, it does not mean that they will get a stroke, just that their risk is increased by a certain amount.

Stroke risk factors that CAN be controlled

Clinical studies have identified several traits and lifestyle habits that directly increase the risk of having a stroke.

The good news is that we can do something about these to reduce our risk of stroke!

Risk factors that are directly linked to stroke include:

• High blood pressure
  The most important risk factor for stroke is high blood pressure (140/90 mm Hg or more).^3,12 As it usually has no specific symptoms and no early warning signs, everyone (adults, especially those over 35 years13) should have their blood pressure checked regularly.³
• Smoking
  Smoking doubles your risk of having a stroke.¹¹ So if you’re a smoker it’s important that you stop. Have a chat with your doctor – they may be able to help you to stop smoking.
• High blood cholesterol
  High concentration of total cholesterol in the blood (240 mg/dL [6.22 mmol/L] or higher) increases the risk of heart disease, which consequently raises the risk of stroke.^3,12
• Heart diseases
  People with atrial fibrillation, coronary heart disease or heart failure have a higher risk of stroke.³
• Diabetes
  A diagnosis of diabetes is given if fasting blood sugar is 126 mg/dL (7.00 mmol/L14) or more when measured on two occasions.3 Some people may be at risk of developing Type 2 diabetes during their lifetime. Anyone who has risk factors for Type 2 diabetes, eg people over 40-years-old, people of Aboriginal, African, Latin American or Asian ethnic ancestry, people who are overweight or who have a family history of diabetes should be checked for diabetes.^15,16
• Excessive alcohol intake
  Regular heavy drinking raises blood pressure, and binge drinking can cause blood vessels within the brain to burst.^3,12

  How to control stroke risk factors

• By making some modifications in our lives we can easily reduce our exposure to these risk factors.
• We can make some changes ourselves and others will require help from our doctor and/or nurse.
• Following these six easy steps can help to reduce your risk of stroke:

Steps to reduce your stroke risk		Why? Aim to avoid/minimise exposure to stroke risk factor…	Who’s best placed to help?	Will it help?
1.	Have regular blood pressure checks. If it is high, your doctor/nurse may advise how to reduce it.	High blood pressure	Doctor/ nurse	v
2.	If you smoke, stop.	Smoking	Ourselves/ doctor/nurse	v
3.	Have regular checks of your cholesterol.  If it is high, your doctor/nurse may advise how to reduce it.	High blood cholesterol	Doctor/nurse	v
4.	Have regular checks of the health of your heart (eg ECG, chest X-ray and physical examination). If it is abnormal, your doctor may suggest treatment.	Heart disease	Doctor	v
5.	Have regular blood sugar checks. If it is high, your doctor/nurse may advise how to reduce it.	Diabetes	Doctor/ nurse	v
6.	If you drink alcohol, only do so in moderation.	Binge and excessive alcohol intake	Ourselves/ doctor	v

Everyone is at risk of stroke and it attacks many people. Worldwide approximately 15 million strokes occur every year.⁷ There are several risk factors for stroke. Many we can control or modify either by ourselves or with help from our doctor and/or nurse.


NOTE: This is a repost.
Source:www.patienthealthinternational.com/stroke/?itemId=1620336&nav=yes

Click Deborah Koval to know more about her and her work.