The majority of strokes (cerebrovascular accidents) follow the same sequence of events that results in coronary heart disease. A stroke is essentially the result of diseased blood vessels that supply the brain. It shares the same risk factors as coronary heart disease, and it takes years to develop.
Strokes are caused by a thrombus (a clot that forms and occludes an artery supplying the brain) or an embolus (a clot that forms elsewhere in the body and fractures, dislodges, and is transported to one of the cerebral blood vessels that is too small for its passage). Cerebral hemorrhage (the bursting of a blood vessel in the brain because of arterial brittleness or aneurysm) is also a cause of stroke. An aneurysm is a weak spot in an artery that forms a balloon like pouch that can rupture. It may be a congenital defect or the result of uncontrolled or poorly controlled hypertension.
Strokes that are caused by hemorrhages result in a 50% mortality rate. These victims die from the pressure imposed by blood leaking into the brain. However, those who survive this type of stroke are likely to recover more of their normal functions than those whose strokes were caused by a blood clot. A clot chokes off blood to a portion of the brain that quickly dies and never regenerates. On the other hand, the blood that spills on the brain during a hemorrhagic stroke produces pressure that gradually abates as the blood is absorbed by the body. Function is regained as the pressure relents.
On many occasions a stroke is preceded by warning signs and signals that may be experienced days, weeks, or months before a major stroke. These must first be recognized and then acted on so that prompt medical and lifestyle interventions may be instituted to prevent or delay a stroke.
Preventing a stroke is similar to preventing coronary heart disease. Both include blood pressure and cholesterol control, smoking cessation, weight management, exercise, and proper nutrition.
Management of stroke victims depends on the nature and extent of the damage as determined by diagnostic tests. In addition to a physical examination, cerebral autobiography provides information on the status of the cerebral arteries, a computed topography (CT) scan enables physicians to examine structures within the body that cannot be observed with conventional x-ray procedures, and an electroencephalograph (EEG) provides radiographic imaging of the brain.
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