Brain Basics and Preventing a
Stroke
National Institute of Neurological Disorders
Stroke National Institutes of Health
If you're
like most Americans, you plan for your future. When you
take a
job, you examine its benefit plan. When you buy a home,
you consider
its location and condition so that your investment is
safe. Today, more
and more Americans are protecting their most important
asset-their
health. Are you?
Stroke
ranks as the third leading killer in the United States. A
stroke
can be devastating to individuals and their families,
robbing them of
their independence. It is the most common cause of adult
disability.
Each year more than 500,000 Americans have a stroke, with
about 145,000
dying from stroke- related causes. Officials at the
National Institute
of Neurological Disorders and Stroke (NINDS) are
committed to reducing
that burden through biomedical research.
A stroke,
or "brain attack," occurs when blood
circulation to the brain
fails.
What is a
Stroke?
A stroke,
or "brain attack," occurs when blood
circulation to the brain
fails. Brain cells can die from decreased blood flow and
the resulting
lack of oxygen. There are two broad categories of stroke:
those caused
by a blockage of blood flow and those caused by bleeding.
While not
usually fatal, a blockage of a blood vessel in the brain
or neck, called
an ischemic stroke, is the most frequent cause of stroke
and is
responsible for about 80 percent of strokes. These
blockages stem from
three conditions: the formation of a clot within a blood
vessel of the
brain or neck, called thrombosis; the movement of a clot
from another
part of the body such as the heart to the neck or brain,
called
embolism; or a severe narrowing of an artery in or
leading to the brain,
called stenosis. Bleeding into the brain or the spaces
surrounding the
brain causes the second type of stroke, called
hemorrhagic stroke.
Many
communities encourage those with stroke's warning signs
to dial 911
for emergency medical assistance.
Heart
disease.
Common
heart disorders such as coronary artery disease, valve
defects,
irregular heart beat, and enlargement of one of the
heart's chambers can
result in blood clots that may break loose and block
vessels in or
leading to the brain. The most common blood vessel
disease, caused by
the buildup of fatty deposits in the arteries, is called
atherosclerosis. Your doctor will treat your heart
disease and may also
prescribe medication, such as aspirin, to help prevent
the formation of
clots. Your doctor may recommend surgery to clean out a
clogged neck
artery if you match a particular risk profile. If you are
over 50,
NINDS scientists believe you and your doctor should make
a decision
about aspirin therapy. A doctor can evaluate your risk
factors and help
you decide if you will benefit from aspirin or other
blood-thinning
therapy.
o Warning
signs or history of stroke.
If you
experience a TIA, get help at once. Many communities
encourage
those with stroke's warning signs to dial 911 for
emergency medical
assistance. If you have had a stroke in the past, it's
important to
reduce your risk of a second stroke. Your brain helps you
recover from a
stroke by drawing on body systems that now must do double
duty. That
means a second stroke can be twice as bad.
o
Diabetes.
You may
think this disorder affects only the body's ability to
use
sugar, or glucose. But it also causes destructive changes
in the blood
vessels throughout the body, including the brain. Also,
if blood glucose
levels are high at the time of a stroke, then brain
damage is usually
more severe and extensive than when blood glucose is
well-controlled.
Treating diabetes can delay the onset of complications
that increase the
risk of stroke.
Americans
should be able to prevent 80 percent of all strokes by
the end
of the decade.
Do You
Know Your Stroke Risk?
Some of
the most important risk factors for stroke can be
determined
during a physical exam at your doctor's office. If you
are over 55
years old, the worksheet in this pamphlet can help you
estimate your
risk of stroke and show the benefit of risk factor
control.
The
worksheet was developed from NINDS-supported work in the
well-known
Framingham Study. Working with your doctor, you can
develop a strategy
to lower your risk to average or even below average for
your age.
Many risk
factors for stroke can be managed, some very
successfully.
Although risk is never zero at any age, by starting early
and
controlling your risk factors you can lower your risk of
death or
disability from stroke. With good control, the risk of
stroke in most
age groups can be kept below that for accidental injury
or death.
Americans
have shown that stroke is preventable and treatable. A
better
understanding of the causes of stroke has helped
Americans make
lifestyle changes that have cut the stroke death rate
nearly in half in
the last two decades.
More than
a million stroke survivors suffer little or no long
lasting
disability from their strokes. Another two million,
however, live with
the crippling and lifelong disabilities of paralysis,
loss of speech,
and poor memory. Scientists at the NINDS predict that,
with continued
attention to reducing the risks of stroke and by using
currently
available therapies and developing new ones, Americans
should be able to
prevent 80 percent of all strokes by the end of the
decade.
Score your
stroke risk for the next 10 years-MEN
Key:
SBP = systolic blood pressure (score one line only,
untreated or
treated);
Diabetes = history of diabetes;
Cigarettes = smokes cigarettes;
CVD (cardiovascular disease) = history of heart disease;
AF = history of atrial fibrillation;
LVH = diagnosis of left ventricular hypertrophy
Box A
Points 0
+1 +2 +3 +4 +5 +6 +7 +8 +9 +10
Age 55-
57- 60- 63- 66- 69- 73- 76- 79- 83- 85
56 59 62 65 68 72 75 78 81 84
SBP-
untrtd 97- 106- 116- 126- 136- 146- 156- 166- 176- 186-
196-
105 115 125 135 145 155 165 175 185 195 205
or SBP-
97- 106- 113- 118- 124- 130- 136- 143- 151- 162- 177-
trtd 105 112 117 123 129 135 142 150 161 176 205
Diabetes
No Yes
Cigarettes
No Yes
CVD No Yes
AF No Yes
LVH No Yes
Box B
Your
10-Year Your 10-Year Your 10-Year
Points Probability Points Probability Points Probability
1 3% 11
11% 21 42%
2 3% 12
13% 22 47%
3 4% 13
15% 23 52%
4 4% 14
17% 24 57%
5 5% 15
20% 25 63%
6 5% 16
22% 26 68%
7 6% 17
26% 27 74%
8 7% 18
29% 28 79%
9 8% 19
33% 29 84%
10 10% 20
37% 30 88%
Box C
Compare
with Your Age Group Average 10-Year Probability of Stroke
55-59 5.9%
60-64 7.8%
65-69
11.0%
70-74
13.7%
75-79
18.0%
80-84
22.3%
Score your
stroke risk for the next 10 years-WOMEN
Key:
SBP =
systolic blood pressure (score one line only, untreated
or
treated);
Diabetes = history of diabetes;
Cigarettes = smokes cigarettes;
CVD (cardiovascular disease) = history of heart disease;
AF = history of atrial fibrillation;
LVH = diagnosis of left ventricular hypertrophy
Box A
Points 0
+1 +2 +3 +4 +5 +6 +7 +8 +9 +10
Age 55-
57- 60- 63- 65- 68- 71- 74- 77- 79- 82-
56 59 62 64 67 70 73 76 78 81 84
SBP-
untrtd 95- 107- 119- 131- 144- 156- 168- 181- 193- 205-
106 118 130 143 155 167 180 192 204 216
or SBP-
95- 107- 114- 120- 126- 132- 140- 149- 161- 205-
trtd 106 113 119 125 131 139 148 160 204 216
Diabetes
No Yes
Cigarettes
No Yes
CVD No Yes
AF No Yes
LVH No Yes
Box B
Your
10-Year Your 10-Year Your 10-Year
Points Probability Points Probability Points Probability
1 1% 10 6%
19 32%
2 1% 11 8%
20 37%
3 2% 12 9%
21 43%
4 2% 13
11% 22 50%
5 2% 14
13% 23 57%
6 3% 15
16% 24 64%
7 4% 16
19% 25 71%
8 4% 17
23% 26 78%
9 5% 18
27% 27 84%
Box C
Compare
with Your Age Group Average 10-Year Probability of Stroke
55-59 3.0%
60-64 4.7%
65-69 7.2%
70-74
10.9%
75-79
15.5%
80-84
23.9%
Source:
D'Agostino, R.B.; Wolf, P.A.; Belanger, A.J.; &
Kannel,
W.B. "Stroke Risk Profile: The Framingham
Study." Stroke, Vol.
25,, No. 1, pp.40-43
The
National Institute of Neurological Disorders and Stroke
Since its
creation by Congress in 1950, the NINDS has grown to
become
the leading supporter of neurological research in the
United States.
Most research funded by the NINDS is conducted by
scientists in public
and private institutions such as universities, medical
schools, and
hospitals. Government scientists also conduct a wide
variety of
neurological research in the 21 laboratories and branches
of the NINDS
itself. This research ranges from studies on the
structure and function
of single brain cells to tests of new diagnostic tools
and treatments
for those with neurological disorders. For more
information, write or
call:
NIH Neurological Institute
P.O. Box 5801
Bethesda, MD 20824
Phone: (301) 496-5751
Toll-free number: (800) 352-9424
Fax number: (301) 402-2186
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