Entries in Stroke (67)


American Heart Association Lists Seven Ways to Limit Stroke Risk

Comstock/Thinkstock(NEW YORK) -- The American Heart Association put out a list this week of the seven health factors that can increase your risk of suffering a stroke.

Nearly 795,000 Americans suffer a stroke every year, making strokes the fourth-leading cause of death in the United States, and a leading cause of disability.

Researchers analyzed data from nearly 23,000 Americans age 45 and older and created a scoring system based on seven criteria. Those seven criteria were:

Manage blood pressure
Control cholesterol
Be physically active
Control blood sugar
Keep weight down
Eat a healthful diet (and)
Don't smoke.

Each patient was given a grade from zero to two in each of the above categories. For each point gained, a patient's stroke risk decreased by 8 percent. Patients with a total score of 10 or higher saw a 60 percent drop in their stroke risk. Comparatively, those with a score between five and nine were 40 percent likely to suffer a stroke than those with a score between zero and four.

According to the study, the most important factor in stroke prevention was having good blood pressure.

For Americans, regardless of race, a better score in the AHA's seven criteria was linked to a reduced risk of stroke.

However, blacks generally had worse overall scores, highlighting the added importance for black Americans to improve their scores in the "simple seven" factors.

Copyright 2013 ABC News Radio


Depression May Increase Stroke Risk in Middle-Aged Women

iStockphoto/Thinkstock(NEW YORK) -- Many people suffer from depression as a complication after suffering a stroke, however, a new study shows that depression may be a risk factor for future strokes.

Researchers studied women born between 1946 and 1961, surveying the participants every three years between 1988 and 2010. Women were asked to self-report their depression, medication use and diagnosis or treatment. They also self-reported any stroke they may have suffered. Additionally, stroke deaths were identified using a national database.

Over 10,000 women participated in the survey, the results of which were published in the journal Stroke.

The data determined that women who were depressed were more than twice as likely to suffer a stroke than those who were not depressed.

The researchers believe that improvement in the diagnosis and treatment of depression could play a role in limiting stroke risk later in life.

Copyright 2013 ABC News Radio


Study Finds Brisk Walking to Be Helpful in Recovery After a Stroke

Comstock/Getty Images(NEW YORK) -- Heading outside for a brisk walk can improve your quality of life. According to a new study released Thursday, stroke victims could have a lot to gain from walking for exercise.
For the study, published in the journal Stroke, researchers at the University of the West Indies in Jamaica  looked at nearly 130 people who had suffered from strokes -- all of them able to walk with or without an assistive device -- and who were not participating in any regular exercise programs. The subjects were randomized into two groups, an intervention group and a control group, with assessments done at six weeks and three months.
The intervention group was supervised by trained instructors and walked vigorously along a prescribed course for 15 minutes, three times a week, adding five minutes each week until they reached a half hour.  The control group received massage therapy.
After three months, those who walked regularly reported a 16.7 percent improvement in quality of life and also walked nearly 20 percent farther in an endurance test than their massaged counterparts.  

The study's authors say their findings suggest that aerobic walking should be part of a stroke survivor's overall health promotion strategy.

"Walking is a great way to get active after a stroke," lead study author Carron Gordon, Ph.D., said in a statement. "It's familiar, inexpensive and it's something people could very easily get into."
Copyright 2013 ABC News Radio


Pediatric Stroke Often Misdiagnosed, Treatment Delayed

James Finnerty pictured seated in middle. (Courtesy Thomas Finnerty)(NEW YORK) -- James Finnerty, a 15-year-old rugby player from Parma Heights, Ohio, woke up with a piercing pain in his head one morning last April and, barely able to walk, stumbled to the bathroom vomiting.

The emergency room doctors where Finnerty sought treatment assumed he had a severe migraine and delayed treatment for 25 hours before his mother insisted he be transferred to Cleveland Clinic where they discovered he had suffered a stroke.

The swelling in his brain was so intense that part of his skull was removed to relieve the pressure and, in a second stroke, he lost the use of speech and his limbs.

Almost a year later, after months of physical therapy, Finnerty, now 16, is on the road to recovery, but his experience is a shocking reminder that strokes can strike even the young.

About 3,000 children a year will suffer a stroke -- one of the top 10 causes of death among children, according to Dr. Neil Friedman, a pediatric neurologist at the Cleveland Clinic's Center for Pediatric Neurology, where Finnerty was treated.  The majority of these children will live, but will face lingering neurological or cognitive impairment.

"The big difference in pediatric stroke is that there is an almost 100 percent recovery because of the ability of children to adapt and accommodate far better than adults," said Friedman.  "When they do survive, they can have six or seven decades of disability."

Finnerty still has some deficits in his comprehension and balance problems, and even though a recent MRI showed his artery has no blockage, he is still at risk for future strokes.

"People tend not to realize that two thirds of children have some residual deficits from stroke and the recurrence rate is 20 percent," said Friedman.

And those residual deficits mean high health care costs.  One study Friedman cited showed that the first year of care for a child disabled by stroke is $42,000, not including loss of parents' work.

Stroke is more common in boys than in girls.  African Americans are also more vulnerable, even excluding those who have sickle cell anemia, which is associated with stroke risk.

A stroke happens when the blood supply to part of the brain is cut off, resulting in tissue injury and loss of brain function.  When tissue is starved of oxygen for more than three minutes, it begins to die.

The two types of strokes are ischemic, when brain arteries are blocked by a clot, and hemorrhagic, when brain arteries rupture from trauma or malformation.

In older children, about one third of all strokes are associated with heart disease.  But that was not the case with Finnerty, who had no such history.  After taking a hit in a rugby game in 2012, an artery formed a clot in his brain.

"It's a common story," said Friedman.  "There was initial damage to the artery, and he did weightlifting and extended the tear and stroked his cerebellum.  It wasn't for another 25 hours that he had progressive worsening of the headache that we realized he had a stroke. …The brain was basically being pushed down through an opening in the skull."

Because his diagnosis was delayed to the point of herniation of the brain, the chance of Finnerty dying was "really high," according to Friedman.

Quick medical attention is critical when treating stroke, and yet the average delay in diagnosis of pediatric cases is 28 hours, wasting precious time when a child could get life-saving medication.

Although stroke can occur anytime during childhood, the risk is highest in the late stages of pregnancy and the early newborn period, occurring in about 1 in 3,000 live births.  An estimated 40 to 50 percent of all strokes in children happen in the first year of life.

Copyright 2013 ABC News Radio


Woman's Scrambled Text Message Helps Diagnose Stroke 

Goodshoot RF/Thinkstock(NEW YORK) -- Smartphone autocorrect is famous for scrambling messages into unintelligible gibberish but when one man received this garbled text from his 11-week-pregnant wife, it alarmed him:

“every where thinging days nighing,” her text read. “Some is where!”

Though that may sound like every text you’ve ever received, the woman’s husband knew her autocorrect was turned off. Fearing some medical issue, he made sure his 25-year-old wife went immediately to the emergency room.

When she got there, doctors noted that she was disoriented, couldn’t use her right arm and leg properly and had some difficulty speaking. A magnetic resonance imaging scan — MRI — revealed that part of the woman’s brain wasn’t getting enough blood. The diagnosis was stroke.

Fortunately, the story has a happy ending. A short hospital stay and some low-dose blood thinners took care of the symptoms and the rest of her pregnancy was uneventful.

The three doctors from Boston’s Harvard Medical School, who reported the case study online in this week’s Archives of Neurology, claim this is the first instance they know of where an aberrant text message was used to help diagnose a stroke. In their report, they refer to the woman’s inability to text properly as “dystextia,” a word coined by medical experts in an earlier case.

Dystextia appears to be a new form of aphasia, a term that refers to any trouble processing language, be it spoken or written. The authors of the Archives paper said that at least theoretically, incoherent text messages will be used more often to flag strokes and other neurological abnormalities that lead to the condition.

“As the accessibility of electronic communication continues to advance, the growing digital record will likely become an increasingly important means of identifying neurologic disease, particularly in patient populations that rely more heavily on written rather than spoken communication,” they wrote.

Even though jumbled texts are so common, Dr. Larry Goldstein, a neurologist who is the director of the stroke center at Duke University, said he also believes it’s possible they can be used to sound the alarm on a person’s neurological state, especially in a case like this where the text consisted of complete words that amounted to nonsense rather than the usual autocorrected muddle.

“It would have been very easy to dismiss because of the normal problems with texting but this was a whole conversation that wasn’t making sense,” Goldstein said. “I might be concerned about a patient based on a text like this if they were telling me they hadn’t intended to send a disjointed jumble but they weren’t able to correct themselves.”

In diagnosing stroke, Goldstein said both patients and medical professionals tend to discount aphasic symptoms, even in speech, but they can often be the first clue something is up. In this woman’s case, other signs were there. Her obstetrician realized in retrospect that she’d had trouble filling out a form earlier in the day. She had difficulties speaking too which might also have been picked up sooner if a recent upper respiratory infection hadn’t reduced her voice to a whisper.

But unlike this woman, most people leave their autocorrect turned on. If we relied solely on maddeningly unintelligible text messages to determine neurological state, neurologists might have lines out the door.

Copyright 2012 ABC News Radio


Tomatoes Linked to Lower Stroke Risk

George Doyle/Thinkstock(NEW YORK) -- Tomatoes are linked to a decreased risk of stroke in men, a new study finds.

The study, published Monday in the journal Neurology, involved more than 1,000 Finnish men between 46 and 65 who never had a stroke before.

These men had their blood levels of lycopene -- a powerful antioxidant found in tomatoes -- tested at the beginning of the study.  They were followed over an average period of 12 years to see if they developed strokes.

The researchers found that men with the highest blood levels of lycopene were 55 percent less likely to have a stroke, compared to those with the lowest levels.  These results held up even after adjusting for the age of the men.

“Eating tomatoes and tomato-based foods is associated with a lower risk of any stroke,” said lead study author Jouni Karppi of the department of medicine at the Institute of Public Health and Clinical Nutrition at the University of Eastern Finland. “This study adds to the evidence that a diet high in fruits and vegetables is associated with a lower risk of stroke.”

Stroke occurs when a clot blocks the brain’s blood supply or a blood vessel in the brain ruptures. According to the U.S. Centers for Disease Control and Prevention, each year, more than 795,000 Americans have strokes, which can result in paralysis, difficulty with speech, and emotional issues.  Stroke is a leading cause of death in the United States; it’s estimated that every four minutes, someone dies of a stroke.

How can tomatoes and other lycopene-rich foods -- such as pink grapefruits, papaya, watermelon and apricots -- prevent stroke?  Lycopene may help reduce stroke risk by preventing the formation of clots that obstruct the brain’s blood supply, Karppi said.

It’s not hard to raise your lycopene levels.  Tomatoes can be plentiful and cheap.

“It is easy to decrease your risk of stroke by eating tomatoes and tomato-based products,” Karppi said.  “The results support the recommendation that people get more than five servings of fruits and vegetables a day.”

This study further supports the importance of consuming fruits and vegetables rather than nutritional supplements in the prevention of conditions like stroke and heart disease, said Dr. Lori Mosca, professor of medicine at Columbia University Medical Center and director of preventive cardiology at New York-Presbyterian Hospital in New York City, who was not involved in the study.

“Tomato intake has also been associated with a lower risk of prostate cancer,” she said. “And tomatoes may just be a secret weapon in the fight against stroke.”

Copyright 2012 ABC News Radio


'Mini Strokes' Can Lead to Major Disability, Study Finds

iStockphoto/Thinkstock(NEW YORK) -- A transient ischemic attack, or TIA, occurs when symptoms of a stroke come and then go away within 24 hours. The cause is often a clot in a vessel in the brain that temporarily blocks blood flow.

What makes TIAs and minor strokes so dangerous is that many who experience symptoms ignore them after they go away -- even though they may have experienced some degree of brain damage and are also at a higher risk for a full-blown stroke.

Now, new research suggests that in roughly one out of eight cases in which people experience major disability from TIA and minor stroke, the first occurrence of symptoms was their only warning sign that something was wrong.

A team of Canadian researchers monitored 510 people who experienced "mini strokes" -- a label doctors use to describe TIAs and minor strokes that involve mild and/or transient symptoms. These patients' initial symptoms were recorded and rechecked at 90 days with repeat brain imaging and measured level of disability.

What the researchers found was that 12 percent of patients who had the initial "mini stroke" had worsened disability in the next 90 days -- even if they had experienced no repeat events after their initial one.

The research was published Thursday in the American Heart Association's journal Stroke.

"Patients need to get in quickly even if symptoms have resolved or are resolving," said lead study author Dr. Shelagh B. Coutts, assistant professor at Hotchkiss Brain Institute Calgary in Canada. "We like to identify those at highest risk of disability."

Symtoms of a TIA are exactly the same as for a stroke, according the the American Heart Association, and include:

  • Numbness -- Sudden numbness or weakness of the face, arm or leg, especially on one side of the body.
  • Confusion -- Sudden confusion, trouble speaking or understanding.
  • Trouble Seeing  -- Sudden trouble seeing in one or both eyes.
  • Dizziness  -- Sudden trouble walking, dizziness, loss of balance or coordination.
  • Headache -- Sudden, severe headache with no known cause.

Stroke experts not involved with the study said the findings are an important reminder that stroke symptoms, even if they don't linger, must be taken seriously.

"TIA is to stroke what chest pain is to heart attack," said Dr. Fadi B. Nahab, medical director for the stroke program at Emory University Hospital in Atlanta. "People have a better understanding of chest pain and go the emergency room, whereas [they believe] symptoms for TIA must be something else."

"[People who have a TIA] have won the stroke lottery," said Dr. Steven Cramer, clinical director of the stem cell research center at the University of California, Irvine. "They found out there is something wrong without having to pay the big stroke price."

The findings, in fact, were so alarming that the study authors suggested that doctors should consider administering the clot-busting medicine known as tissue plasminogen activator, or tPA, for patients who show up at the hospital after a TIA or minor stroke.

"If patients have symptoms that are mild, we are even currently doing a study to use thrombolysis, in those cases," she said.

Currently, tPA is only indicated for use in patients experiencing full-blown stroke. But as for whether the benefits of this medicine outweigh its risks in patients experiencing mini strokes, most doctors say more research is needed.

"There is no evidence at all that treating TIA acutely with tPA would make any difference," said Dr. Jeffrey M. Katz, director of the stroke center and stroke unit at North Shore University Hospital in Long Island, N.Y. "I think that many times we decide not to treat patients with minor symptoms from stroke because of the risk for bleeding with tPA and the thought that these patients will do well anyway."

But, Katz adds, "this is probably one of the largest studies to say that these patients may not do well ... Of course it says nothing about whether they would do well with tPA, but I think it certainly suggests that they aren't doing better if left untreated."

Copyright 2012 ABC News Radio


Chronic Stress Linked to Stroke Risk, Study Suggests

Goodshoot/Thinkstock(NEW YORK) -- A stroke occurs when a blood vessel in the brain becomes blocked or ruptures, thwarting the flow of oxygenated blood.  And while the mechanism is unclear, a new study suggests chronic stress might raise the risk of stroke.

The Spanish study of 450 people found strokes were more common among those with stressful lives and high-strung personalities, even after controlling for risk factors like smoking and diabetes.

"If you have stress, your risk for stroke is heightened," said Dr. Ana Maria Garcia of the Hospital Clinico Universitario San Carlos in Madrid, co-author of the study published Thursday in the Journal of Neurology Neurosurgery and Psychiatry.

The study was unable to conclude that stress causes strokes.  It could be, rather, that strokes make people more prone to remembering stressful events.  Nevertheless, it adds to mounting evidence that psychological stress can take a physical toll.

Previous studies have linked stress to the common cold, cancer and heart disease.  And people with optimistic outlooks, who expect the best in uncertain times, are less likely to suffer strokes, according to a 2011 study published in the journal Stroke.

Garcia said she plans to tease out whether stress management training can reduce the risk of stroke.

Copyright 2012 ABC News Radio


Study Boasts Benefits of Yoga for Stroke Survivors

Goodshot/Thinkstock(NEW YORK) - Enthusiasts have long extolled yoga's benefits, particularly when it comes to mental health and exercise.  Now a new study, published in the journal Stroke, claims the popular discipline might also improve your quality of life.
Stroke is among the most common diagnoses among patients treated by rehabilitation therapists. These patients often suffer serious post-stroke impairments, including motor problems and difficulty with balance.  Up to 83 percent of stroke victims will struggle with balance and 73 percent will actually fall down. In fact, the fear of falling has a direct correlation on a patient's quality of life.
But researchers at Indiana University suggest that introducing yoga as part of rehab significantly improves balance and lessens a patient's fear of falling.  As a result, their study showed yoga intervention significantly improved quality of life and could prove a cost-effective benefit for stroke survivors.
The study was small, with only 47 patients participating, but the positive results warrant further research.
Interestingly, during post-study interviews, subjects said that because of improved balance, they were more likely to attempt new activities in different and more challenging environments. Though they were aware of potential fall risk, they'd grown more confident they could maintain their balance.

Copyright 2012 ABC News Radio


Late Shift Boosts Heart Attack, Stroke Risk

Digital Vision/Thinkstock(NEW YORK) -- More bad news for late-shift workers: Their odd hours may be raising their risk of heart attack and stroke.

So says a new, large-scale study in the British Medical Journal that adds these two problems -- which fit into a broader category known as vascular disease -- to the previously known risks of shift work. Previous research had suggested that working the graveyard shift, the swing shift or any irregular shift other than the traditional 9-to-5 is linked to high blood pressure, diabetes and obesity.

British and Canadian researchers analyzed the findings of 34 studies that included more than two million people who had work schedules including anything other than regular daytime hours. They found that shift work was linked to a 23 percent increased risk of heart attack and a 5 percent increased risk of stroke. Those working night shifts seemed to be at the highest risk.

The study authors said it pays for workers to know that their jobs may put them at increased risk.

"The increased risk of vascular disease apparent in shift workers, regardless of its explanation, suggests that people who do shift work should be vigilant about risk factor modification," they wrote in the report.

A variety of factors -- not just the shift work itself -- could be culprit in increasing the risk of heart attack and stroke for people in those occupations. A lack of sleep, poor eating habits and lower levels of physical activity could plague those who work irregular hours and drive up the risk of vascular disease.

Dr. Robert Bonow, professor of medicine at Northwestern University Feinberg School of Medicine and past president of the American Heart Association, said it's possible that people working jobs requiring shift work may be economically disadvantaged and have less access to health care -- two factors generally associated with unfavorable health outcomes.

However, the study authors noted that the increased risk of vascular events was still present even when they accounted for things like unhealthy eating, smoking and socioeconomic status -- evidence that something about the nature of shift work other than poor health behaviors might be at play.

But what could it be? One possibility is disruption in circadian rhythm, a feature inherent in shift work. These disruptions can certainly have an effect on heart rate and blood pressure -- two measures intimately tied to vascular health, said Dr. Carl Lavie, a cardiologist at Ochsner Medical Center in New Orleans.

Since shift work is a necessary evil for more than a third of the working population, it is unreasonable to think that everyone can simply change their schedules.

"My advice would be to exercise and make sure their fitness is at a high level, and then I'd treat their risk factors vigorously," Lavie said. He added that if you are a shift worker it is important to recognize that treatments you might be getting for blood pressure control, weight control and cholesterol may be more important for you than someone at a lower risk.

Bonow agreed. "There's somewhat of a signal here, and people who do shift work should be aware that their risk factors should be identified and managed."

Copyright 2012 ABC News Radio

ABC News Radio