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Stroke

Definition:

A stroke is an interruption of the blood supply to any part of the brain. A stroke is sometimes called a "brain attack."



Alternative Names:

Cerebrovascular disease; CVA; Cerebral infarction; Cerebral hemorrhage 



Causes, incidence, and risk factors:

Every 45 seconds, someone in the United States has a stroke. A stroke can happen when:

  • A blood vessel carrying blood to the brain is blocked by a blood clot. This is called an ischemic stroke.
  • A blood vessel breaks open, causing blood to leak into the brain. This is a hemmorhagic stroke.

If blood flow is stopped for longer than a few seconds, the brain cannot get blood and oxygen. Brain cells can die, causing permanent damage.

ISCHEMIC STROKE

This is the most common type of stroke. Usually this type of stroke results from clogged arteries, a condition called atherosclerosis. (See stroke secondary to atherosclerosis.) Fatty deposits and blood platelets collect on the wall of the arteries, forming a sticky substance called plaque. Over time, the plaque builds up. Often, the plaque causes the blood to flow abnormally, which can cause the blood to clot. There are two types of clots:

  • A clot that stays in place in the brain is called a cerebral thrombus.
  • A clot that breaks loose and moves through the bloodstream to the brain is called an cerebral embolism.  

Another important cause of cerebral embolisms is a type of  arrhythmia   called atrial fibrillation. Other causes of ischemic stroke include endocarditis   and the use of a mechanical heart valve. A clot can form on the artificial valve, break off, and travel to the brain. For this reason, those with mechanical heart valves must take blood thinners.

HEMORRHAGIC STROKE

A second major cause of stroke is bleeding in the brain hemorrhagic stroke. This can occur when small blood vessels in the brain become weak and burst. Some people have defects in the blood vessels of the brain that make this more likely. The flow of blood after the blood vessel ruptures damages brain cells.

STROKE RISKS

High blood pressure is the number one reason that you might have a stroke. The risk of stroke is also increased by age, family history of stroke, smoking, diabetes, high cholesterol, and heart disease.

Certain medications increase the chances of clot formation, and therefore your chances for a stroke. Birth control pills can cause blood clots, especially in woman who smoke and who are older than 35.

Men have more strokes than women. But, women have a risk of stroke during pregnancy and the weeks immediately after pregnancy.

Cocaine use, alcohol abuse, head injury, and bleeding disorders increase the risk of bleeding into the brain.

See also:



References:

American Heart Association. Heart Disease and Stroke Statistics -- 2005 Update. Dallas, Texas: American Heart Association; 2005.

Marx JA, Hockberger RS, Walls RM, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 5th Ed. St. Louis, MO: Mosby; 2002.

Goldman L, Ausiello D, eds. Cecil Textbook of Medicine, 22nd Ed. Philadelphia, PA: Saunders; 2004.




Review Date: 6/27/2005
Reviewed By: A.D.A.M. editorial. Previously reviewed by Chitra R. Uppaluri, M.D., Clinical Assistant Professor of Medicine, Saint Louis University, St. Louis, MO. Review provided by VeriMed Healthcare Network.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2004 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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