Stroke

Statistics

Stroke is a leading cause of death in the United States. While strokes may occur at any age, two thirds of stokes occur in people over the age of 65. Estimates suggest that every 40 s someone in the United States has a stroke, and every 4 min someone in the United States dies as a result of a stroke. Nearly 50% of stroke survivors are able to return home independently. Monetary estimates of annual direct costs plus those associated with lost productivity are said to be as high as $30 billion.

Risk Factors and Stroke Prevention

Risk factors involve age, sex, heredity, predisposing diseases or other medical conditions, use of certain medications, and lifestyle choices. Stroke risk increases with age, and men are more likely to have strokes. People of African, Asian, and Latino descent have higher stroke rates than those of European descent. Having a family history of strokes or having already survived a stroke increases one’s risk. A previous medical history of a transient ischemic attack (TIA) (i.e., a reversible ischemic neurological deficit or RIND), diabetes, heart disease, hypertension (i.e., high blood pressure), hyperlipidemia (i.e., elevated LDL cholesterol levels), obesity, and high red blood cell counts are potential risk factors. Taking certain medications, such as hormone replacement therapies for postmenopausal women, may also be associated with increased risk. Lifestyle choices thought to increase the risk of stroke include being sedentary, smoking, exceeding moderate alcohol consumption on a daily basis, and the use of some recreational drugs. Adopting a healthy lifestyle, obtaining routine medical care, and appropriately managing prescription medications can reduce some of these risks.

Traditional Classifications

Three categories of strokes have been classically described: (1) hemorrhagic, the rupturing/bursting of a cerebral blood vessel that prevents oxygenated blood from reaching a portion of the brain; (2) ischemic, interrupted flow caused by either a traveling clot (embolism) that lodges in a cerebral blood vessel or a clot that forms on the wall of a cerebral blood vessel (thrombosis), preventing blood/oxygen from reaching downstream brain tissue; and (3) cryptogenic, whose cause is unknown. A TIA is not considered to be a stroke but rather a temporary strokelike event where the symptoms of neurological dysfunction resolve quickly, within minutes to hours, and no permanent or identifiable infarction/lesion occurs.

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