Written By: Dr. Ahmad Mossavi, MD, FACP

A Stroke, or cerebrovascular accident (CVA), occurs when blood supply to part of the brain is disrupted, causing brain cells to die. When blood flow to the brain is impaired, oxygen and glucose cannot be delivered to the brain. Blood flow can be compromised by a variety of mechanisms.

What causes a stroke?

The blockage of an artery in the brain by a clot (thrombosis) is the most common cause of a stroke. The part of the brain that is supplied by the clotted blood vessel is then deprived of blood and oxygen. As a result of the deprived blood and oxygen, the cells of that part of the brain die. Typically, a clot forms in a small blood vessel within the brain that has been previously narrowed due to a variety of risk factors including:

✓ high blood pressure (hypertension)
✓ high cholesterol
✓ diabetes
✓ smoking

Types of Strokes:

Embolic stroke

This often occurs when a blood clot or a piece of atherosclerotic plaque (cholesterol and calcium deposits on the wall of the inside of the heart or artery) breaks loose, travels through open arteries, and lodges in an artery of the brain. When this happens, the flow of oxygen-rich blood to the brain is blocked and a stroke occurs. An embolism can also originate in a large artery (for example, the carotid artery, a major artery in the neck that supplies blood to the brain) and then travel downstream to clog a small artery within the brain.

Cerebral hemorrhage

A cerebral hemorrhage occurs when a blood vessel in the brain ruptures and bleeds into the surrounding brain tissue. A cerebral hemorrhage (bleeding in the brain) can cause a stroke by depriving blood and oxygen to parts of the brain. Blood is also very irritating to the brain and can cause swelling of brain tissue (cerebral edema). Edema and the accumulation of blood from a cerebral hemorrhage increases pressure within the skull and causes further damage by squeezing the brain against the bony skull.

Subarachnoid hemorrhage

In a subarachnoid hemorrhage, blood accumulates in the space beneath the arachnoid membrane that lines the brain. The blood originates from an abnormal blood vessel that leaks or ruptures Often this is from an aneurysm (an abnormal ballooning out of the wall of the vessel). Subarachnoid hemorrhages usually cause a sudden, severe headache and stiff neck. If not recognized and treated, major neurological consequences, such as coma and brain death, will occur.

Vasculitis

Another rare cause of stroke is vasculitis, a condition in which the blood vessels become inflamed.

Migraine headache

There appears to be a very slight increased occurrence of stroke in people with migraine headaches. The mechanism for migraine or vascular headaches includes narrowing of the brain blood vessels. Some migraine headache episodes can even mimic stroke with loss of function of one side of the body or vision or speech problems. Usually, the symptoms resolve as the headache resolves.

What are stroke symptoms in men and women?

When brain cells are deprived of oxygen, they cease to perform their usual tasks. The symptoms that follow a stroke depend on the area of the brain that has been affected and the amount of brain tissue damage.

Small strokes may not cause any symptoms, but can still damage brain tissue. These strokes that do not cause symptoms are referred to as silent strokes. According to The U.S. National Institute of Neurological Disorders and Stroke (NINDS), these are the five major signs of stroke:

  • Sudden numbness or weakness of the face, arm or leg, especially on one side of the body. The loss of voluntary movement and/ or sensation may be complete or partial. There may also be an associated tingling sensation in the affected area.
  • Sudden confusion or trouble speaking or understanding. Sometimes weakness in the muscles of the face can cause drooling.
  • Sudden trouble seeing in one or both eyes.
  • Sudden trouble walking, dizziness, loss of balance or coordination.
  • Sudden, severe headache with no known cause.

What is the impact of strokes?

In the United States, stroke is the third largest cause of death (behind heart disease and all forms of cancer). The cost of strokes is not just measured in the billions of dollars lost in work, hospitalization, and the care of survivors in nursing homes! The major cost or impact of a stroke is the loss of independence that occurs in 30% of the survivors. What was a self-sustaining and enjoyable lifestyle may lose most of its quality after a stroke and other family members can find themselves in a new role as caregivers.

What can be done to prevent a stroke?

One of the first steps is to get diagnosed to see if you are at risk for this serious condition. Dr. Ahmad Mossavi of Nari Medical Associates specializes in non-invasive cardio evaluation. By taking advantage of his free carotid artery ultrasound, you will be screened for blockage, which if present, may increase your risk of having a stroke.

Once given diagnostic testing by Dr. Mossavi, your risks for stroke will be evaluated. A comprehensive treatment will be initiated to help prevent you from suffering a stroke. The doctor, along with his staff, can perform more extensive testing to determine any other coronary issues you may have concerns about. One of the best ways to start the year off right is to make your appointment right away!