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- A clot from another part of the body like the heart or neck. The clot breaks off and flows through the blood until it becomes trapped in a blood vessel supplying the brain.
- A clot that forms in an artery that supplies blood to the brain.
- A tear in an artery supplying blood to the brain. Called an arterial dissection.
- Race—People of African American, Hispanic, or Asian/Pacific Islander descent are at increased risk.
- Age: Older than 55 years of age
- Family history of stroke
- High blood pressure
- High cholesterol levels—specifically high-LDL bad cholesterol
- Obesity and metabolic syndrome
- High blood homocysteine level
- Diabetes mellitus or impaired glucose tolerance
- Atrial fibrillation
- Blood disorders such as sickle cell disease and polycythemia
- Disease of heart valves, such as mitral stenosis
- Prior stroke or cardiovascular disease, such as heart attack
- Peripheral artery disease
- Transient ischemic attack (TIA) —a warning stroke with stroke-like symptoms that go away shortly after they appear
- Conditions that increase your risk of blood clots such as:
- Certain autoimmune diseases
- Migraine with aura
- Having a blood vessel abnormality
- Previous pre-eclampsia
- Use of birth control pills, especially if you are over 35 years old and smoke
- Long-term use of hormone replacement therapy
- Pregnancy—due to increased risk of blood clots
- Uncoordinated movements of the limbs or trunk (ataxia)
- Difficulty walking, including problems with balance
- Abnormal reflexes
- Vertigo (feeling of spinning or whirling when you are not moving)
- Nausea and vomiting
- Intense headache
- Speech problems and difficulty swallowing
- Problems sensing pain and temperature
- Difficulty hearing
- Problems with vision (eg, eyes move rapidly, difficulty controlling eye movement)
- Problems with eyes (eg, small pupil, droopy eyelid)
- Loss of consciousness
- Magnetic resonance angiography (MRA) —maps blood flow
- CT angiogram (CTA)—creates detailed images of the blood vessels and their blood flow
- Doppler ultrasound —evaluates flow of blood in the head and neck
- Dissolve or remove a clot (for ischemic stroke)
- Stop bleeding (for hemorrhagic stroke)
- Dissolve clots and/or prevent new ones from forming
- Thin blood
- Control blood pressure
- Reduce brain swelling
- Treat an irregular heart rate
- Work against any blood-thinning drugs you were taking before the stroke
- Reduce how your brain reacts to bleeding
- Control blood pressure
- Prevent seizures
- Reroute blood supply around a blocked artery
- Remove fatty deposits from a carotid artery ( carotid artery endarterectomy )
- Widen and keep open a carotid artery ( angioplasty and stenting )
- Remove the clot or deliver clot-dissolving medicine
- Remove a piece of the skull to relieve pressure on the brain ( craniotomy )
- Place a clip or a tiny coil in an aneurysm to stop it from bleeding
- Physical therapy—to regain as much movement as possible
- Occupational therapy—to assist in everyday tasks and self-care
- Speech therapy—to improve swallowing and speech challenges
- Psychological therapy—to improve mood and decrease depression
- Exercise regularly.
- Eat more fruits, vegetables , and whole grains . Limit dietary salt and fat .
- Stop smoking .
- Increase your consumption of fish.
- Drink alcohol only in moderation (1-2 drinks per day).
- Maintain a healthy weight.
- Check blood pressure frequently . Follow your doctor's recommendations for keeping it in a safe range.
- Take aspirin if your doctor says it is safe.
- Keep chronic medical conditions under control. This includes high cholesterol and diabetes.
- Talk to your doctor about the use of a statins. These types of drugs may help prevent certain kinds of strokes in some people.
- Seek medical care if you have symptoms of a stroke, even if symptoms stop.
- Stop the use of recreational drugs (eg, cocaine, heroin, amphetamines).
American Heart Association http://www.americanheart.org
National Stroke Association http://www.stroke.org
Health Canada http://www.hc-sc.gc.ca
Heart and Stroke Foundation of Canada http://ww2.heartandstroke.ca
Furie KL, Kasner SE, Adams RJ, et al. Guidelines for the Prevention of Stroke in Patients With Stroke or Transient Ischemic Attack: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association. Stroke . 2010 October 21. Available at: http://stroke.ahajournals.org/cgi/reprint/STR.0b013e3181f7d043v1 . Updated October 21, 2010. Accessed September 4, 2012.
Hemorrhagic stroke. American Heart Association American Stroke Association website. Available at: http://www.strokeassociation.org/STROKEORG/AboutStroke/TypesofStroke/HemorrhagicBleeds/Hemorrhagic-Strokes-Bleeds%5FUCM%5F310940%5FArticle.jsp . Accessed June 6, 2013.
Hemorrhagic stroke. National Stroke Association website. Available at: http://www.stroke.org/site/PageServer?pagename=HEMSTROKE . A Accessed September 4, 2012.
Intracerebral hemorrhage. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated March 21, 2013. Accessed June 6, 2013.
Ischemic stroke. American Heart Association American Stroke Association website. Available at: http://www.strokeassociation.org/STROKEORG/AboutStroke/TypesofStroke/IschemicClots/Ischemic-Strokes-Clots%5FUCM%5F310939%5FArticle.jsp . Accessed June 6, 2013.
Long term management of stroke. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated April 30, 2013. Accessed June 6, 2013.
Stroke (acute management). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated May 2, 2013. Accessed June 6, 2013.
Nueroimaging for acute stroke. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated May 15, 2013. Accessed June 6, 2013.
Signs and symptoms. National Stroke Association website. Available at: http://www.stroke.org/site/PageServer?pagename=SYMP . A Accessed September 4, 2012.
Stroke (acute management). EBSCO Publishing DynaMed website. Available at: http://www.ebscohost.com/dynamed . Updated August 30, 2012. Accessed September 4, 2012.
Subarachnoid hemorrhage. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated January 22, 2013. Accessed June 6, 2013.
Jensen M, St. Louis E. Management of acute cerebellar stroke. Archives of Neurology website. Available at: http://archneur.ama-assn.org/cgi/reprint/62/4/537.pdf . Published April 2005. Accessed June 11, 2013.
2/7/2014 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance: Bushnell C, et al. AHA/ASA Guideline for the Prevention of Stroke in Women. Stroke. 2014 Feb 6. [Epub ahead of print]
- Reviewer: Rimas Lukas, MD
- Review Date: 12/2013
- Update Date: 02/07/2014