Health & Exercise Forum

Part I

We all know someone who has been affected by a stroke. It can be a devastating and life-changing event. According to the National Stroke Association, (NSA) it is the 5^th leading cause of death and number one cause of disability in the United States. Nearly 800,000 people in the USA have a stroke every year. Every 40 seconds someone has a stroke and every 4 minutes someone dies of a stroke in the USA. 897% of all strokes are ischemic from a clot or mass blocking a blood vessel in the brain.

THE GOOD NEWS

According to a study in the Journal of the American Medical Association, there is almost a 50% reduction in strokes and 40% reduction in stroke deaths more than two decades from 1987 to 2011. THE GOOD NEWS: According to a study in the Journal of the American Medical Association, there is almost a 50% reduction in strokes and 40% reduction in stroke deaths more than two decades from 1987 to 2011. Improved smoking cessation, management of high blood pressure and cholesterol are believed to be significant contributing factors. THE BAD NEWS: Progress has slowed in recent years! THE MESSAGE: Continued vigilance and lifestyle changes are essential!

What is a Stroke?

A stroke occurs when the arteries of the brain are unable to bring necessary blood flow to a specific region of the brain. When blood flow carrying essential oxygen and nutrients is unable to reach brain tissue, the brain cells in that tissue die. The longer the blood flow is cut off, the greater and more permanent the residual damage. Two primary causes of loss of blood flow to the brain are ischemic stroke and hemorrhagic stroke. In an ischemic stroke a clot obstructs or blocks the flow of blood to the brain. In a hemorrhagic stroke, a blood vessel tears or ruptures which interrupts the flow of blood to the brain. Another term used when describing a stroke is a “mini stroke” which is a transient ischemic attack (TIA) which caused by a temporary clot.

The Effects:

The effects of a stroke depend on several factors such as the location and duration of the tissue damage. The brain is unique in that one side of the brain is responsible for the opposite side of the body. So, a stroke that damages the right side of the brain will result in damage to the left side of the body.

Symptoms Associated with Damage to the Right Side of the Brain

• Weakness on the left side of the face
• Paralysis on the left side of the body
• Quick and inquisitive behavior
• Memory loss  

Symptoms Associated with Damage to the Left Side of the Brain

• Weakness on the right side of the face
• Paralysis on the right side of the body
• Speech and language difficulty
• Slow and cautious behavior
• Memory loss

Symptoms Associated with Damage to the Brain Stem

The brain stem is the central trunk of the brain which traverses downward to form the spinal cord. Symptoms include:

• Deficits on both sides of the body
• May lead to a “locked-in” state where the patient is unable to speak or move below the neck

Risk Factors For Stroke That CANNOT be Changed (NSA)

• Age – For every decade of life after age 55, the chance of having a stroke doubles. While common in the elderly, many people under 65 have strokes.
• Hereditary (Family History) – Both family history (parents, grandparents, siblings) and genetics can increase your risk for stroke.
• Race -The incidence of death from stroke is much higher in African-Americans than in Caucasians. This is partly related to the higher incidence of high blood pressure, diabetes and obesity in African-Americans.
• Gender – Women have a significantly more strokes and deaths by stroke than men in great part due to: use of birth control pills, pregnancy, and history of preeclampsia or gestational diabetes, smoking, post-menopausal hormone therapy.
• Prior Stroke, TIA OR Heart Attack – are strong predictors of stroke. In fact, those suffering a TIA are almost 10 times more likely to have a stroke.

Risk Factors For Stroke That CAN be Changed (NSA)

• High Blood Pressure - is the leading cause of stroke and therefore the most important controllable risk factor.
• Smoking – nicotine and carbon monoxide from cigarette smoking increases the risk of stroke. When combined with oral contraceptives, the risk increases significantly.
• Diabetes – this disease directly increases the risk of stroke. However, when combined with high blood pressure, high cholesterol and obesity, the risk increases exponentially.
• Carotid or Peripheral Artery Disease - When arteries become diseased and plaque builds up in the walls of the arteries, the risk of stroke increases.
• Atrial Fibrillation & Other Heart Diseases - a disorder in the rhythm of the heart or malformation of the heart tissues can lead to blood clots that may enter the blood stream and travel to the brain.
• Sickle Cell Disease & Other Blood Diseases - Blood diseases that lead to blood clotting can increase the risk for stroke
• High Cholesterol – Poor Diet – Obesity & Inactivity - all of these factors, individually or in any combination, increases the risk for stroke.
• Geographic Location, Socioeconomic Factors, Alcohol & Drug Abuse - are less documented but have strong associations with stroke risk.

Keep moving, eat healthy foods, and exercise regularly

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email: drpmackarey@msn.com

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice in downtown Scranton, PA and is an associate professor of clinical medicine at GCSOM.

SOURCES: National Stroke Association, National Institutes of Health; www.strokeassociation.org; www.stroke.org