Monday, June 28, 2010

Ten risk factors: You can impact all of them

Recent research identified the 10 risk factors for stroke:
The new study compared risk factors among 3,000 people who had a stroke to those of 3,000 age- and sex-matched individuals who did not have a stroke. Study participants came from 22 countries.

The 10 risk factors that account for 90% of stroke risk are:

  • History of high blood pressure
  • Current smoking
  • Abdominal obesity
  • Diabetes
  • Lack of physical activity
  • Poor diet
  • More than 30 drinks per month or binge drinking
  • Ratio of blood fats known as apolipoprotein B (apo B) to apolipoprotein AI (apo AI)
  • Heart disease
  • Psychosocial stress/depression
Now, for some of these, genetics might play a part. But for all of these, people with these risk factors can at least attempt to at least semi-control them. And it's worth the effort - a brain is at stake.

(Image from Centers for Disease Control and Prevention)

Friday, June 25, 2010

Strange but true: One stroke sufferer's story

A fascinating telling of a story on NPR the other day, about The Writer Who Couldn't Read:
Engel had suffered a stroke. It had damaged the part of his brain we use when we read, so he couldn't make sense of letters or words. He was suffering from what the French neuroscientist Stanislas Dehaene calls "word blindness." His eyes worked. He could see shapes on a page, but they made no sense to him. And because Engel writes detective stories for a living (he authored the Benny Cooperman mystery series, tales of a mild-mannered Toronto private eye), this was an extra-terrible blow. "I thought, well I'm done as a writer. I'm finished."

Wednesday, June 23, 2010

A refreshing find...

On a lark the other day, I did a Google search on these terms (without quotes): "prayers for stroke patients."

Among other hits, a Prayer for Strength After a Stroke:

...Grant them strength and hope
to envision new days ahead...

(Image from

Monday, June 21, 2010

More places, more hope

Number of U.S. Stroke Centers nearly double since 2006 | Stroke Awareness Foundation Blog
Nearly 80 percent of the population (250 million residents) lives within an hours drive of a stroke center and nearly 211 million residents lives within a 30-minute drive.

Saturday, June 19, 2010

Stroke prevention device? No answer yet

Companies' research announcements should almost always be taken with a grain of salt, so don't hold your breath for exciting news about this next week.

But atrial fibrillation is a common problem and known stroke-causing ailment. So look for more news and perhaps answers on this in the months ahead.

AGA Medical enrolls first patient in stroke-prevention trial
The trial is intended to evaluate the safety and efficacy of the plug in preventing blood clots in the heart that can lead to strokes. The trial will be conducted with patients suffering from atrial fibrillation, a condition in which the heart quivers and doesn’t pump blood properly. That can cause clots that travel to the brain and result in strokes, according to a statement from the company.

Wednesday, June 16, 2010

Exercise for stroke survivors often helps

We all know exercise is good for you. Turns out, after a stroke, even light exercise can often help get hands and arms working again:
The finding stems from Canadian research involving 103 people who'd had a stroke and were receiving standard follow-up care in a hospital. About half were then enrolled in an additional experimental effort called the Graded Repetitive Arm Supplementary Program (GRASP).
The GRASP group spent 35 minutes four times a week doing such non-intense arm exercises as buttoning a shirt, pouring water into a glass and playing speed and accuracy games. The functioning of arms and hands that had been affected by the stroke improved, on average, 33 percent for these participants, the study found. The amount that people used their arms and hands increased as well.

Monday, June 14, 2010

Good news - but could be much better

Every find news that sounds good but you know it must get better? Recent stories reported just that kind of news.

On one hand, almost 30 percent of stroke patients showed up an an emergency room within the first hour. That's good. But that means more than 70 percent don't show up within the first hour. That's the downside. The downside means fewer treatment options, and, the study shows, fewer people who show up after the first hour receive a clot-busting drug.

There are two other interesting findings: If the stroke is more obviously serious or the patient shows up in an ambulance, then you get a much higher percentage of those arriving at an ER with in the first. Now, the first item is out of your control. However, the second item - how an ambulance can get someone to help quicker - is advice that anyone can follow.

Here's a snippet of one article:

A substantial portion of ischemic stroke patients present to emergency departments within an hour of onset, and they are more likely to receive thrombolytic therapy than those who arrive later, but both factors present room for improvement, according to research published online June 3 in Stroke. ...

The researchers found that onset-to-door time was 60 minutes or less in 28.3 percent of patients, 61 to 180 minutes in 31.7 percent, and more than 180 minutes in 40.1 percent. Characteristics most strongly associated with early arrival included severe neurologic deficit and arrival by ambulance versus private vehicle. Patients arriving in the first 60 minutes more frequently received intravenous thrombolytic therapy than those arriving in 61 to 180 minutes (27.1 versus 12.9 percent), but their door-to-needle time was longer (90.6 versus 76.7 minutes).

Thursday, June 10, 2010

Couple of news items regarding clot-busting drug

New 4.5-hour window for tPA in stroke boosts number of patients treated, causes no new delays
...[T]he increase did not appear to come at the expense of the number of patients treated in the earlier period up to 3 hours after onset, something investigators had feared would happen once physicians knew they had more time to decide whether to treat.

Patients treated later had similar functional outcomes to the earlier window, the researchers found; there was a small increase in symptomatic intracerebral hemorrhage (ICH) and death but not enough to prevent use of the treatment, the researchers conclude.
Clot buster more critical for female stroke victims
"Women need to be treated for stroke as soon as possible. We found that women who weren't treated had a worse quality of life after stroke than men. However, the good news is that women who were treated responded just as well as men to the treatment," study author Dr. Michael D. Hill, of the University of Calgary in Canada, said in a news release from the journal's publisher.

Hill and his colleagues analyzed data on more than 2,100 stroke patients. Of the 232 patients treated with tPA within three hours after their stroke, 44 percent were women.

Only 58 percent of women who didn't receive tPA had a good outcome six months after their stroke, compared with 70 percent of men who weren't given the drug. Women and men treated with tPA after their stroke had similar outcomes.
(Image from the National Institutes of Health)

Monday, June 07, 2010

More and more stories about younger stroke victims

From entertainer Bret Michaels and Delaware Attorney General Beau Biden to countless others, story after story of late shows that strokes can often happen to the under-50 crowd:
Is Beau Biden too young to have a stroke? Sadly, no:
Dr. Irene Katzan, director of the Primary Stroke Care Center at the Cleveland Clinic, told Newsweek that given Biden's quick recovery, he likely suffered an ischemic stroke, in which an artery to the brain somehow becomes blocked, cutting off blood flow and oxygen supply. (A more serious form of stroke occurs when a blood vessel breaks completely, and blood seeps into the brain.)

At 41, the Delaware attorney general doesn't seem like someone who is at high risk of a stroke: according to the American Heart Association, more than 75 percent of stroke victims in the U.S. are 65 or older. But Katzan says it's not unheard of in a younger man.

 From | The News Journal:
"There's a common misconception that stroke is a condition only of the elderly," said Matarese, also the medical director of the stroke center at St. Mary Medical Center in Langhorne, Pa. "In fact, it can affect anyone, including young adults. There are young, otherwise seemingly healthy adults who have had them and, in many times, the cause of their stroke is not the more commonly seen problems that we see in older individuals."

There were 1,163 men between 35 and 44 who died of stroke in 2006, the most recent year in which data is available, according to the federal National Center for Health Statistics.

Former "Miss Arizona" suffered stroke at 26:
Leean Hendrix was featured speaker at a conference titled, "Stroke: It's Not Just an Old Person's Disease" at Forrest General Hospital.

Hendrix suffered a massive stroke at the age of 26 after injuring her ankle while jogging. She says she still hasn't fully recovered.
Drawing hope after stroke:
The backing of family and friends is crucial, survivors say, but there's nothing like talking to someone who has lived through the terror of stroke.

Thursday, June 03, 2010

Stroke Awareness Month is over, but....

Time is critical in treating stroke victims:

"Quite literally, the more time you waste or lose trying to treat a stroke, the more brain cells die," says Dr. Nasser Razack, director of neurosciences at Northside Hospital in St. Petersburg. "It's critically important that if you think you are having a stroke, or someone you know might be having a stroke, to dial 911 immediately and get help."

Time determines the treatment available to the estimated 780,000 Americans affected by stroke each year; one of the first questions doctors must answer when a patient arrives at a hospital emergency room is how much time has passed. It's especially critical as stroke remains the third leading cause of death in the country today, killing 187,000 people a year, the Centers for Disease Control and Prevention says.

Wednesday, June 02, 2010

Myth: Only the obviously unhealthy have strokes

 Now, it's trendy to be stroke aware - it happened when Bret Michaels had a warning stroke and later diagnosed with a patent foramen ovale - a hole between the upper chambers of his heart:
So what exactly is a patent foramen ovale, and how common is it? We spoke with Dr. Jonathan Tobis, clinical professor of cardiology and director of interventional cardiology at the Ronald Reagan UCLA Medical Center, who explained that this is a congenital condition. Fetuses normally have a hole, or flap, between the left and right atria of the heart that allows blood to flow in between, bypassing the lungs. Once the baby is born and taking in oxygen to the lungs, that flap seals up -- or it's supposed to. In about 20% to 25% of people it stays open, leaving a small to large hole that still allows some blood to flow between the atria.

Most people never know they have this condition. But it may cause strokes, although rarely, Tobis said: "A blood clot can form and travel a pathway from the right to the left atrium and up to the brain, causing a stroke." It’s typically corrected these days with a catheter-based method that "is sort of like closing a button hole," he said. "It's a relatively simple procedure done as an outpatient."

Tobis said people shouldn't go running to their doctors demanding an echocardiogram to see whether they have this condition, because most remain asymptomatic throughout their lives.

Michaels, 47, has had a few struggles in his life but on appearance, seems healthy enough. His story, though, can serve as a cautionary tale. He's not old. Not puny or weak-looking. Active. So was I. So have countless others.

So even if someone seems healthy, know and pay attention to the signs and symptoms of a stroke.