Insufficient blood flow to brain resulting in cell death. Also see Inosine Production Stimulate.Encyclopedia Entry for Stroke :Stroke - discharge. Because of possible injury to the brain from the stroke, you may notice problems with: Changes in behavior Doing easy tasks Memory Moving one side of the body Muscle spasms Paying attention Sensation or awareness of one part of the body Swallowing Talking or understanding others Thinking Seeing to one side (hemianopia) You may need help with daily activities you used to do alone before the stroke. Depression after a stroke is fairly common as you learn to live with the changes. It may develop soon after the stroke or up to 2 years after the stroke. DO NOT drive your car without your doctor s permission.Moving around and doing normal tasks may be hard after a stroke. Make sure your home is safe. Ask your doctor, therapist, or nurse about making changes in your home to make it easier to do everyday activities. Find out about what you can do to prevent falls and keep your bathroom safe to use. Family and caregivers may need to help with: Exercises to keep your elbows, shoulders, and other joints loose Watching for joint tightening (contractures) Making sure splints are used in the correct way Making sure arms and legs are in a good position when sitting or lying If you or your loved one is using a wheelchair, follow-up visits to make sure it fits well are important to prevent skin ulcers. Check every day for pressure sores at the heels, ankles, knees, hips, tailbone, and elbows. Change positions in the wheelchair several times per hour during the day to prevent pressure ulcers. If you have problems with spasticity , learn what makes it worse. You or your caregiver can learn exercises to keep your muscles lose. Learn how to prevent pressure ulcers.Tips for making clothing easier to put on and take off are: Velcro is much easier than buttons and zippers. All buttons and zippers should be on the front of a piece of the clothing. Use pullover clothes and slip-on shoes. People who have had a stroke may have speech or language problems. Tips for family and caregivers to improve communication include: Keep distractions and noise down. Keep your voice lower. Move to a quieter room. DO NOT shout. Allow plenty of time for the person to answer questions and understand instructions. After a stroke, it takes longer to process what has been said. Use simple words and sentences, speak slowly. Ask questions in a way that can be answered with a yes or no. When possible, give clear choices. DO NOT give too many options. Break down instructions into small and simple steps. Repeat if needed. Use familiar names and places. Announce when you are going to change the subject. Make eye contact before touching or speaking if possible. Use props or visual prompts when possible. DO NOT give too many options. You may be able to use pointing or hand gestures or drawings. Use an electronic device, such as a tablet computer or cell phone, to show pictures to help with communication.Nerves that help the bowels work smoothly can be damaged after a stroke. Have a routine. Once you find a bowel routine that works, stick to it: Pick a regular time, such as after a meal or a warm bath, to try to have a bowel movement. Be patient. It may take 15 to 45 minutes to have bowel movements. Try gently rubbing your stomach to help stool move through your colon. Avoid constipation: Drink more fluids. Stay active or become more active as much as possible. Eat foods with lots of fiber. Ask your health care provider about medicines you are taking that may cause constipation (such as medicines for depression, pain, bladder control, and muscle spasms).Have all of your prescriptions filled before you go home. It is very important that you take your medicines the way your provider told you to. DO NOT take any other drugs, supplements, vitamins, or herbs without asking your provider about them first. You may be given one or more of the following medicines. These are meant to control your blood pressure or cholesterol, and to keep your blood from clotting. They may help prevent another stroke: Antiplatelet medicines (aspirin or clopidogrel) help keep your blood from clotting. Beta blockers, diuretics (water pills), and ACE inhibitor medicines control your blood pressure and protect your heart. Statins lower your cholesterol. If you have diabetes, control your blood sugar at the level your provider recommends. DO NOT stop taking any of these medicines. If you are taking a blood thinner, such as warfarin (Coumadin), you may need to have extra blood tests done.If you have problems with swallowing, you must learn to follow a special diet that makes eating safer. The signs of swallowing problems are choking or coughing when eating. Learn tips to make feeding and swallowing easier and safer. Avoid salty and fatty foods and stay away from fast food restaurants to make your heart and blood vessels healthier. Limit how much alcohol you drink to a maximum of 1 drink a day if you are a woman and 2 drinks a day if you are a man. Ask your provider if it is OK for you to drink alcohol. Keep up to date with your vaccinations. Get a flu shot every year. Ask your doctor if you need a pneumonia shot. DO NOT smoke. Ask your provider for help quitting if you need to. DO NOT let anybody smoke in your home. Try to stay away from stressful situations. If you feel stressed all the time or feel very sad, talk with your provider. If you feel sad or depressed at times, talk to family or friends about this. Ask your provider about seeking professional help.Call your provider if you have: Problems taking drugs for muscle spasms Problems moving your joints (joint contracture) Problems moving around or getting out of your bed or chair Skin sores or redness Pain that is becoming worse Recent falls Choking or coughing when eating Signs of a bladder infection (fever, burning when you urinate, or frequent urination) Call 911 if the following symptoms develop suddenly or are new: Numbness or weakness of the face, arm, or leg Blurry or decreased vision Not able to speak or understand Dizziness, loss of balance, or falling Severe headache.Cerebrovascular disease - discharge; CVA - discharge; Cerebral infarction - discharge; Cerebral hemorrhage - discharge; Ischemic stroke - discharge; Stroke - ischemic - discharge; Stroke secondary to atrial fibrillation - discharge; Cardioembolic stroke - discharge; Brain bleeding - discharge; Brain hemorrhage - discharge; Stroke - hemorrhagic - discharge; Hemorrhagic cerebrovascular disease - discharge; Cerebrovascular accident - discharge.Intracerebral hemorrhage Intracerebral hemorrhage.Dobkin BH. Rehabilitation and recovery of the patient with stroke.Encyclopedia Entry for Stroke :Stroke - risk factors. A risk factor is something that increases your chance of getting a disease or health problem. Some risk factors for stroke you cannot change. Some you can. Changing the risk factors that you have control over will help you live a longer, healthier life.You cannot change these stroke risk factors: Your age. Risk of stroke goes up with age. Your sex. Men have a higher risk of getting heart disease than women, except in older adults. Your genes and race. If your parents had a stroke, you are at higher risk. African Americans, Mexican Americans, American Indians, Hawaiians, and some Asian Americans also have a higher risk. Diseases such as cancer, chronic kidney disease, and some types of arthritis. Weak areas in an artery wall or abnormal arteries and veins. Pregnancy. Both during and in the weeks right after the pregnancy. Blood clots from the heart may travel to the brain and cause a stroke. This may happen in people with manmade or infected heart valves. It may also happen because of a heart defect you were born with. A very weak heart and abnormal heart rhythm, such as atrial fibrillation , can also cause blood clots.Some risk factors for stroke that you can change are: Not smoking. If you do smoke, quit. Ask your doctor for help quitting. Controlling your cholesterol through diet, exercise, and medicines , if needed. Controlling high blood pressure through diet, exercise, and medicines, if needed. Ask your doctor what your blood pressure should be. Controlling diabetes through diet, exercise , and medicines, if needed. Exercising at least 30 minutes a day. Maintaining a healthy weight. Eat healthy foods, eat less, and join a weight loss program, if you need to lose weight. Limiting how much alcohol you drink. Women should have no more than 1 drink a day, and men no more than 2 a day. DO NOT use cocaine and other recreational drugs. Birth control pills can raise your risk of blood clots. Clots are more likely in women who also smoke and who are older than 35. Good nutrition is important to your heart health. It will help control some of your risk factors. Choose a diet rich in fruits, vegetables, and whole grains. Choose lean proteins, such as chicken, fish, beans and legumes. Choose low-fat dairy products, such as 1% milk and other low-fat items. Avoid sodium (salt) and fats found in fried foods, processed foods, and baked goods. Eat fewer animal products and fewer foods with cheese, cream, or eggs. Read food labels. Stay away from saturated fat and anything with partially-hydrogenated or hydrogenated fats. These are unhealthy fats. Your doctor may suggest taking aspirin or another blood thinner to help prevent blood clots from forming. DO NOT take aspirin without talking to your doctor first. If you are taking these medicines, take steps to prevent yourself from falling or tripping , which can lead to bleeding. Follow these guidelines and the advice of your doctor to lower your chances of stroke.Preventing stroke; Stroke - prevention; CVA - prevention; TIA - prevention.Meschia JF, Bushnell C, Boden-Albala B, et al, American Heart Association Stroke Council; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; Council on Functional Genomics and Translational Biology; Council on Hypertension. Guidelines for the primary prevention of stroke: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014;45(12):3754-3832. PMID 25355838 www.ncbi.nlm.nih.gov/pubmed/25355838.Encyclopedia Entry for Stroke :Stroke. There are two major types of stroke: Ischemic stroke Hemorrhagic stroke Ischemic stroke occurs when a blood vessel that supplies blood to the brain is blocked by a blood clot. This may happen in two ways: A clot may form in an artery that is already very narrow. This is called a thrombotic stroke. A clot may break off from another place in the blood vessels of the brain, or from some other part of the body, and travel up to the brain. This is called cerebral embolism, or an embolic stroke. Ischemic strokes may also be caused by a sticky substance called plaque that can clog arteries. Stroke Watch this video about: Stroke Stroke - secondary to cardiogenic embolism Watch this video about: Stroke - secondary to cardiogenic embolism A hemorrhagic stroke occurs when a blood vessel in part of the brain becomes weak and bursts open. This causes blood to leak into the brain. Some people have defects in the blood vessels of the brain that make this more likely. These defects may include: Aneurysm (weak area in the wall of a blood vessel that causes the blood vessel to bulge or balloon out) Arteriovenous malformation (AVM; abnormal connection between the arteries and veins) Cerebral amyloid angiopathy (CAA; condition in which proteins called amyloid build up on the walls of the arteries in the brain) Hemorrhagic strokes may also occur when someone is taking blood thinners, such as warfarin (Coumadin). Very high blood pressure may cause blood vessels to burst, leading to hemorrhagic stroke. An ischemic stroke can develop bleeding and become a hemorrhagic stroke. High blood pressure is the main risk factor for strokes. Other major risk factors are: Irregular heartbeat, called atrial fibrillation Diabetes Family history of stroke Being male High cholesterol Increasing age, especially after age 55 Ethnicity (African Americans are more likely to die of a stroke) Obesity History of prior stroke or transient ischemic attack (occurs when blood flow to a part of the brain stops for a brief time) Hypertension - overview Watch this video about: Hypertension - overview Stroke risk is also higher in: People who have heart disease or poor blood flow in their legs caused by narrowed arteries People who have unhealthy lifestyle habits such as smoking, excessive use of alcohol, use recreational drugs, a high-fat diet, and lack of exercise Women who take birth control pills (especially those who smoke and are older than 35) Women who are pregnant have an increased risk while pregnant Women who take hormone replacement therapy.Symptoms of stroke depend on which part of the brain is damaged. In some cases, a person may not know that a stroke has occurred. Most of the time, symptoms develop suddenly and without warning. But symptoms may occur on and off for the first day or two. Symptoms are usually most severe when the stroke first happens, but they may slowly get worse. Cerebellum - function A headache may occur if the stroke is caused by bleeding in the brain. The headache: Starts suddenly and may be severe May be worse when you are lying flat Wakes you up from sleep Gets worse when you change positions or when you bend, strain, or cough Brainstem function Other symptoms depend on how severe the stroke is, and what part of the brain is affected. Symptoms may include: Change in alertness (including sleepiness, unconsciousness, and coma) Changes in hearing or taste Changes that affect touch and the ability to feel pain, pressure, or different temperatures Confusion or loss of memory Problems swallowing Problems writing or reading Dizziness or abnormal feeling of movement (vertigo) Eyesight problems, such as decreased vision, double vision, or total loss of vision Lack of control over the bladder or bowels Loss of balance or coordination, or trouble walking Muscle weakness in the face, arm, or leg (usually just on one side) Numbness or tingling on one side of the body Personality, mood, or emotional changes Trouble speaking or understanding others who are speaking.The doctor will do a physical exam to: Check for problems with vision, movement, feeling, reflexes, understanding, and speaking. Your doctor and nurses will repeat this exam over time to see if your stroke is getting worse or improving. Listen to the carotid arteries in the neck with a stethoscope for an abnormal sound, called a bruit, which is caused by abnormal blood flow. Check for high blood pressure. Carotid stenosis, X-ray of the left artery You may have the following tests to help find the type, location, and cause of the stroke and rule out other problems: CT scan of the brain to determine if there is any bleeding MRI of the brain to determine the location of the stroke Angiogram of the head to look for a blood vessel that is blocked or bleeding Carotid duplex (ultrasound) to see if the carotid arteries in your neck have narrowed Echocardiogram to see if the stroke could have been caused by a blood clot from the heart Magnetic resonance angiography ( MRA ) or CT angiography to check for abnormal blood vessels in the brain Other tests include: Blood tests Electroencephalogram ( EEG ) to determine if there are seizures Electrocardiogram ( ECG ) and heart rhythm monitoring.A stroke is a medical emergency. Quick treatment is needed. Call 911 or your local emergency number right away or seek urgent medical care at the first signs of a stroke. People who are having stroke symptoms need to get to a hospital as quickly as possible. If the stroke is caused by a blood clot, a clot-busting drug may be given to dissolve the clot. To be effective, this treatment must be started within 3 to 4 1/2 hours of when the symptoms first started. The sooner this treatment is started, the better the chance of a good outcome. Other treatments given in the hospital depend on the cause of the stroke. These may include: Blood thinners such as heparin, warfarin (Coumadin), aspirin, or clopidogrel (Plavix) Medicine to control risk factors, such as high blood pressure, diabetes, and high cholesterol Special procedures or surgery to relieve symptoms or prevent more strokes Nutrients and fluids Physical therapy, occupational therapy, speech therapy, and swallowing therapy will all begin in the hospital. If the person has severe swallowing problems, a feeding tube in the stomach (gastrostomy tube) will likely be needed. The goal of treatment after a stroke is to help you recover as much function as possible and prevent future strokes. Recovery from your stroke will begin while you are still in the hospital or at a rehabilitation center. It will continue when you go home from the hospital or center. Be sure to follow up with your health care provider after you go home.Support and resources are available from the American Stroke Association -- www.strokeassociation.org.How well a person does after a stroke depends on: The type of stroke How much brain tissue is damaged What body functions have been affected How quickly treatment is given Problems moving, thinking, and talking often improve in the weeks to months after a stroke. Many people who have had a stroke will keep improving in the months or years after their stroke. Over half of people who have a stroke are able to function and live at home. Others are not able to care for themselves. If treatment with clot-busting drugs is successful, the symptoms of a stroke may go away. However, people often do not get to the hospital soon enough to receive these drugs, or they cannot take these drugs because of a health condition. People who have a stroke from a blood clot (ischemic stroke) have a better chance of surviving than those who have a stroke from bleeding in the brain (hemorrhagic stroke). The risk for a second stroke is highest during the weeks or months after the first stroke. The risk begins to decrease after this period.Stroke is a medical emergency that needs to be treated right away. The acronym F.A.S.T. is an easy way to remember signs of stroke and what to do if you think a stroke has occurred. The most important action to take is to call 911 right away for emergency assistance. F.A.S.T. stands for: FACE. Ask the person to smile. Check if one side of the face droops. ARMS. Ask the person to raise both arms. See if one arm drifts downward. SPEECH. Ask the person to repeat a simple sentence. Check if words are slurred and if the sentence is repeated correctly. TIME. If a person shows any of these symptoms, time is essential. It is important to get to the hospital as quickly as possible. Call 911. Act F.A.S.T.Reducing your stroke risk factors lessens your chance of having a stroke.Cerebrovascular disease; CVA; Cerebral infarction; Cerebral hemorrhage; Ischemic stroke; Stroke - ischemic; Cerebrovascular accident; Stroke - hemorrhagic; Carotid artery - stroke.Angioplasty and stent placement - carotid artery - discharge Being active when you have heart disease Brain aneurysm repair - discharge Butter, margarine, and cooking oils Caring for muscle spasticity or spasms Carotid artery surgery - discharge Communicating with someone with aphasia Communicating with someone with dysarthria Constipation - self-care Dementia and driving Dementia - behavior and sleep problems Dementia - daily care Dementia - keeping safe in the home Dementia - what to ask your doctor Eating extra calories when sick - adults Headache - what to ask your doctor High blood pressure - what to ask your doctor Preventing falls Stroke - discharge Swallowing problems.Brain Brain Carotid stenosis, X-ray of the left artery Carotid stenosis, x-ray of the left artery Carotid stenosis, X-ray of the right artery Carotid stenosis, x-ray of the right artery Stroke Stroke Brainstem function Brainstem function Cerebellum - function Cerebellum - function Circle of Willis Circle of Willis Left cerebral hemisphere - function Left cerebral hemisphere - function Right cerebral hemisphere - function Right cerebral hemisphere - function Endarterectomy Endarterectomy Plaque buildup in arteries Plaque buildup in arteries Stroke - Series Stroke - series Carotid dissection Carotid dissection.Biller J, Ruland S, Schneck MJ. Ischemic cerebrovascular disease. In Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology in Clinical Practice. 7th ed. Philadelphia, PA: Elsevier; 2016:chap 65. Crocco TJ, Meurer WJ. Stroke.Encyclopedia Entry for Stroke :Stroke. Can be caused by the bacteria Chlamydia pneumoniae, Helicobacter pylori, Mycobacterium tuberculosis, and Mycoplasma pneumoniae, as well as the virus Varicella Zoster virus and the fungus Histoplasma.Information from Marcello Allegretti.