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Description - from the National Institute of Neurological Disorders and Stroke

A stroke occurs when the blood supply to the part of the brain is suddenly interrupted (ischemic) or when a blood vessel in the brain bursts, spilling blood into the spaces surrounding the brain cells (hemorrhagic). The symptoms of stroke are easy to spot: sudden numbness or weakness, especially on one side of the body; sudden confusion or trouble speaking or understanding speech; sudden trouble seeing in one or both eyes; sudden trouble walking; dizziness; or loss of balance or coordination. Brain cells die when they no longer receive oxygen and nutrients from the blood or when they are damaged by sudden bleeding into or around the brain. These damaged cells can linger in a compromised state for several hours. With timely treatment, these cells can be saved. Stroke is diagnosed through several techniques: a short neurological examination, blood tests, CT scans, MRI scans, Doppler ultrasound, and arteriography. Stroke seems to run in some families. Family members may have a genetic tendency for stroke or share a lifestyle that contributes to stroke. The most important risk factors for stroke are hypertension, heart disease, diabetes, and cigarette smoking. Other risks include heavy alcohol consumption, high blood cholesterol levels, illicit drug use, and genetic or congenital conditions. Some risk factors for stroke apply only to women. Primary among these are pregnancy, childbirth, and menopause.

Generally, there are three treatment stages for stroke: prevention, therapy immediately after stroke, and post-stroke rehabilitation. Therapies to prevent stroke are based on treating an individual's underlying risk factors. Acute stroke therapies try to stop a stroke while it is happening. Post-stroke rehabilitation is to overcome disabilities that result from stroke damage. Medication or drug therapy is the most common treatment for stroke. Surgery can be used to prevent stroke, to treat acute stroke, or to repair vascular damage or malformations in and around the brain. For most stroke patients, physical therapy is the cornerstone of the rehabilitation process. Another type of therapy involving relearning daily activities is occupational therapy (OT). OT also involves exercise and training to help the stroke patient relearn everyday activities such as eating, drinking and swallowing, dressing, bathing, cooking, reading and writing, and toileting. Speech therapy is appropriate for patients who have no deficits in cognition or thinking, but have problems understanding speech or written words, or problems forming speech.

Although stroke is a disease of the brain, it can affect the entire body. Some of the disabilities that can result from stroke include paralysis, cognitive deficits, speech problems, emotional difficulties, daily living problems, and pain.

Some brain damage that results from stroke may be secondary to the initial death of brain cells caused by the lack of blood flow to the brain tissue. This brain damage is a result of a toxic reaction to the primary damage. Researchers are studying the mechanisms of this toxic reaction and ways to prevent this secondary injury to the brain. Scientists hope to develop neuroprotective agents to prevent this damage. Another area of research involves experiments with vasodilators, medication that expand or dilate blood vessels and thus increase the blood flow to the brain. Basic research has also focused on the genetics of stroke and stroke risk factors. One area of research involving genetics is gene therapy. One promising area of stroke animal research involves hibernation. The dramatic decrease of blood flow to the brain in hibernating animals is extensive enough t that it would kill a non-hibernating animal. If scientists can discover how animals hibernate without experiences brain damage, then maybe they can discover ways to stop the brain damage associated with decreased blood flow in stroke patients. Other studies are looking at the role of hypothermia, or decreased body temperature, on metabolism and neuroprotection. Scientists are working to develop new and better ways to help the brain repair itself and restore important functions to the stroke patients. Some evidence suggests that transcranial magnetic stimulation (TMS), in which a small magnetic current is delivered to an area of the brain, may possibly increase brain plasticity and speed up recover of function after stroke.

Wegner Center Resources

Living With Stroke: A Guide for Families - Book
Wegner Books WL 355 S44 1999

Post-stroke Rehabilitation - Video
Wegner Electronic W 1 NE235t no.757 1999

Stroke - Video
Wegner Electronic WL 355 S921 1996

Stroke Smart: The Voice of Prevention, Treatment, and Recovery - Journal
Wegner Journals

Homespun Medical Tips - Requires RealAudio

Stroke
with Dr. Greg Schultz, Surgeon from Sioux Falls, SD (January 2003)

Stroke - Prevention
with Dr. Gene Koob, Neurologist from Sioux Falls, SD (December 2000)

Stroke - Risks and Symptoms
with Dr. Jim Reynolds, Cardiologist from Sioux Falls, SD (June 2001)

Web Resources

American Stroke Association
http://www.strokeassociation.org
A division of the American Heart Association, the American Stroke Association focuses on reducing disability and death from stroke through research, education, fund raising, and advocacy. This site has sections on: warning signs; stroke; stroke care; stroke programs; and advocacy.

National Institute of Neurological Disorders and Stroke - Know Stroke
http://www.ninds.nih.gov/knowstroke
This site offers information on the stroke prevention and treatment. An eight-minute video is also provides that discusses the symptoms of stroke and what to do, as well as stories from people who have successfully recovered from a stroke.

National Stroke Association
http://209.107.44.93/NationalStroke
The National Stroke Association focus on the development and implementation of innovative approaches and programs to advance prevention, acute treatment, recovery, and rehabilitation for stroke. This site is available in English, Spanish, and French.

Current Literature

Stroke from MEDLINEplus
http://www.nlm.nih.gov/medlineplus/stroke.html
MEDLINEplus provides extensive information from the a variety of trusted sources, in English and in Spanish.

Medem Medical Library - Heart Disease/Stroke
http://www.medem.com/medlb/medlib_entry.cfm
Medem's award-winning Medical Library represents the full rant of patient education information from medical societies and other trusted sources, and is unsurpassed in quality, breadth and depth of health care information.

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