Strokes In Women
• What Is a Stroke?
Guide To Stroke
A stroke is where blood flow to a part of the brain is suddenly stopped. A stroke is not a heart attack, but rather a brain attack. It occurs when blood flow is suddenly reduced, either by a blockage or a rupture in an artery in the brain. After a few seconds the brain cells start to die because they are starved of oxygen and nutrients. When the cells die, body functions controlled by that part of the brain are lost, resulting in disability. Stroke kills twice as many women a year as breast cancer, yet a recent survey revealed that most women thought breast cancer was 5 times more common. Nearly 40 percent said they were somewhat or not at all concerned with experiencing a stroke in their lifetime. Yet, roughly 42-49 percent of all strokes occur in women - and women who have strokes are twice as likely as men to die of them. Stroke is a largely preventable condition, but 70 percent of women admit to not knowing or only somewhat knowing the risk factors. Currently 4 million American's are living with the effects of stroke, making it the number one cause of adult disability.
There are 2 types of strokes: an ischemic stroke and a hemorrhage stroke.
Ischemic strokes account for more than 80 percent of all strokes, and they are further divided into another 2 types: embolic and thrombotic.
An embolic ischemic stroke is where a blood clot forms somewhere in the body (usually the heart) and travels through the bloodstream towards the brain (a traveling clot!). Eventually it travels to a blood vessel small enough to block its passage. There the clot lodges, blocking blood flow to the brain and causing a stroke. Such a blood clot is called an embolus. Atrial fibrillation (irregular heart beat) is a common cause of embolic strokes at it creates favorable conditions in the heart for a clot to form and break off.
A thrombotic ischemic stroke is where a clot forms directly in an artery in the brain. Atherosclerotic plaques are fatty deposits which form over time (see atherosclerosis) in the arteries of the body, including those that supply blood to the heart and the brain. As the blood vessels become clogged, damage to the artery walls occurs. Like any wound the body responds by forming clots around the damaged area. This creates a further blockage, until blood flow is prevented altogether.
About 20 percent of all strokes are hemorrhagic strokes. These occur when weakened blood vessels burst and blood seeps into surrounding brain tissue (reducing the amount of blood that reaches the brain). The most common cause is long-standing high blood pressure (hypertension) and brain aneurysms (a weak spot in the wall of the artery believed to be hereditary - image).
What Is A Mini Stroke?
Common symptoms of stroke seen in both women and men are:
Unique stroke symptoms reported by women (image):
Symptoms of stroke in pregnant women include:
• Severe headaches
If you have any of these symptoms, dial 9-1-1 immediately. Every minute counts and acting F.A.S.T. (image) can lead patients to the stroke treatments which may save their life. The most effective treatments are given within 3 hours of the stroke occurring. If a patient is bought to hospital soon enough, treatments may even reverse the effects of the attack. On the other hand, if the person arrives to hospital 3 hours after the stroke, they may not even be eligible for treatment.
How To Recognize a Stroke
If you think someone may be having a stroke, apply the F.A.S.T. rule. That is:F /FACE: Ask them to smile. Does one side of the face droop?
A /ARMS: Ask them to raise both arms. Does one arm drift down?
S /SPEECH: Ask the person to repeat a simple phrase. Is their speech slurred or strange?
T /TIME: If you see any of these signs, call 9-1-1 immediately. Time is crucial.
Some stroke risk factors are equal for both women and men:
• Age, the risk of stroke increases with age.
While other risks are unique to women:
• Pregnancy, hemorrhagic strokes are a rare complication of pregnancy but they remain the leading cause of maternal death (which itself is uncommon). Pregnancy also increases the risks of rupturing pre-existing aneurysms. See also: Heart disease in pregnancy.
Stroke Diagnosis: If a stroke is suspected a doctor will carry out a detailed neurological exam and blood tests which will distinguish a stroke from other possible causes (such as infection, tumors, low or high blood sugar levels). If a stroke is diagnosed, treatment will depend on its type and location, so this will need to be identified. A CT scan or MRI scan of the head can show if there has been a hemorrhage. If no blood is visible, the stroke is probably due to an ischemic stroke. An echocardiogram (image) and electrocardiogram (ECG/image) can monitor the flow of blood through the arteries, to check for signs of blockages and irregular heart rhythms.
Stroke treatment: while waiting for an ambulance:
Medical Emergency Intervention in Hospital
The key to recovery is quick treatment, ideally with transfer to a hospital with a specialized stroke center. Since the mid 1990s, thrombolytic therapy (traditionally used for heart attack treatment) is usually prescribed for ischemic strokes. Thrombolytics must be taken within 3 hours of a stroke to have any effect, although an experimental drug called r-pro UK can be effective for up to 6 hours. Thrombolytics help to re-establish blood flow by dissolving clots in the brain. Activase (Alteplase recombinant) became the first treatment to be approved by the FDA for the treatment of ischemic strokes. It is an engineered form of TPA, which is a natural occurring substance in the body that helps dissolve blood clots. However, while clot busters can save lives, they can also cause bleeding, particularly in the brain, so they should only be attempted after a consultation with a highly skilled neurologist and a CAT scan has determined that the stroke is caused by a clot. Aspirin therapy is sometimes used in combination with other antiplatelets such as Ticlid and Plavix.
If stroke is caused by a hemorrhage, thrombolytics are not be used because of their potential to exacerbate bleeding. Instead treatment will involve breathing aids and medications to control seizures, reduce brain swelling and maintain normal blood pressure.
Two types of surgical interventions are commonly used for treating ischemic stroke: carotid endarterectomy and angioplasty with stents.
Carotid Endarterectomy: An invasive procedure where the artery is cut open, the blockage removed and then the artery is repaired and closed again.
Stroke Prevention: The risk of stroke can be significantly reduced by eliminating some of the known risk factors (see also risk factors for heart disease).
Those with severely narrowed arteries can reduce the risk of stroke by surgery, although major studies indicate that women are less likely than men to benefit from surgery.
Stroke recovery is the process a stroke survivor undergoes to recover as much independence and return of bodily functions as possible. It normally begins with formal stroke rehabilitation where specialists can help restore some physical, mental and emotional functions. General recovery guidelines indicate:
10 percent of those who survive a stroke recover almost completely.
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