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When brain cells are deprived of their blood supply, a stroke occurs. Without access to vital nutrients and oxygen, brain cells die. The effects of a stroke can vary widely depending on where it occurs in the brain, the severity of the attack, and the general health of the person. A minor stroke may not even be noticed, while a major one can cause crippling mental and physical disabilities or even death.
Approximately 75-80% of strokes are of the clotting (ischemic) variety, while the remainder (hemorrhagic strokes) are due to bleeding from broken blood vessels. Sometimes platelets (cells in the blood stream responsible for clotting) become 'sticky' and promote clotting. If the blood clots too easily it can result in blood flow blockage and subsequent tissue death in that part of the brain normally nourished by the affected blood vessel. You can reduce the risk of the blockage type strokes by keeping your blood platelets from becoming sticky.
A completed stroke is caused by irreversible brain injury due to the interruption of blood flow. In contrast, a Transient Ischemic Attack (TIA) is a temporary focal neurologic deficit caused by the brief interruption of local cerebral blood flow. Strokes occur in one third of patients who have had a TIA.
The duration of a focal neurologic deficit that leads to cerebral infarction has arbitrarily been determined to be 24 hours or greater. Any focal neurologic deficit that resolves completely within 24 hours is considered a TIA.
Incidence; Risk Factors
Stroke is the third leading cause of death in the United States and the primary cause of disabilities in adults. By the start of the 21st century, more than 700,000 Americans were experiencing a stroke each year and more than 167,000 of those were dying. The estimated cost of that to the nation each year was 51.2 billion dollars (and rising).
Elevated blood pressure increases the risk of stroke substantially. Discontinuing hypertensive medication with a return of high blood pressure significantly increases the risk of stroke, especially for someone under the age of 55. Hypertensives are strongly advised not to discontinue medication permanently unless their blood pressure stays close to the normal range.
One study found that while patients on pressure-lowering medications still faced double the stroke risk of healthy controls, patients who abandoned these medications had nearly five times the risk. They authors speculate that the thinning of the arterial wall that occurs with the use of many antihypertensive drugs (due to lowered pressure) might render the wall more subject to injury from high pressure that may occur when medications are ceased. The stroke risk associated with stopping hypertension medication appears to be even higher - almost eight times higher in patients under the age of 55 years than in older patients. This phenomenon might be explained by the vascular thickening that accompanies aging.
Other risk factors for stroke include:- High blood pressure
- Heart disease
- Smoking
- Diabetes
- A history of stroke or TIA's
- History of stroke in the family
- Obesity
- Diets high in alcohol, cholesterol, fat and sodium consumption
- Using oral contraceptives after the age of 35, especially if combined with smoking
- Chronic stress - stress may contribute to maintaining blood pressure at high levels.
Signs & Symptoms
The symptoms of a TIA depend on the region of the brain that is supplied by the transiently occluded cerebral artery. If a TIA is recognized, steps can be taken to prevent future ischemic stroke. All TIAs should be promptly investigated because the risk of ischemic stroke is highest soon after a TIA.
What To Look Out For
During a stroke, parts of your brain are not receiving enough oxygen and this can produce a number of warning signs. These symptoms include:- A sudden change in your vision, particularly if it occurs in one eye
- Sudden numbness, weakness or paralysis in your leg, arm, or face
- A sudden, severe headache that has no known cause
- A sudden change in your ability to speak or understand speech
- Difficulty standing, unsteadiness, or unexplained dizziness
- Personality changes
- Nausea, vomiting, or drowsiness may also occur during a stroke.
Unfortunately, these symptoms can be permanent.
Diagnosis & Tests
Diagnosis concerning the specific type of stroke, its location, and how severe the damage is, can be determined by using a number of advanced imaging tests including Computerized Tomography (CT) Scans and Magnetic Resonance Imaging (MRI).
The diagnosis of a TIA indicates that no irreversible neurologic injury has occurred and provides an excellent opportunity to prevent permanent damage.
The first step in the evaluation of a patient with possible TIA is to determine if the event in question actually represents a TIA. Certain conditions should be ruled out before the diagnosis of TIA is made. Excluding other diagnoses reduces the possibility of inappropriately labeling a patient with the diagnosis of cerebrovascular disease and launching into a course of costly and potentially dangerous diagnostic testing.
Treatment & Prevention
Treatment and rehabilitation after a stroke may involve work with many health care specialists, including physicians, occupational therapists, physical therapists, nurses, social workers and speech/language specialists. Recovery from a stroke can vary a great deal from person to person. Some people recover in a few weeks, while others may take months or years.
Prognosis; Seek medical attention if
More than half of men and women under age 65 who have a stroke die within 8 years; long-term survival is worse in men than in women.
It is extremely important that you call a doctor or emergency services immediately if you experience any stroke symptoms. Treatments provided within hours of symptoms may help prevent brain damage. If these same symptoms occur just briefly, and then stop, it is still very important to seek help. These brief symptoms may indicate a TIA (Transient Ischemic Attack) or "mini-stroke" and may be a sign of a serious problem.
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Signs, symptoms & indicators of Stroke: | | | | | Lab Values - Common |  Rapid pulse rate | See the link between Increased Risk of Coronary Disease / Heart Attack and Pulse Rate. |
Counter-indicators:
 Slowed pulse rate| | See the link between Increased Risk of Coronary Disease / Heart Attack and Pulse Rate. |
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Symptoms - Head - Eyes/Ocular |
 Peripheral vision loss |
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Conditions that suggest Stroke:
Risk factors for Stroke: | | | | | Addictions | Cigarette Smoke Damage| | Smoking causes cerebrovascular disease primarily by increasing atherosclerosis and thrombosis. Between 50% and 55% of all strokes in the United States are directly attributable to cigarette smoking. A smoker is 1.5 to 3 times more likely to develop cerebrovascular disease. |
Cocaine Addiction |
Circulation |
Hypertension (High Blood Pressure) |
Family History |
Stroke in family members |
Lab Values |
Low Total Cholesterol| | Researchers have found that as cholesterol levels drop, the risk of hemorrhagic stroke (accounting for 20% of strokes) increased significantly. A person with a cholesterol level below 180mg/dl had twice the risk of that type of stroke when compared with someone at a level of 230mg/dl. |
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Metabolic |
Hemochromatosis (Iron overload)| | According to a study published in Neurology, high iron levels in stroke patients may prompt more severe neurological symptoms and possibly increase brain damage. Elevations of iron may intensify post-stroke neurological problems such as increased weakness, speech and orientation difficulties, and decreased levels of consciousness. Stroke patients with high ferritin concentrations may also have larger areas of the brain damaged due to stroke. High body iron stores may increase free radical production in brain cells, thus prompting stroke progression. |
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Nutrients |
Copper Deficiency| | A copper deficiency has been associated with weakening of connective tissue that can be a contributing factor for the development of cerebral aneurysms and hemorrhagic strokes. |
EFA (Essential Fatty Acid) Type 3 Requirement| | Consuming cold water fish (and probably omega-3 fatty acids) reduced the incidence of stroke in women by 28 percent. This study demonstrated a reduction in clotting type strokes, without an increase in hemorrhagic strokes. |
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Organ Health |
Diabetes Type II| | Cardiovascular disease is the leading cause of diabetes-related death. People with diabetes are two to four times more likely to develop cardiovascular disease. At least 65% of people with diabetes die from heart disease or stroke. |
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Personal Background |
African ethnicity| | The death rate from stroke in African Americans is almost double that of Caucasians. |
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Supplements and Medications |
History of/occasional/regular COX-2 inhibitor use| | Animal research suggests that the selectivity of COX-2 inhibitors could create an imbalance that promotes blood clotting and blood vessel constriction. COX-1 makes thromboxane A2, which promotes blood vessel constriction and "stickiness" in blood cells called platelets. COX-2 is the major source of prostacyclin, which helps prevent platelets from clumping and promotes blood vessel dilation. Until further research is completed it may be wise to use COX-2 inhibitors cautiously, if at all, if you are at greater risk of stroke. [Science April 19, 2002;296: pp.539-41] |
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Symptoms - Aging |
 Having had/having had mini- strokes (confirmed) |
Symptoms - Food - Intake |
Counter-indicators:
 Moderate/low/high cold water fish consumption
Moderate/high fruit/vegetable consumption |
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Stroke could instead be:
Preventive measures against Stroke: | | | | | Amino Acid / Protein |  L-Taurine |
Botanical |
Garlic
Cayenne Pepper| | Cayenne reduces platelet aggregation (makes the blood less likely to clot) and thus may reduce the risk of clotting strokes. |
Ginkgo Biloba
Gugulipids
Turmeric Extract, Curcumin |
Detoxification |
Chelation Therapy |
Diet |
 Plant-Based Nutrition| | A low incidence of cerebrovascular disease was associated with geographical regions where fresh fruit and vegetable consumption (and therefore increased potassium) was high. [Low fruits and vegetables, high-meat diet increase cerebrovascular event risk. Medical Tribune March 10, 1997:26] |
Increased Water Consumption| | A Seven Day Adventist study found that those who drank 5 glasses of water per day have on average half the cardiac mortality and half the fatal stroke rate of the general population. |
Low/Decreased Fat Diet
Caffeine/Coffee Avoidance| | Coffee, including decaf, contains significant amounts of Vitamin K which is an important factor for blood coagulation. People at high risk for blood clots, strokes, and heart attacks should avoid coffee and decaf for this reason. |
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Digestion |
Bromelain| | Bromelain is potent enzyme that naturally supports the body’s ability to break down blood clots as they develop and diminish inflammation. |
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Drug |
 Anticoagulant / Blood Thinner
Aspirin| | Aspirin reduces platelet 'stickiness' or aggregation as do other natural products that 'thin blood'. The use of aspirin to reduce clotting and stroke risk, even at doses as low as 81mg three times per week, is still controversial. The risks at the lowest doses are low, but the benefit may be limited. Aspirin seems to work better in men with low blood pressure than high, and in men who have had a previous heart attack compared to those who have not. There are many natural substances that can reduce stroke risk with fewer side effects. |
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Extract |
Policosanol/Octacosanol| | Policosanol inhibits the formation of clots, and may work synergistically with aspirin in this respect. 75% of strokes are of the clotting kind. In a comparison of aspirin and policosanol, aspirin was better at reducing one type of platelet aggregation (clumping together of blood cells) but policosanol was better at inhibiting another type. Together, policosanol and aspirin worked better than either alone. |
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Hormone |
Testosterone |
Nutrient |
EPA (eicosapentanoic acid)| | EPA reduces platelet aggregation and thus helps prevent those strokes that are due to an abnormal clotting tendency. |
Essential Fatty Acids| | High doses of Omega-3 oils reduce platelet aggregation and thus reduce the abnormal clotting tendency which is seen in 75% of strokes. |
Alpha Lipoic Acid |
Vitamins |
Folic Acid| | A study found that people with a dietary intake of at least 300mcg per day of folic acid reduced their risk of stroke and heart disease by 20% and 13% respectively, compared with those who consumed less than 136mcg of folic acid per day.
[Stroke 2002;33: pp.1183-9] |
Vitamin E| | Vitamin E at 300 IU or above reduces platelet aggregation, as do the tocotrienols. It is interesting to note that some doctors report that starting to take large doses of vitamin E immediately after a stroke will encourage a higher level of recovery than without the use of vitamin E. For example, instead of having to use a walker, a patient may become mobile with just a cane.
A study reported in the June 15, 1999, issue of the "Annals of Internal Medicine" presented data derived from over 40,000 subjects -- male health professionals whose dietary intake, use of vitamin supplements and health status were followed starting in 1986.
The researchers found no difference in risk of stroke between the high vitamin E- and C-consuming subjects and those who consumed lower levels of the two nutrients. Similarly, the researchers found that a higher intake of most of the carotenoids did not decrease the risk in these men of either total stroke or ischemic stroke. Only with respect to lutein (a carotenoid found mainly in dark-green leafy vegetables) did the investigators find a weak trend of decreased risk of stroke with increased intake. |
Vitamin B6 (Pyridoxine) |
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KEY | | Weak or unproven link | | | Strong or generally accepted link | | | Proven definite or direct link | | | Weakly counter-indicative | | | Strongly counter-indicative | | | May do some good | | | Likely to help | | | Highly recommended |
GLOSSARY
Apnea
Cessation of breathing.
Arterial (Arteries, Artery)
Blood that leaves the heart. When it leaves the right ventricle, it is venous blood; and when it leaves the left ventricle, through the aorta, it is fresh and oxygenated. After it has passed out to the capillaries and started to return, it is venous blood.
Atherosclerosis
Common form of arteriosclerosis associated with the formation of atheromas which are deposits of yellow plaques containing cholesterol, lipids, and lipophages within the intima and inner media of arteries. This results in a narrowing of the arteries, which reduces the blood and oxygen flow to the heart and brain as well as to other parts of the body and can lead to a heart attack, stroke, or loss of function or gangrene of other tissues.
Bell's Palsy
One-sided facial paralysis of sudden onset and unknown cause. The mechanism is presumed to involve swelling of the nerve due to immune or viral disease, with ischemia and compression of the facial nerve in the narrow confines of its course through the temporal bone.
Cardiac
Pertaining to the heart, also, pertaining to the stomach area adjacent to the esophagus.
Cardiovascular
Pertaining to the heart and blood vessels.
Carotenoid
A group of red, orange and yellow pigments found in plant foods and in the tissues of organisms that consume plants. Carotenoids have antioxidant activity and some, but not all, can act as precursors of vitamin A. Studies have shown that several carotenoids other than beta-carotene are potent antioxidants that provide profound health benefits. Because of this, the scientific community has now recognized the importance of natural mixed carotenoids including beta-carotene.
Cholesterol
A waxy, fat-like substance manufactured in the liver and found in all tissues, it facilitates the transport and absorption of fatty acids. In foods, only animal products contain cholesterol. An excess of cholesterol in the bloodstream can contribute to the development of atherosclerosis.
Chronic (Chronicity)
Usually referring to chronic illness: Illness extending over a long period of time.
Copper
An essential mineral that is a component of several important enzymes in the body and is essential to good health. Copper is found in all body tissues. Copper deficiency leads to a variety of abnormalities, including anemia, skeletal defects, degeneration of the nervous system, reproductive failure, pronounced cardiovascular lesions, elevated blood cholesterol, impaired immunity and defects in the pigmentation and structure of hair. Copper is involved in iron incorporation into hemoglobin. It is also involved with vitamin C in the formation of collagen and the proper functioning in central nervous system. More than a dozen enzymes have been found to contain copper. The best studied are superoxide dismutase (SOD), cytochrome C oxidase, catalase, dopamine hydroxylase, uricase, tryptophan dioxygenase, lecithinase and other monoamine and diamine oxidases.
Deciliter (dL)
0.1 or one tenth of a liter.
Dementia (Senile Dementia)
An acquired progressive impairment of intellectual function. Marked compromise exists in at least three of the following mental activity spheres: memory, language, personality, visuospatial skills, and cognition (i.e. abstraction and calculation).
Diabetes Mellitus (Diabetes, Diabetic, Diabetics)
A disease with increased blood glucose levels due to lack or ineffectiveness of insulin. Diabetes is found in two forms; insulin-dependent diabetes (juvenile-onset) and non-insulin-dependent (adult-onset). Symptoms include increased thirst; increased urination; weight loss in spite of increased appetite; fatigue; nausea; vomiting; frequent infections including bladder, vaginal, and skin; blurred vision; impotence in men; bad breath; cessation of menses; diminished skin fullness. Other symptoms include bleeding gums; ear noise/buzzing; diarrhea; depression; confusion.
Enzymes (Enzyme)
Specific protein catalysts produced by the cells that are crucial in chemical reactions and in building up or synthesizing most compounds in the body. Each enzyme performs a specific function without itself being consumed. For example, the digestive enzyme amylase acts on carbohydrates in foods to break them down.
EPA
Environmental Protection Agency. Also: Eicosapentanoic Acid. A metabolite of the omega-3 fatty acid alpha-linolenic acid.
Fatty Acids (Fatty Acid)
Chemical chains of carbon, hydrogen, and oxygen atoms that are part of a fat (lipid) and are the major component of triglycerides. Depending on the number and arrangement of these atoms, fatty acids are classified as either saturated, polyunsaturated, or monounsaturated. They are nutritional substances found in nature which include cholesterol, prostaglandins, and stearic, palmitic, linoleic, linolenic, eicosapentanoic (EPA), and decohexanoic acids. Important nutritional lipids include lecithin, choline, gamma-linoleic acid, and inositol.
Fibrinolysis
A normal ongoing process within the body that dissolves fibrin and results in the removal of small blood clots.
Folic Acid
A B-complex vitamin that functions along with vitamin B-12 and vitamin C in the utilization of proteins. It has an essential role in the formation of heme (the iron containing protein in hemoglobin necessary for the formation of red blood cells) and DNA. Folic acid is essential during pregnancy to prevent neural tubular defects in the developing fetus.
Free Radical (Free Radicals)
A free radical is an atom or group of atoms that has at least one unpaired electron. Because another element can easily pick up this free electron and cause a chemical reaction, these free radicals can effect dramatic and destructive changes in the body. Free radicals are activated in heated and rancid oils and by radiation in the atmosphere, among other things.
Hypertension
High blood pressure. Hypertension increases the risk of heart attack, stroke, and kidney failure because it adds to the workload of the heart, causing it to enlarge and, over time, to weaken; in addition, it may damage the walls of the arteries.
Iron
An essential mineral. Prevents anemia: as a constituent of hemoglobin, transports oxygen throughout the body. Virtually all of the oxygen used by cells in the life process are brought to the cells by the hemoglobin of red blood cells. Iron is a small but most vital, component of the hemoglobin in 20,000 billion red blood cells, of which 115 million are formed every minute. Heme iron (from meat) is absorbed 10 times more readily than the ferrous or ferric form.
Ischemia (Ischemic)
Localized tissue anemia due to obstruction of the inflow of arterial blood. A decrease in the blood supply to a bodily organ, tissue, or part caused by constriction or obstruction of the blood vessels.
IU (mIU, uIU)
International Unit: An arbitrarily defined but agreed upon unit that depends on what is being measured.
mIU: 0.001 or one thousandth of an IU.
uIU: 0.000001 or one millionth of an IU.
Magnetic Resonance Imaging (MRI)
A technique used in diagnosis that combines radio waves and magnetic forces to produce detailed images of the internal structures of the body.
Microgram (mcg, Micrograms, ug)
0.000001 or a millionth of a gram.
Milligram (mg, Milligrams)
0.001 or a thousandth of a gram.
Nausea
Symptoms resulting from an inclination to vomit.
Platelet Aggregation
Platelets are the small, rather uniform fragments of large bone marrow cells that aid the blood in coagulation, hemostasis, inflammation, and thrombus formation. Mild subclotting and sticking is a common early condition that can lead to thrombosis, atherosclerosis, and strokes, and can be helped by an aspirin a day, better fat digestion, and Ceanothus.
Platelets (Platelet)
Cells that help the blood to clot.
Potassium
A mineral that serves as an electrolyte and is involved in the balance of fluid within the body. Our bodies contain more than twice as much potassium as sodium (typically 9oz versus 4oz). About 98% of total body potassium is inside our cells. Potassium is the principal cation (positive ion) of the fluid within cells and is important in controlling the activity of the heart, muscles, nervous system and just about every cell in the body. Potassium regulates the water balance and acid-base balance in the blood and tissues. Evidence is showing that potassium is also involved in bone calcification. Potassium is a cofactor in many reactions, especially those involving energy production and muscle building.
Sodium
An essential mineral that our bodies regulate and conserve. Excess sodium retention increases the fluid volume (edema) and low sodium leads to less fluid and relative dehydration. The adult body averages a total content of over 100 grams of sodium, of which a surprising one-third is in bone. A small amount of sodium does get into cell interiors, but this represents only about ten percent of the body content. The remaining 57 percent or so of the body sodium content is in the fluid immediately surrounding the cells, where it is the major cation (positive ion). The role of sodium in the extracellular fluid is maintaining osmotic equilibrium (the proper difference in ions dissolved in the fluids inside and outside the cell) and extracellular fluid volume. Sodium is also involved in nerve impulse transmission, muscle tone and nutrient transport. All of these functions are interrelated with potassium.
Stenosis
Usually referring to Esophageal or GI tract: Narrowing.
Stroke (Stroke-Type Event)
A sudden loss of brain function caused by a blockage or rupture of a blood vessel that supplies the brain, characterized by loss of muscular control, complete or partial loss of sensation or consciousness, dizziness, slurred speech, or other symptoms that vary with the extent and severity of the damage to the brain. The most common manifestation is some degree of paralysis, but small strokes may occur without symptoms. Usually caused by arteriosclerosis, it often results in brain damage.
Taurine
A nonessential amino acid but may be essential for individuals with certain diseases or nutritional concerns. May be needed for the proper development and maintenance of the central nervous system. Taurine's role in bile formation is important for fat metabolism and blood cholesterol control.
Thrombosis
Formation of blood clots causing vascular obstruction.
Vascular
Relating to the blood vessels of the body. The blood vessels of the body, as a group, are referred to as the vascular system. They are composed of arteries, veins and capillaries - arteries that pass oxygen-rich blood to the tissues of the body; veins which return oxygen-depleted blood from the tissues to the lungs for oxygen; and the capillaries that are the tiniest vessels and are between the arteries and veins.
Vitamin B6 (B6, B-6)
Influences many body functions including regulating blood glucose levels, manufacturing hemoglobin and aiding the utilization of protein, carbohydrates and fats. It also aids in the function of the nervous system.
Vitamin E
An essential fat-soluble vitamin. As an antioxidant, helps protect cell membranes, lipoproteins, fats and vitamin A from destructive oxidation. It helps protect red blood cells and is important for the proper function of nerves and muscles. For Vitamin E only, 1mg translates to 1 IU.
Vitamin K
Helps the blood clot when the body is injured.
Last updated: Jun 28, 2009
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