Stroke: Symptoms, causes & prevention

 A stroke occurs when the blood supply to part of your brain is interrupted or reduced, preventing brain tissue from getting oxygen and nutrients. Brain cells begin to die in minutes. A stroke is a medical emergency, and prompt treatment is crucial.

You may experience confusion, slur your words or have difficulty understanding speech. You may develop sudden numbness, weakness or paralysis in your face, arm or leg. This often affects just one side of your body. Try to raise both your arms over your head at the same time. If one arm begins to fall, you may be having a stroke. Also, one side of your mouth may droop when you try to smile.

You may suddenly have blurred or blackened vision in one or both eyes, or you may see double. A sudden, severe headache, which may be accompanied by vomiting, dizziness or altered consciousness, may indicate that you're having a stroke.

Stroke occurs due to a decrease or blockage in the brain’s blood supply. 

Ischemic stroke: This is the most common type of stroke, making up 87% of all cases. A blood clot prevents blood and oxygen from reaching an area of the brain. 

Hemorrhagic stroke: This occurs when a blood vessel ruptures. These are usually the result of aneurysms or arteriovenous malformations (AVMs). 

Transient ischemic attack (TIA): This occurs when blood flow to a part of the brain is inadequate for a brief period of time. Normal blood flow resumes after a short amount of time, and the symptoms resolve without treatment. Some people call this a ministroke.

Prevention of Stroke

Knowing your stroke risk factors, following your doctor's recommendations and adopting a healthy lifestyle are the best steps you can take to prevent a stroke. Many stroke prevention strategies are the same as strategies to prevent heart disease. In general, healthy lifestyle recommendations include:

1.   Controlling high blood pressure (hypertension). 

Hypertension  is by far the most potent risk factor for stroke. Hypertension causes a two-to four-fold increase in the risk of stroke before age 80.  If your blood pressure is high, you and your doctor need to work out an individual strategy to bring it down to the normal range. Some ways that work: Maintain proper weight. Avoid drugs known to raise blood pressure. Eat right:  cut down on salt and eat fruits and vegetables to increase potassium in your diet. Exercise more. Your doctor may prescribe medicines that help lower blood pressure. Controlling blood pressure will also help you avoid heart disease, diabetes, and kidney failure.

High blood pressure is a huge factor, doubling or even quadrupling your stroke risk if it is not controlled. High blood pressure is the biggest contributor to the risk of stroke in both men and women. Monitoring blood pressure and, if it is elevated, treating it, is probably the biggest difference people can make to their vascular health.

Maintain a blood pressure of less than 120/80 if possible. For some older people, this might not be possible because of medication side effects or dizziness with standing

Reduce the salt in your diet, ideally to no more than 1,500 milligrams a day (about a half teaspoon).

Increase polyunsaturated and monounsaturated fats in your diet, while avoiding foods high in saturated fats.

Eat 4 to 5 cups of fruits and vegetables every day, one serving of fish two to three times a week, and several daily servings of whole grains and low-fat dairy.

Get more exercise — at least 30 minutes of activity a day, and more, if possible.

2.   Watch the Cholesterol

Eating less cholesterol and fat, especially saturated fat and trans fats, may reduce the buildup in your arteries. If you can't control your cholesterol through dietary changes alone, your doctor may prescribe a cholesterol-lowering medication.

Too much of this can clog your arteries and lead to heart attack and stroke. Keep your numbers in the healthy range:

• Total cholesterol: under 200 mg/dL of blood
• LDL (bad) cholesterol: under 100 mg/dL
• HDL (good) cholesterol: above 60 mg/dL

If diet and exercise aren’t enough to keep your cholesterol in check, your doctor may recommend medication.

3.   Managing diabetes. 

High blood sugar can make you 2-4 times more likely to have a stroke. If it’s not managed well, diabetes can lead to fatty deposits or clots inside your blood vessels. This can narrow the ones in your brain and neck and might cut off the blood supply to the brain.

If you have diabetes, check your blood sugar regularly, take medications as prescribed, and see your doctor every few months so they can keep an eye on your levels. 

Diet, exercise and losing weight can help you keep your blood sugar in a healthy range. If lifestyle factors don't seem to be enough to control your diabetes, your doctor may prescribe diabetes medication. 

Keep your blood sugar under control .

Monitor your blood sugar as directed by your doctor .

Use diet, exercise, and medicines to keep your blood sugar within the recommended range.

4.   Exercise more

Aerobic exercise reduces your risk of stroke in many ways. Exercise can lower your blood pressure, increase your levels of good cholesterol, and improve the overall health of your blood vessels and heart. It also helps you lose weight, control diabetes and reduce stress. Gradually work up to at least 30 minutes of moderate physical activity — such as walking, jogging, swimming or bicycling — on most, if not all, days of the week. 

Being a couch potato can lead to obesity, high cholesterol, diabetes, and high blood pressure -- a recipe for stroke. So get moving. You don’t have to run a marathon. It’s enough to work out 30 minutes, 5 days a week. You should do enough to make you breathe hard, but not huff and puff. Talk to your doctor before you start exercising.

Take a walk around your neighborhood every morning after breakfast.

Start a fitness club with friends.

When you exercise, reach the level at which you're breathing hard, but you can still talk.

Take the stairs instead of an elevator when you can.

If you don't have 30 consecutive minutes to exercise, break it up into 10- to 15-minute sessions a few times each day.

5.   Drinking alcohol in moderation, if at all. 

Heavy alcohol consumption increases your risk of high blood pressure, ischemic strokes and hemorrhagic strokes. Alcohol may also interact with other drugs you're taking. However, drinking small to moderate amounts of alcohol, such as one drink a day, may help prevent ischemic stroke and decrease your blood's clotting tendency. Talk to your doctor about what's appropriate for you.

6.   Lose Weight 

Obesity, as well as the complications linked to it (including high blood pressure and diabetes), raises your odds of having a stroke. If you're overweight, losing as little as 10 pounds can have a real impact on your stroke risk. 

While an ideal body mass index (BMI) is 25 or less, that may not be realistic for you. Work with your doctor to create a personal weight loss strategy. 

Try to eat no more than 1,500 to 2,000 calories a day (depending on your activity level and your current BMI). 

Increase the amount of exercise you do with activities like walking, golfing, or playing tennis, and by making activity part of every single day. 

7.   Eating a diet rich in fruits and vegetables. A diet containing five or more daily servings of fruits or vegetables may reduce your risk of stroke. The Mediterranean diet, which emphasizes olive oil, fruit, nuts, vegetables and whole grains, may be helpful.

Healthy eating can lower your risk of a stroke and help you shed weight if you need to. Load up on fresh fruits and veggies (broccoli, Brussel sprouts, and leafy greens like spinach are best) every day. Choose lean proteins and high-fiber foods. Stay away from trans and saturated fats, which can clog your arteries. Cut salt, and avoid processed foods. They’re often loaded with salt, which can raise your blood pressure, and trans fats.

8.   Quit smoking

Smoking accelerates clot formation in a couple of different ways. It thickens your blood, and it increases the amount of plaque buildup in the arteries. Along with a healthy diet and regular exercise, smoking cessation is one of the most powerful lifestyle changes that will help you reduce your stroke risk significantly.

Smoking raises the risk of stroke for smokers and nonsmokers exposed to secondhand smoke. Quitting tobacco use reduces your risk of stroke.

Ask your doctor for advice on the most appropriate way for you to quit.

Use quit-smoking aids, such as nicotine pills or patches, counseling, or medicine.

Don't give up. Most smokers need several tries to quit. See each attempt as bringing you one step closer to successfully beating the habit.

9.   Treating obstructive sleep apnea (OSA). 

Your doctor may recommend a sleep study if you have symptoms of OSA — a sleep disorder that causes you to stop breathing for short periods repeatedly during sleep. Treatment for OSA includes a device that delivers positive airway pressure through a mask to keep your airway open while you sleep.

The lifestyle changes mentioned above can help control these conditions to a large degree, but you may also need to take regular medication.