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Stroke occurs when the supply of blood to the brain is either interrupted or reduced. When this happens, the brain does not get enough oxygen or nutrients, which causes brain cells to die.
There are three main kinds of stroke; ischemic, hemorrhagic, and TIA. This article will focus on ischemic and hemorrhagic strokes, as there is a separate Knowledge Center article for TIAs, which goes into specific detail about them.
In the U.S., approximately 40 percent of stroke deaths are in males, with 60 percent in females. According to the American Heart Association (AHA), compared with white people, black people have nearly twice the risk of a first-ever stroke and a much higher death rate from stroke.
In 2009, stroke was listed as the underlying cause of death in 128,842 persons in the U.S., resulting in an age-adjusted rate of 38.9 deaths per 100,000 population. The rate was almost twice as high among non-Hispanic blacks (73.6 per 100,000), and the rate of premature death from stroke was also higher among non-Hispanic blacks than their white counterparts (25.0 versus 10.2).
Stroke is more likely to affect people if they are overweight, aged 55 or older, have a personal or family history of stroke, do not exercise much, drink heavily, smoke, or use illicit drugs.
What causes stroke?
The different forms of stroke have different specific causes.
Causes of ischemic stroke
Ischemic stroke is the most common form, accounting for around 85 percent of strokes. This type of stroke is caused by blockages or narrowing of the arteries that provide blood to the brain, resulting in ischemia - severely reduced blood flow that damages brain cells.
These blockages are often caused by blood clots, which can form either in the arteries within the brain, or in other blood vessels in the body before being swept through the bloodstream and into narrower arteries within the brain. Fatty deposits within the arteries called plaque can cause clots that result in ischemia.
Causes of hemorrhagic stroke
Hemorrhagic strokes are caused by arteries in the brain either leaking blood or bursting open. The leaked blood puts pressure on brain cells and damages them. It also reduces the blood supply reaching the brain tissue after the hemorrhage point. Blood vessels can burst and spill blood within the brain or near the surface of the brain, sending blood into the space between the brain and the skull.
The ruptures can be caused by conditions such as hypertension, trauma, blood-thinning medications, and aneurysms (weaknesses in blood vessel walls).
Intracerebral hemorrhage is the most common type of hemorrhagic stroke and occurs when brain tissue is flooded with blood after an artery in the brain bursts. Subarachnoid hemorrhage is the second type of hemorrhagic stroke and is less common. In this type of stroke, bleeding occurs in an artery in the subarachnoid space - the area between the brain and the thin tissues that cover it.
Causes of transient ischemic attack (TIA)
TIAs are different from the kinds above because the flow of blood to the brain is only briefly interrupted. TIAs are similar to ischemic strokes in that they are often caused by blood clots or other clots.
TIAs should be regarded as medical emergencies just like the other kinds of stroke, even if the blockage of the artery and symptoms are temporary. They serve as warning signs for future strokes and indicate that there is a partially blocked artery or clot source in the heart.
According to the Centers for Disease Control and Prevention (CDC), over a third of people who experience a TIA go on to have a major stroke within a year if they have not received any treatment. Between 10-15 percent will have a major stroke within 3 months of a TIA.
Preventing a stroke
The best way to prevent a stroke is to address the underlying causes. This is best done by living healthfully, which means:
Eating a healthy diet.Maintaining a healthy weight.Exercise regularly.Don't smoke.Avoiding alcohol or drink moderately.
Eating a healthful diet means plenty of fruits, vegetables, and healthy whole grains, nuts, seeds, and legumes; eating little or no red or processed meat; limiting intake of cholesteroland saturated fat (typically found in foods of animal origin); and minimizing salt intake so as to support healthy blood pressure.
Other measures taken to help reduce the risk of stroke include:
Keeping blood pressure under control.Managing diabetes.Treating obstructive sleep apnea (if present).
As well as these lifestyle changes, a doctor can help to re
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