Stroke: Key Q&A

What is a stroke?

A stroke is a life-threatening event in which part of the brain is deprived of adequate oxygen. A stroke can cause oxygen-starved brain cells to die within minutes, and damage can continue for several days afterward. The condition must be treated immediately. A stroke is also known as a cerebrovascular accident or a "brain attack."

How dangerous is a stroke?

Strokes are extremely dangerous, accounting for more than 160,000 deaths each year, according to the Centers for Disease Control and Prevention. Stroke is the third leading cause of death in the United States, behind heart disease and cancer. It is also a leading cause of adult disability and institutionalization. Each year, about 700,000 people suffer strokes. Of those, 500,000 are first-time strokes.

Are all strokes the same?

No. There are two kinds of strokes. An ischemic stroke occurs when the blood supply to the brain is interrupted, usually by a blood clot. These clots may be caused by "hardening of the arteries" in the carotid arteries, which feed the head and brain with oxygen-rich blood. The second kind of stroke is a hemorrhagic stroke, which occurs when there is bleeding into or around the brain. Strokes can also have a variety of severities.

What is the difference between a "mini-stroke" and a "little stroke?"

A transient ischemic attack or "mini-stroke" is different from a "little stroke." A mini-stroke tends to produce transient symptoms of stroke without causing permanent damage because the oxygen flow to the brain is only temporarily interrupted. Whereas, a little stroke will cause permanent damage, but only in a very small part of the brain.

After a "little stroke," people may not notice any changes in their own functioning. However, friends and family members may notice slight changes. For example, people who were very particular about their personal appearance may suddenly start paying less attention to it. There may be short memory lapses and slight alterations in speech. The effects of many little strokes can add up over time, such that people may eventually be diagnosed with a type of mental confusion called dementia.

Does a stroke affect men and women the same way?

No. Although strokes occur with roughly equal frequency in both men and women, women are more likely to have a stroke at a younger age, such as in their 40s or 50s, and to die from stroke. Female victims account for more than 60 percent of the annual deaths due to stroke, making strokes the second leading cause of death among American women.

Does race affect the risk of having a stroke?

Yes. Research finds that the risk for a first stroke in African Americans is approximately twice that of white Americans. The reason may be that African Americans have more risk factors for stroke, such as high blood pressure, diabetes and - particularly dangerous in African American women - poor dietary habits and lack of exercise.

A genetic cause has also been suggested. Until researchers have fully understood the risks, African Americans are urged to learn everything they can about the risk factors, symptoms, diagnostic tests and treatments associated with strokes.

Can a stroke be prevented?

Usually, yes. Stroke is one of the most preventable neurological disorders. Many strokes can be prevented by controlling weight, blood pressure, cholesterol levels and other risk factors. One of the best ways for people to prevent a stroke is to learn about these risk factors and to make healthy lifestyle changes accordingly. To survive a stroke, people are also encouraged to learn how they can recognize the symptoms of a stroke and what to do if they are having a stroke.

How is a stroke treated?

After a stroke begins, it is imperative to seek treatment as soon as possible to reestablish the flow of oxygen-rich blood to the brain cells before permanent tissue damage or death occurs. Medical personnel must act quickly to maintain the patient's breathing, reduce fever, run tests to determine the cause of the stroke, administer appropriate medications and perform any necessary procedures while racing against the clock to re-establish blood flow to the brain.

People who survive a stroke should begin stroke rehabilitation as soon as possible to regain lost functions, such as lack of coordination or strength. Most recovery occurs during the first few months following a stroke. However, new intensive rehabilitation techniques are offering new hope for recovery even a year or so following a debilitating stroke.

There have been a number of recent advances in the treatment of stroke. Many are still under development, but they offer hope of minimizing damage caused by a stroke. They include new methods to remove or break up clots, and new medications to protect the brain from injury during stroke.

Can a stroke recur?

Yes. The risk of a recurrent stroke is very real, and people who have had a stroke are usually advised to take a number of steps to reduce their risk for another stroke. These steps might include eating a heart-healthy diet and taking aspirin or other antiplatelet agents. For people with severe blockage of a carotid artery, a doctor might also recommend a surgery called carotid endarterectomy or the placement of a carotid artery stent.