A stroke occurs when
the blood supply to part of the brain is suddenly interrupted due to the
presence of a blood clot (ischemic stroke) or when a blood vessel in the brain
bursts, spilling blood into the spaces surrounding brain cells (hemorrhagic
stroke). When blood flow to the brain stops, brain cells no
longer receive oxygen and nutrients from the blood and die. Sudden
bleeding in or around the brain can also cause brain cells to die. This results
in temporary or permanent neurologic impairment. Ischemic stroke, also known as
cerebral infarction, accounts for 80 - 85% of all strokes, while hemorrhagic
stroke accounts for the other 15 - 20%. Prior to a stroke, some people suffer
transient ischemic attacks (TIAs), mini-strokes that generally last only 5 - 20
minutes but can linger for up to 24 hours before the symptoms go away
completely. Many times, a TIA is a warning of an impending stroke. An estimated
700,000 people in the United States suffer a stroke each year, making this one
of the most serious of all health problems. Half of stroke sufferers are left
disabled, with many undergoing years of rehabilitation.
Symptoms of a stroke
depend on which area of the brain is affected and, in turn, what functions in
the body that area controls. Many of the warning signs of a possible stroke
(like a TIA) and symptoms of an actual stroke are the same. If any of these symptoms
occur, you should seek medical attention right away and start appropriate
treatment as quickly as possible. The sooner treatment begins, the more likely
it is that brain function will be preserved.
Symptoms and warning
signs include:
- Sudden weakness or numbness of the face, arm, and leg
on one side of the body
- Sudden loss of vision or dimmed vision, particularly in
one eye
- Loss of speech, or trouble talking or understanding
speech
- Sudden, severe headaches with no apparent cause
- Unexplained dizziness, unsteadiness, or sudden falls,
especially if accompanied by any of the previous symptoms
Women are more likely
to report nontraditional symptoms of stroke and, in particular, altered mental
states.
Ischemic stroke
results from the following causes:
- A clot (embolus) forms in a part of the body other than
the brain, travels through blood vessels, and becomes wedged in a brain
artery.
- A blood clot (thrombus) forms in a brain artery and
stays attached to the artery wall until it grows large enough to block
blood flow.
Hemorrhagic stroke
results from the following causes:
- A bleeding aneurysm -- a weak or thin spot on an artery
wall that, over time, has stretched or ballooned out under pressure from
blood flow. The wall ruptures and blood spills into the space surrounding
brain cells.
- Artery walls lose their elasticity and become brittle
and thin, prone to cracking.
- Arteriovenous malformation (AVM) -- a tangle of
defective blood vessels and capillaries within the brain that have thin
walls that can rupture.
Free radical damage
may make someone susceptible to stroke and other brain disorders. Free radicals
are waste products created when the body turns food into energy (metabolism).
Even though they are created naturally by normal metabolic processes (called oxidation),
free radicals cause harmful chemical reactions that can damage cells in the
body. There are also many environmental sources of free radicals, such as
ultraviolet rays, radiation, and toxic chemicals in cigarette smoke, car
exhaust, and pesticides. Anyone can have a stroke, but certain factors place
you at higher risk. You can't change some factors that increase the risk of
stroke, while you can change others linked to lifestyle.
Ways to help protect
yourself include:
- Avoid extra exposure to oxidative stress and its
subsequent free radicals by staying away from environmental sources.
- Take antioxidants (see Nutrition and Dietary
Supplements).
Anybody can have a
stroke, but certain factors place you at higher risk. Some factors that
increase the risk of stroke cannot be changed, while others are linked to
lifestyle factors, and thus are under your control.
Risk factors that cannot be changed:
- Age -- The older a person gets, the greater the risk of
stroke.
- Sex -- Men are 30% more likely to have a stroke than
women. But after menopause, a woman's risk of stroke rises significantly.
- Family history -- Having a parent, grandparent, or
sibling who has had a stroke, puts you at greater risk yourself.
- Race -- African-Americans have a greater risk of stroke
than Caucasians. This is related to an increased risk of high blood
pressure, obesity, and diabetes in African-Americans.
- Heart attack – If you have had a heart attack in the
past, you are more likely to have a stroke than someone who has not had a
heart attack.
- A history of migraine headaches -- Recent studies
indicate that people with migraines may be at higher risk for ischemic
stroke.
- A prior stroke -- If you have had a stroke, you are at
increased risk for another.
- Sickle cell anemia -- People with this condition are at
risk for stroke at a younger age.
- Berry aneurysms -- Some people are born with small,
sac-like areas within the wall of an artery in the brain. They occur most
often at the junctures of vessels at the base of the brain. Berry
aneurysms may rupture without warning, causing bleeding within the brain.
Risk factors that can be changed with medical treatment:
- High blood pressure -- High blood pressure has no
symptoms, so regular blood pressure checks are important. The condition
can be easily and successfully controlled with medication.
- High blood cholesterol levels -- Studies have shown
that lowering cholesterol levels by changing your lifestyle and taking
medication can reduce the risk of stroke by as much as 30%. Keeping
cholesterol low can reduce the risk of blood clots and plaque buildup
within the walls of arteries in the brain.
- TIAs, or "mini-strokes" -- A surprising
number of people ignore the symptoms of TIAs, which are warning signs that
a stroke may be imminent. In fact, 50% of people who have had a TIA suffer
a stroke within one year. It is very important to seek medical attention
for these symptoms because if you have had a TIA, there are definite steps
you can take to help prevent a major stroke. Doctors prescribe blood
thinners such as aspirin, warfarin (Coumadin), or other drugs to prevent
blood clots if you have had a TIA.
- Cardiovascular disease -- Certain disorders of the heart
or blood vessels, such as atherosclerosis (plaque buildup in artery walls)
and atrial fibrillation (an abnormal heart rhythm), can produce blood
clots that may break loose and travel to the brain. These conditions are
also treated with blood thinners to reduce risk of stroke.
- Diabetes -- People with diabetes are more at risk. It
is important to note that type 2 diabetes (often called adult onset) is
highly influenced by certain lifestyle factors, particularly diet and
excess weight.
- Blood clotting disorders -- People who form blood clots
more easily, called hypercoagulable conditions, are at greater risk for
stroke. Hypercoagulable states are also treated with blood thinners such
as warfarin (Coumadin) in order to try to prevent stroke and other
complications.
- Sleep apnea -- People with sleep apnea have 3 - 6 times
the risk of stroke compared to people who do not have this disorder. This
condition, defined as cessation of breathing many times throughout the
night, is generally treatable by losing weight and using a special device
called a CPAP machine.
Risk factors that can change through lifestyle modifications:
- Cigarette smoking -- Cigarette smoking has been linked
to heart attacks, strokes, artery disease in the legs, and lung cancer.
Nicotine raises blood pressure, carbon monoxide reduces the amount of
oxygen the blood can carry to the brain, and cigarette smoke makes the
blood thicker and more likely to clot. It is never too late to give up
smoking.
- Smoking and birth control pills -- Research shows that
smoking and taking birth control pills significantly increases a woman's
risk for stroke. Together, they can cause blood clots to form. Women who
take birth control pills should not smoke.
- Drinking large amounts of alcohol -- Frequent
intoxication can make a person more likely to experience bleeding in the
brain. Also, alcohol in large amounts can raise blood pressure.
- Obesity -- Being overweight increases your risk of
having a stroke, along with other health problems.
- Lack of exercise -- Moderate exercise can help keep
blood pressure and cholesterol levels within normal ranges.
- Poor diet -- A diet high in fat and sugar can
cause conditions within the body -- such as obesity, type 2 diabetes,
and high cholesterol -- that contribute to a greater risk of stroke.
- Stress -- Ongoing stress can raise blood pressure.
Plus, not dealing well with stress can contribute to unhealthy habits such
as smoking and overeating. Finding healthy ways to handle stress is important.
Other factors that may
put you at increased risk for stroke include pregnancy, infection or
inflammation, gum disease, and high homocysteine levels. Homocysteine is an
amino acid that rises in the body if you have low levels of vitamins B6, B12,
B9 (folic acid), and betaine.
If you or someone you
know experiences symptoms associated with stroke, call 911 or your local
emergency number immediately. There are effective therapies for stroke that
must be administered at a hospital within the first 3 hours after stroke
symptoms appear. At the hospital, a health care provider will make a diagnosis
and guide you in determining which treatment or combination of therapies will
work best for you. The health care provider will do a complete neurological
exam and run a battery of tests, such as blood tests, an electrocardiogram, and
a test to measure the severity of the stroke. Imaging techniques -- such
as CT scans, magnetic resonance imaging (MRI), and magnetic resonance
angiography (MRA) -- may be used to reveal the cause of the stroke and pinpoint
blockages or reveal malformations.
The best way to
prevent stroke is to reduce your risk factors and take control of your own
health:
- If you smoke, stop smoking -- many excellent smoking
cessation programs are available; your health care provider can advise you
about tools to use, such as the nicotine patch, as well as exercise and
other behavioral modifications.
- Keep your weight within normal limits.
- Get a moderate amount of exercise, preferably 5 days a
week.
- Eat a diet that is rich in fruits and vegetables. Green
leafy vegetables may be particularly important, as well as whole grains,
nuts (especially walnuts), and fish.
- If you have heart disease or an abnormal heart rhythm,
work with your doctor to treat it. Certain types of problems with the
heart and blood vessels, such as atherosclerosis and atrial fibrillation,
can cause blood clots to form. These clots can travel through the bloodstream
and block an artery in the brain, causing a stroke (or can block a blood
vessel in the heart and cause a heart attack).
- If you have high blood pressure, take your medication
regularly.
- Lower your cholesterol level if it is elevated -- some
people can do this by modifying their diet; others need to take
medication. Lowering cholesterol levels has been proven to reduce the risk
of stroke.
- If you have diabetes, keep it under good control.
- Know the warning signs of TIAs and strokes, and get
help right away if you experience them.
Medications for prevention
Certain medications
have been shown to reduce the risk of stroke. These drugs, which aim to prevent
the formation of dangerous blood clots, fall under two major categories:
- Antiplatelet agents -- These include aspirin and
stronger prescription drugs like ticlopidine (Ticlid) and clopidogrel
(Plavix). In one study, aspirin therapy reduced the risk of cardiovascular
events, including stroke, by 21%. These drugs help keep tiny blood cells
called "platelets" from clumping together in the bloodstream.
When a blood vessel is damaged or injured, platelets will migrate to the
area to begin a healing process. However, large numbers of platelets can
clump together and form a clot that plugs up an artery. Antiplatelet
agents help prevent this clumping.
- Anticoagulants -- These drugs also prevent clots, but
are much stronger than antiplatelet agents. Common anticoagulants are
warfarin (Coumadin) and heparin (generally given at the hospital through
injection into a vein).
A stroke is a medical
emergency, regardless of whether it is a major stroke or a short-lasting TIA.
A person suffering
symptoms consistent with a stroke should be taken immediately to a hospital
emergency department.
The ability to quickly
pinpoint the type of stroke is critically important in treatment decisions. A
stroke caused by a blocked artery is treated in an entirely different way than
a stroke caused by bleeding within the brain.
The key to survival
and recovery is prompt medical treatment.
Lifestyle
Rehabilitation --
learning certain skills that you might have lost is crucial following a stroke and
can consist of one or more of the following:
- Physical therapy -- Teaches walking, sitting, lying
down, and switching from one type of movement to another.
- Occupational therapy -- To relearn eating, drinking,
swallowing, dressing, bathing, cooking, reading, writing, and toileting.
- Speech therapy -- To relearn language and communication
skills. Often, non-verbal alternatives are encouraged until speech
returns.
- Psychological/psychiatric therapy -- To help relieve
some mental and emotional stresses (such as depression) that often
accompany a stroke. These feelings may be due to the location of the brain
damage itself or may be a reaction to the stroke.
In addition, learning
yoga may help you recover after a stroke, even months later. If you have had a
stroke and are considering yoga, talk to your doctor first. Then, find a
qualified teacher in your area who has worked a lot with stroke victims. This
is very important because there are certain yoga postures that you should not
do if you have high blood pressure, narrowed carotid arteries (the main
arteries in your neck supplying blood to the brain), or history of stroke.
Check with your physical therapist for a referral.
Medications
If the stroke is
caused by a blockage in an artery, medications called thrombolytics can be
used. The only drug in this class approved by the Food and Drug Administration
(FDA) for treatment of stroke is tissue plasminogen activator (tPA). Popularly
referred to as clot busting, this medication has been used for years to treat
heart attacks and only more recently has been used as part of the treatment of
stroke.
Not all hospitals have
the ability to give tPA to people having a stroke. Before this drug can be
given, doctors must be certain that the stroke is the result of a blockage in
the artery, not due to bleeding from an artery. This is determined through
imaging procedures such as a computed tomography (CT) scan or magnetic
resonance imaging (MRI). But not all hospitals have around-the-clock imaging
services. If the stroke is due to bleeding, this powerful blood thinner can
worsen the hemorrhage.
If tPA cannot be used
(for example, too much time has passed since the stroke symptoms began), your
doctor may consider a less potent blood thinner called heparin.
Once the acute phase
of the stroke has resolved, other less potent blood thinners called
antiplatelet agents (such as aspirin and ticlopidine) or anticoagulants (such
as warfarin) may be used to prevent future strokes due to blood clots (See
"Preventing Care").
If a stroke is caused
by bleeding, medication (such as mannitol) can reduce swelling of brain tissue.
Following the acute
treatment of a stroke, while in recovery, medications to control risk factors
for stroke like high blood pressure and high cholesterol will be started or
adjusted if you are already taking. Daily aspirin is also recommended for those
who have had a stroke or a TIA.
Surgery and Other Procedures
If the stroke or TIA
is caused by a blockage, a procedure called carotid endarterectomy can be used
to remove the buildup of plaque from inside the effected carotid artery, one of
the major vessels supplying blood to the head and neck.
This surgical
procedure is best for those who have had symptoms and have a blockage of 70% or
more of one of their carotid arteries. If the narrowing of the vessel is less
than 50%, medication (not surgery) is the most appropriate treatment to prevent
future strokes.
Unfortunately, carotid
endarterectomy may actually cause a stroke. Therefore, the risks and benefits
of this procedure must be carefully weighed with your doctor.
If the stroke is
caused by bleeding, an artery within the brain can sometimes be
"clipped" to prevent further bleeding. Emergency surgery for a
bleeding stroke may involve locating and surgically evacuating (removing) blood
that has pooled in the brain tissue (called a hematoma). A brain specialist,
called a neurosurgeon, will determine if this procedure is appropriate or not.
Interventional
radiologists, if this specialized service is available at your hospital, may be
trained to perform carotid angioplasty. This procedure begins with carotid
angiography, as described earlier, to locate the blockage in this main artery
supplying blood to the brain. Once located, a tiny balloon is threaded up to
the blocked area and then inflated to break up the clot or plaque responsible
for the narrowing in the vessel. The specialist may leave a wire mesh (stent)
inside the vessel to keep it open. This procedure is quite risky, however, and
may even cause a stroke.
If an aneurysm is
present but has not bled, your doctor will discuss the possibility of removing
it surgically. The decision is based primarily on the size of the aneurysm.
Nutrition and Dietary Supplements
Stroke should be
treated by conventional medicine. If complementary and alternative therapies
are used, they should bu used only under the supervsion of a health care
provider.
Potentially beneficial
nutritional supplements include the following:
Alpha-lipoic acid. Alpha-lipoic acid works together with other antioxidants, such
as vitamins C and E. It is important for growth, helps to prevent cell damage,
and helps the body rid itself of harmful substances. Because alpha-lipoic acid
can pass easily into the brain, it has protective effects on brain and nerve
tissue and shows promise as a treatment for stroke and other brain disorders
involving free radical damage. Animals treated with alpha-lipoic acid, for
example, suffered less brain damage and had a four times greater survival rate
after a stroke than the animals who did not receive this supplement, especially
when alpha-lipoic acid is combined with vitamin E. While animal studies are
encouraging, more research is needed to understand whether this benefit applies
to people as well.
Calcium. In a population based
study (one in which large groups of people are followed over time), women who
take in more calcium, both through the diet and supplements, were less likely
to have a stroke over a 14 year period. More research is needed to fully assess
the strength of the connection between calcium and risk of stroke.
Folic Acid, Vitamin B6, Vitamin B12, and Betaine. Many clinical studies indicate that patients
with elevated levels of the amino acid homocysteine are as much as 2.5 times
more likely to suffer from a stroke than those with normal levels. Homocysteine
levels are strongly influenced by dietary factors, particularly vitamin B9
(folic acid), vitamin B6, vitamin B12, and betaine. These substances help break
down homocysteine in the body. Some studies have even shown that healthy
individuals who consume higher amounts of folic acid and vitamin B6 are less
likely to develop atherosclerosis than those who consume lower amounts of these
substances. One recent study found that loweing of homocysteine with folic acid
and vitamins B6 and B12 reduced the overall risk of stroke, but not stroke
severity or disability. Despite these findings, the American Heart Association
(AHA) reports that there is insufficient evidence to suggest that
supplementation with betaine and B vitamins reduce the risk of atherosclerosis
or that taking these supplements prevents the development or recurrence of
heart disease. The AHA does not currently recommend population wide
homocysteine screening, and suggests that folic acid, as well as vitamin B6,
B12, and betaine requirements be met through diet alone. Individuals at high
risk for developing atherosclerosis, however, should be screened for blood
levels of homocysteine. If elevated levels are detected, a health care provider
may recommend supplementation.
Magnesium. Population based
information suggests that people with low magnesium in their diet may be at
greater risk for stroke. Some preliminary scientific evidence suggests that
magnesium sulfate may be helpful in the treatment of a stroke or transient
ischemic attack. More research is needed to know for certain if use of this
mineral following a stroke or TIA is helpful. Magnesium may lower blood
pressure and potentially interact with some heart medicines.
Omega-3 Fatty Acids. Strong evidence from population-based studies suggests that
omega-3 fatty acid intake (primarily from fish) helps protect against stroke
caused by plaque buildup and blood clots in the arteries that lead to the
brain. In fact, eating at least 2 servings of fish per week can reduce the risk
of stroke by as much as 50%. However, people who eat more than 3 grams of
omega-3 fatty acids per day (equivalent to 3 servings of fish per day) may be
at an increased risk for hemorrhagic stroke, a potentially fatal type of stroke
in which an artery in the brain leaks or ruptures. Omega-3 fatty acids may
increase the chances of bleeding, especially in those taking anticoagulant
medications, such as warfarin (Coumadin) or even aspirin.
The U.S. Food and Drug
Administration (FDA) recommends that pregnant women and women of childbearing
age, who may become pregnant, limit their consumption of shark, tuna, and
swordfish to no more than once a month. These fish have much higher levels of
methyl mercury than other commonly consumed fish. Since the fetus may be more
susceptible than the mother to the adverse effects of methyl mercury, FDA
experts say that it is prudent to minimize the consumption of fish that have
higher levels of methyl mercury, like shark, tuna, and swordfish.
Potassium. Although low levels of
potassium in the blood may be associated with stroke, taking potassium
supplements does not seem to reduce the risk of having a stroke.
Vitamin C. Having low levels of
vitamin C contributes to the development of atherosclerosis and other damage to
blood vessels and the consequences, such as stroke. Vitamin C supplements may
also improve cognitive function if you have suffered from multiple strokes.
Vitamin E. Eating plenty of foods
rich in vitamin E, along with other antioxidants like vitamin C, selenium, and
carotenoids, reduces your risk for stroke. In addition, low levels of vitamin E
in the blood may be associated with risk of dementia (memory impairment)
following stroke. Animal studies also suggest that vitamin E supplements, possibly
in combination with alpha-lipoic acid, may reduce the amount of brain damaged
if taken prior to the actual stroke. Researchers suggest testing this theory in
people who are at high risk for stroke. Thus far, however, some large and
well-designed studies of people suggest that it is safest and best to obtain
this antioxidant via food sources and that supplements do not provide any added
benefit.
Others. Additional supplements
that require further research but may be useful as part of the treatment or prevention
of stroke include:
- Coenzyme Q10 -- works as an antioxidant and may reduce
damage following a stroke. CO Q10 may interfere with some blood-thinning
medicines, such as warfarin (Coumadin) and others.
- Selenium -- low levels can worsen atherosclerosis and
its consequences. However, it is not known if taking selenium supplements
will help.
Herbs
The use of herbs is a
time-honored approach to strengthening the body and treating disease. Herbs,
however, contain active substances that can trigger side effects and interact
with other herbs, supplements, or medications. For these reasons, you should
take herbs only under the supervision of a health care provider knowledgeable
in the field.
Bilberry (Vaccinium myrtillus). A close relative of the cranberry, bilberry
fruits contain flavonoid compounds called anthocyanidins. Flavonoids are plant
pigments that have excellent antioxidant properties. This means that they
scavenge damaging particles in the body known as free radicals and may help
prevent a number of long term illnesses, such as heart disease.
Garlic (Allium sativum). Clinical studies suggest that fresh garlic and garlic
supplements may prevent blood clots and destroy plaque. Blood clots and plaque
block blood flow and contribute to the development of heart attack and stroke.
Garlic may also be beneficial for reducing risk factors for heart disease and
stroke like high blood pressure, high cholesterol, and diabetes. Homocysteine,
similar to cholesterol, may contribute to increasing amounts of blood clots and
plaque in blood vessels. If you take aspirin or other blood thinners like
warfarin (Coumadin), ACE inhibitors (a class of blood pressure medications),
sulfonylureas for diabetes, or statins for high cholesterol, talk to your
doctor before using garlic supplements.
Ginkgo (Ginkgo biloba). Gingko may reduce the likelihood of dementia following multiple
strokes (often called multi-infarct dementia). The protection from ginkgo may
be related to the prevention of platelet adhesion which can help prevent blood
clot formation. Most health care providers choose to use medications for this
effect rather than herbs. Ginkgo may also decrease the amount of brain damage
following a stroke. While animal studies support these possible benefits of
ginkgo, more research in people is needed. Also, ginkgo should not be used with
the blood thinner warfarin (Coumadin) unless specifically instructed by your
health care provider.
Ginseng (Panax ginseng). Asian ginseng may decrease endothelial cell dysfunction.
Endothelial cells line the inside of blood vessels. When these cells are
disturbed, referred to as dysfunction, it may lead to a heart attack or stroke.
The potential for ginseng to quiet down the blood vessels may prove to be
protective against these conditions. Much more research is needed. Ginseng may
also thin your blood and, therefore, should be used only under the supervision
of a doctor if you are taking blood thinning medication warfarin (Coumadin).
Turmeric (Curcuma longa). Early studies suggest that turmeric may prove helpful in
preventing heart attack or stroke in one of two ways. First, in animal studies
an extract of turmeric lowered cholesterol levels and inhibited the oxidation
of LDL ("bad") cholesterol. This is helpful because oxidized LDL
deposits in the walls of blood vessels and contributes to the formation of
atherosclerotic plaque and other damage to the vessels. Turmeric may also
prevent platelet build up along the walls of an injured blood vessel. Platelets
collecting at the site of a damaged blood vessel cause blood clots to form and
contribute to blockage of the artery as well. Turmeric may also thin your blood
and, therefore, should only be used under the supervision of a health care
provider, particularly if you are taking blood-thinning medications such as
warfarin (Coumadin). Clinical studies of the use of turmeric to prevent or
treat stroke in people would be interesting in terms of determining if these
mechanisms discovered in animals apply to people at risk for this condition.
Homeopathy
Although an
experienced homeopath might prescribe a regimen for treating stroke that
includes one of the remedies listed below, the scientific evidence to date does
not confirm the value of homeopathy for this purpose.
- Acontitum napellus for numbness or paralysis after a cerebral accident
- Belladonna for stroke that leaves the person very sensitive to any
motion, with vertigo and trembling
- Kali bromatum for stroke resulting in restlessness, wringing of the
hands or other repeated gestures, insomnia, and night terrors
- Nux vomica for cerebral accident with paresis (muscular weakness
caused by disease of the nervous system), expressive aphasia (language
disorder), convulsions, and great irritability
Acupuncture
Many studies have been
conducted on the effects of acupuncture during stroke rehabilitation. These
studies show that acupuncture reduces hospital stays and improves recovery
speed. Acupuncture has been shown to help stroke patients regain motor and
cognitive skills and to improve their ability to manage daily functioning.
Based on the available data, the National Institutes of Health recommend
acupuncture as an alternative or supplemental therapy for stroke
rehabilitation. In general, the evidence indicates that acupuncture is most
effective when initiated as soon as possible after a stroke occurs, but good
results have been found for acupuncture started as late as 6 months following a
stroke.
People who have
suffered a stroke often have a deficiency of qi in the liver meridian and a
relative excess in the gallbladder meridian. In addition to a primary needling
treatment on the liver meridian and the supporting kidney meridians,
moxibustion (a technique in which the herb mugwort is burned over specific
acupuncture points) may be used to enhance therapy. Treatment may also include
performing acupuncture on affected limbs. Certain scalp acupuncture techniques
that have been developed by Chinese, Korean, and Japanese practitioners also
show promise.
Chiropractic
Chiropractors do not
treat stroke, and high velocity manipulation of the upper spine is considered
inappropriate in individuals who are taking blood-thinning medications or other
medications used to reduce the risk of stroke. It should also be noted that
chiropractic spinal manipulation of the neck is associated with an exceedingly
small risk of causing stroke (reports range from 1 per 400,000 to 1 per
2,000,000).
Traditional Chinese Medicine
In Traditional Chinese
Medicine, there are reports of more than 100 substances that have been used to
treat stroke. In fact, pharmacologic research of these substances is focused on
understanding the ingredients and their mechanisms of action in order to
develop new drugs.
Prognosis and Complications
There are many
possible complications associated with stroke.
- Seizures
- Paralysis
- Cognitive (thinking) deficits
- Speech problems
- Emotional difficulties
- Daily living problems
- Pain
Many people begin to
recover from a stroke almost immediately after it has occurred.
The recovery process
is most rapid in the first 3 months after a stroke, but improvement will
continue for 6 months or a year. Many stroke survivors even report that they
slowly continue to regain function for years after their stroke. It is very
important not to lose hope.
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