The human brain is a complex organ that acts as the body's control center. The brain comprises more than 100 billion nerve cells that are supported by a network of blood vessels. When one of these blood vessels becomes blocked or bursts, the brain cannot get the oxygen it needs, and within minutes the nerve cells begin to die, causing certain functions of the body to shut down. The result of this chain of events is known as a stroke, the after-effects of which can lead to lifelong disabilities and even death.

The prevalence of strokes has led the American Heart Association (AHA) to put forth various sets of guidelines that help in knowing how to prevent strokes and the steps that should be taken in the event of a stroke. Gaining a better understanding of strokes and the AHA stroke guidelines could differentiate life and death for stroke victims.

What Exactly is a Stroke.

Also known as a "brain attack”, a stroke occurs due to a blocked or burst a blood vessel in the brain. These blood vessels are vital in providing oxygen-rich blood to the brain. When the blood supply is cut off, the nerve cells and tissue in the brain don’t get the oxygen or nutrients they need to survive, and within several minutes they begin to die.

The Different Types of Strokes.

There are three primary types of strokes: hemorrhagic strokes, ischemic strokes, and transient ischemic attacks.

  • Hemorrhagic stroke. The most serious of all strokes, the hemorrhagic stroke, occurs when a weakened blood vessel in the brain begins to bleed suddenly - known as a hemorrhage. When a hemorrhage happens, blood is forced out of the vessel with so much force that it can damage the brain tissue. There are two locations of hemorrhagic strokes: intracerebral and subarachnoid. The most prevalent of these two is intracerebral hemorrhage, caused by a blood vessel rupturing deep in the brain tissue. The less common subarachnoid hemorrhage  results in bleeding on the surface between the brain and the skull.Hemorrhagic strokes can occur due to an aneurysm, a ballooning out of a weakened blood vessel wall, high blood pressure, head trauma, bleeding disorders, brain tumors or other blood vessel abnormalities,  
  • Ischemic stroke. This type of stroke results from a blood vessel clotting in the brain, thus cutting off the blood supply. When a blood vessel in the brain clots, the site is called a "thrombus.”  An "embolu," is a blood vessel clot that travels to the brain from another part of the body. Blood clots can be formed by a build-up of fatty plaque deposits inside a blood vessel, or there are genetic factors that can increase your risk for blood clotting. Ischemic stroke accounts for nearly 90% of all strokes. An ischemic stroke can be treated using a medication called tPA, which helps dissolve the clot to restore blood flow. However, the effectiveness of tPA depends on how quickly it is administered.
  • Transient ischemic attack. Although it is not technically classified as a stroke, transient ischemic attack (TIA) has nearly identical symptoms. The only difference with the TIA is that the symptoms are time limited, usually lasting no longer than twenty-four hours, and it doesn't permanently affect the nerve cells in the brain. However, the transient ischemic attack is a reliable indicator of an oncoming stroke. Research suggests that roughly 35% of people who have experienced a TIA will eventually suffer a stroke.

Why Does a Stroke Affect Different Parts of the Body.

There are more than 100 billion nerve cells in the brain, and they are continuously communicating with other cells. This communication controls every function of the body, including hearing, touch, and movement. When there is damage to the brain as a result of a stroke, it hinders the ability of the cells to communicate with each other properly. In essence, each specific area of the brain controls a specific function, so if that brain area is damaged, then the corresponding function will be impaired.

What are the Warning Signs of a Stroke.

Several early warning signs could signal a stroke, and knowing them is crucial for diagnosis and quick treatment. Fortunately, the acronym B-E-F-A-S-T has been developed to make it easy to remember the symptoms of a stroke.

  • Balance: loss of balance and coordination
  • Eyes: sudden loss of vision or blurred vision
  • Face drooping: weakness causes one side of the face to droop
  • Arms: numbness or weakness in the arms or legs
  • Speech: slurred or distorted speech
  • Time: it is time to act fast! Call 9-1-1 immediately if you have any of these symptoms.

How Can I Prevent a Stroke.

A couple of factors are out of our control when it comes to preventing a stroke, such as older age and family history. Even still, it has been said that 80% of strokes are preventable. So what can you do to ensure that you don’t add to this statistic?

Follow these generalized ACH Stroke Prevention Guidelines:

  • Lower your blood pressure levels. Having high blood pressure puts too much pressure on the blood vessel walls and can damage them directly, and/or cause fatty deposits to collect inside them, often resulting in  artery walls and restriction of free blood flow If one of these deposits breaks loose, it could lead to a blood clot in the brain, known as an ischemic stroke. High blood pressure with or without plaque buildup can also cause a blood vessel to burst, resulting in a hemorrhagic stroke.
  • Quit smoking tobacco. The list of reasons to quit smoking is endless, but near the top should be stroke prevention. Smoking doubles your susceptibility to having a stroke. This is because nicotine increases your blood pressure and carbon monoxide decreases the amount of oxygen in your blood. It’s a double whammy.
  • Adopt healthier eating and drinking habits. Eating healthy foods, such as fruits, vegetables, and whole grains, helps maintain low blood pressure and cholesterol levels and keeps your weight within an acceptable range. Additionally, alcohol is best avoided due to its propensity for raising blood pressure.
  • Exercise regularly. In line with eating healthy foods, exercising regularly aids in lowering blood pressure, keeping your weight in check, and preventing diabetes. All of which, if left unchecked, will significantly raise your probability of a stroke. So find an exercise regimen that you're comfortable with and stick with it.

Takeaways from the AHA Secondary Stroke Prevention Guidelines.

When you suffer a stroke, it puts you at a higher risk of secondary stroke. Statistics show that 1 in 4 stroke survivors will eventually have another stroke. To help curb this trend, the American Heart Association has developed the Secondary Stroke Prevention Guidelines.

These are the top 6 takeaways from the AHA Guidelines for Secondary Stroke Prevention:

  1. The management or reduction of vascular risk factors, such as diabetes, hypertension, and quitting smoking, is vital in preventing a secondary stroke. It is recommended that patients undergo comprehensive medical management therapy specifically tailored to individual patients' needs.
  2. Combining a healthy diet and physical activity reduces the chance that a second stroke will occur. A Mediterranean diet, focusing on fruits and vegetables, healthy whole grains, protein and fats, and limited salt intake, is the most effective food plan for preventing a second stroke. Physical activity is especially important for those patients with prolonged sitting behaviors, as this places them at an exceptionally high risk of secondary stroke. A qualified health care provider should supervise these patients while they perform physical activity.
  3. When attempting to change the lifestyle factors of patients, including diet, exercise, and medication compliance, simple advice and informative pamphlets are not enough. Instead, proven techniques need to be applied, like theoretical models of behavior change and disciplined support.
  4. Patients with atrial fibrillation, also known as arrhythmia or irregular heartbeat, remain at risk for a secondary ischemic stroke. If the patient has no contraindications, meaning that the treatment does not pose a risk to them, then anticoagulation is typically recommended. It is important to monitor the patient's heart rhythm for occult atrial fibrillation if no other cause of stroke is evident.  
  5. Atherosclerotic disease, or, more appropriately, extracranial carotid artery disease, is a treatable cause of ischemic stroke. Antithrombic therapy is the preferred treatment of atherosclerotic disease, combined with changes in lifestyle factors, such as smoking cessation and physical activity. In addition, patients with severe stenosis ipsilateral to a transient ischemic attack should undergo treatment for the stenosis soon after their ischemic stroke, assuming they are good candidates for the treatment.
  6. Intense medical management of risk factors, combined with dual-antiplatelet treatment, is the preferred first-line therapy for patients who suffer from severe intracranial stenosis in the vascular region of ischemic stroke. This should be used as the go-to treatment before considering stenting and angioplasty.

What are the After-Effects of a Stroke?

The after-effects of a stroke vary depending on the area of the brain and the extent of the damage.

Here are some common after-effects that are caused by a stroke:

  • Paralysis or partial paralysis
  • Inability to speak or communicate
  • Difficulty swallowing
  • Weakness or numbness in specific parts of the body
  • Numbness
  • Loss of vision
  • Loss of memory
  • Confusion or disorientation
  • Personality or emotional changes

With Stroke Prevention Comes Peace of Mind.

When blood flow to the brain ceases due to a clogged or ruptured blood vessel, it becomes deprived of oxygen, resulting in a stroke. Within minutes the brain cells begin to die, and the longer this goes untreated, the more serious the complications get. But by recognizing the signs of a stroke, you might save someone's life. And while there is no way to eliminate the possibility of a stroke occurring, the AHA has published a list of preventative measures that, when followed, will significantly reduce the chances of suffering a stroke.