Stroke

A stroke (cerebrovascular accident) happens when there is a loss of blood flow to a section of the brain, which, in 87% of cases occurs due to blood clot (ischemic stroke) and in 13% of cases occurs due to bleeding in the brain (hemorrhagic stroke). When blood flow is lost, not enough oxygen and nutrients get to brain cells, which start to die in minutes. Strokes that are not caught and treated quickly can result in death, brain damage, and/or disability. Sometimes, stroke symptoms will resolve within minutes to hours of onset; this is known as a transient ischemic attack (TIA) and is a strong risk factor for stroke. ^[1]

Symptoms of stroke can vary from person to person and depend on the type of stroke and the area of the brain affected. One common similarity is that these symptoms start suddenly about 96% of the time.^[2] Some common symptoms include:

• Dizziness
• Falling
• Loss of balance
• One-sided weakness or numbness in an arm, leg or the face
• Slurred speech and trouble speaking
• Trouble seeing clearly/double vision
• Headache
• Nausea and/or vomiting
• Abnormal and uncoordinated movements

A health care provider will diagnose a stroke based on signs and symptoms, medical history, and diagnostic scans to image the brain (CT or MRI scans). The provider checks a person’s alertness, coordination/balance, sensation and strength in certain body parts, and any difficulties seeing. Sometimes additional tests of the heart (electrocardiogram and/or an echocardiography) are done to search for blood clots and other problems.^[1]

Medical treatments of stroke can be split up into 3 categories.^[1]

• Acute treatment is usually performed at the hospital to mitigate a stroke while it is happening; to learn more, see the CDC page for stroke treatments.
• Post-stroke rehabilitation, to reduce disabilities after the stroke has been stopped, can include physical therapy, speech therapy, psychotherapy, and more.
• Preventative treatments, to reduce stroke recurrence, includes various medications, and healthy lifestyle changes, such as quitting smoking, losing weight, and lowering blood pressure and lipid levels.

Certain dietary supplements have been studied for stroke recovery and prevention. Multivitamins and nutrients like vitamin D, calcium, and vitamin C do not seem to prevent stroke. However, folic acid and B vitamin complex do seem to reduce the risk of stroke, especially in geographic locations that lack folic acid food fortification.^[3] Fewer supplements, such as ginkgo and astragalus, have been studied for stroke recovery and evidence is inconclusive at best.^[4][5]

A healthy diet plays a role in reducing the risk of a recurrent or first time stroke, while an unhealthy diet can increase the risk of stroke. Being overweight increases the risk of stroke. In general, a healthy diet is low in saturated fats, sodium, and sugar while being high in fresh fruit, vegetables, and whole grains. Examples of heart healthy diets include the DASH diet, the Mediterranean diet, and certain vegetarian diets.^[6]

Behaviors and interventions that help to control high blood pressure, diabetes, and high cholesterol can also help prevent stroke. For example, regular exercise, stress reduction, and maintaining a healthy weight can help to reduce the risk of stroke.^[1]

A stroke is caused by either a blood clot (ischemic stroke) or a bleed (hemorrhagic stroke) inside the brain. Many conditions can increase the risk of stroke over time, especially if they are not properly treated. While the main condition that increases the risk for stroke is uncontrolled high blood pressure, conditions such as diabetes, heart disease, obesity, and atrial fibrillation (irregular heart beat) also increase risk. Other risk factors for stroke include smoking, past history of stroke or transient ischemic attack, elderly age, African American race, substance use, unhealthy diet, and insufficient exercise.^[1]