Strokes

By Kimberly Ponce Gonzalez

“Stroke is the fifth leading cause of death in the US.” (​Ni, Yizhao. February 2018.)​ It is a

disease (sometimes called a “brain attack”) that occurs in the brain where the brain cells abruptly

die from either a rupture of an artery to the brain or if the blood supply is “blocked” or

interrupted. So, there are different ways for a stroke to occur but they mainly take place in three

forms which are: Ischemic Strokes, Hemorrhagic Strokes, and Transient Ischemic Attack. They

may all eventuate distinctively but they all result in depriving oxygen and the needed nutrients in

the brain tissue.

Ischemic Stroke is a type of stroke that occurs in the blood vessels where there is either a

blockage in the arteries or it narrows down, which gravely

deducts the amount of blood flow to the brain. Thrombotic

stroke is one of the most common Ischemic Strokes. It is

when a blood clot or “thrombus” configures into one of the

arteries that supplies the blood to the brain. The thrombus

could be caused by fatty deposits or “plaque” that builds

up over time and by this, it causes the blood flow to be

obstructed. This type of stroke “is responsible for almost 50 percent of all strokes.” (The Internet

Stroke Center. 2018) Embolic stroke is another type of ischemic stroke. It is one of the most

common along with thrombotic stroke. The way it occurs is when a clot forms in other parts of

the body. The clot can get loose and then dislodge itself from the part of the body it was latched

onto and then travel to the brain through the bloodstream. The most common body parts that
have embolic strokes are usually in the arteries near the chest or in the heart. If it enters into a

blood vessel smaller than the clot itself then it will get stuck causing the blood flow to be

obstructed. The blocks are called emboli. Just like a thrombus it can form plaque and even air

bubbles.

Hemorrhagic Stroke is another type of Stroke. It can occur when a weak blood vessel is

ruptured and the blood flow leaks around or into the brain. This causes the brain to swell because

of the pressure and damages the brain tissue. There are two types of hemorrhagic strokes:

intracerebral, and subarachnoid. “Intracerebral hemorrhage (ICH) accounts for 10–15% of all

strokes.” (Silverman, Isaac E. 2010.) It

occurs when small intracranial vessels are

destroyed, because of the pressure it was

put under. Subarachnoid Hemorrhage

Strokes are the other kind of Hemorrhagic

Strokes. The subarachnoid is a part in

between the skull and brain and is full of cerebrospinal fluid. It protects the brain by acting as a

cushion. If blood flows into this area it damages the brain cells by having too much pressure put

onto it and inflames the lining of the brain. While this happens, the blood flow is suddenly

obstructed in the artery, causing the subarachnoid stroke.

The third type of stroke is Transient Ischemic Attack (TIA). These kind of strokes are not

technically called strokes because it is similar to it but not exactly like one. The main difference

is that it doesn’t cause permanent damage and only lasts a couple of minutes. “​TIA’s are

sometimes called ​mini-strokes.”​ (Transient Ischemic Attack. 2017.) It is caused by a blood clot
 blocking the flow of blood supply and stops the nutrients

from entering into the brain. The blood clot can be cause

by many factors which include: “​hypertension​ (high

blood pressure), ​atrial fibrillation​ (a type of irregular,

abnormally rapid heartbeat), and ​carotid artery disease

(narrowing of the arteries in the neck due to fatty

deposits). Other causes include diabetes, high levels of cholesterol in the blood, and cigarette

smoking.” (Transient Ischemic Attack. 2017.) People who get Transient Ischemic Attack are

more likely to get an actual stroke between a half of a year to a year.

“Each year, about 795,000 people in the United States have strokes, and of these

incidents, 137,000 of the people die.” (Office of Communications. 2016.) Of all the strokes that

exist, “​87% are ischemic stroke, 10% are intracerebral hemorrhage

(ICH), and 3% are subarachnoid hemorrhage (SAH) in the United

States (2).” (​Yamada, Yoshiji. July, 2018.) The effects strokes can

have on different types of people may be crucial. Three-quarters of

strokes occur in people over the age of 65 and risks of having one

doubles over the

age of 55. Gender wise, it occurs more often

in men than in women. Strokes occur in

African Americans more than Americans.

Hispanic Americans and Native Americans

are at a higher risk than Americans but less

than African Americans. The biggest areas of being more likely to have a stroke is in the

Southern Eastern parts of the United States. There are other risk factors to take into like health

issues in the body or genetics.

Although there are many types of strokes and many risk factors of getting a stroke, there

are ways of preventing it as well. Getting the needed nutrients is an important part of having a

healthy lifestyle. Having too little or too much of nutrients can also increase the chances of

having a stroke. “Too much vitamin A, E or calcium may actually increase stroke risk, while

research has failed to prove vitamin C reduces risk. Deficiencies of B vitamins, especially folate,

may be linked with greater stroke risk. … low vitamin D levels are associated with greater risk…

Dr. Hankey noted, testing the possible benefit of vitamin D supplementation to prevent stroke.

(Healthy Diet, Not Specific Nutrients, Best for Stroke Protection. 2012.) So, having too little or

too much of a vitamin can increase risk. A nutrient that can decrease the risk in having a stroke is

potassium, because it can affect the blood pressure in a good way. If someone has a stroke the

nutrients needed to be eaten are little in sodium and fat, high in fruits and vegetables, whole

grains, and high-fiber foods.

Improving a healthier lifestyle also means treatment for those people that have

experienced a stroke or if in the future do, there are many things to do to treat it. Each type of

stroke has its own treatment. To treat Ischemic Strokes the clot needs to be removed or

disintegrated. A type of medication that can be used for Ischemic Strokes is Alteplase IV r-tPA.

It is FDA approved so it is officially safer than a regular type of medication. Its use is to dissolve

the clot to and immediately is needed 3-4.5 hours after a stroke. If medication is not a choice

then a physical removal of the clot is to happen. It is called an endovascular procedure or

 “mechanical thrombectomy.” A stent retriever can

be used or suction tubes to remove it and the

procedure usually lasts within 6 hours. As for

treatment for a Hemorrhagic Stroke, it has to stop

the bleeding. The physica; way of getting it out is

through a catheter, which is inserted into the artery

and then into the brain to fix it using a mini camera for the doctor to look at it. A coil gets

inserted to stop the rupture from getting worse and the doctor makes their way to making it heal.

In conclusion, Strokes are a disease that can occur that is dangerous but it can be

prevented. There are many types including: Ischemic Stroke, Hemorrhagic Stroke, and Ischemic

Transient Attack. Thrombotic and Embolic Strokes are the most common Ischemic Strokes.

Intracerebral and Subarachnoid are the types of Hemorrhagic Strokes. Transient Ischemic Attack

is a “mini stroke” because it only lasts for a couple of minutes and does not have permanent

damage. In the United States there are many people that have a stroke in year but with the right

kind of nutrients and treatment it can be at little to almost no risk of having a stroke.
 References

“Healthy Diet, Not Specific Nutrients, Best for Stroke Protection.” ​Tufts University Health &

Nutrition Letter​, vol. 30, no. 2, Apr. 2012, p. 6. ​EBSCOhost,​

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Ni, Yizhao, et al. “Towards Phenotyping Stroke: Leveraging Data from a Large-Scale

Epidemiological Study to Detect Stroke Diagnosis.” ​PLoS ONE​, vol. 13, no. 2, Feb.

2018, pp. 1–20. ​EBSCOhost​, doi:10.1371/journal.pone.0192586.

No Author. “The Internet Stroke Center.” ​The Internet Stroke Center. An Independent Web

Resource for Information about Stroke Care and Research.​, 2018,

www.strokecenter.org/patients/about-stroke/ischemic-stroke/.

Office of Communications. “How Many People Are Affected by/at Risk for Stroke?” ​Eunice

Kennedy Shriver National Institute of Child Health and Human Development,​ U.S.

Department of Health and Human Services, 2016,

www.nichd.nih.gov/health/topics/stroke/conditioninfo/risk

Silverman, Isaac E., and Marilyn M. Rymer. Hemorrhagic Stroke. Clinical Publishing, 2010.

“Transient Ischemic Attack (TIA).” ​Funk & Wagnalls New World Encyclopedia,​ 2017, p. 1p. 1.

EBSCOhost​,

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Yamada, Yoshiji, et al. “Identification of Nine Genes as Novel Susceptibility Loci for

Early-Onset Ischemic Stroke, Intracerebral Hemorrhage, or Subarachnoid Hemorrhage.”

Biomedical Reports​, vol. 9, no. 1, July 2018, pp. 8–20. ​EBSCOhost​,

doi:10.3892/br.2018.1104