American Medical Association Family Medical Guide - American Medical Association [413]
• Heavy drinking Too much alcohol can raise blood pressure and increase the amount of triglycerides (a potentially harmful type of fat) in the blood.
• Previous strokes or transient ischemic attacks People who have had transient ischemic attacks (TIAs; see page 675) or who have already had a stroke have a significantly increased risk of stroke.
• Family history of heart disease or stroke A family history of heart disease or stroke increases your risk, especially if your father or brother had heart disease before age 55, or your mother or sister had heart disease before age 65.
• Race Blacks have an increased risk of having high blood pressure, which is a strong risk factor for stroke.
• Stress Long-term stress can contribute to high blood pressure.
• High C-reactive protein levels Inflammation (which contributes to atherosclerosis) leaves a chemical by-product in the blood called C-reactive protein (CRP); the higher a person’s CRP level, the greater his or her risk of a stroke or heart attack.
• High homocysteine level Too much of a chemical called homocysteine (see page 559) in the blood can damage artery walls and promote formation of blood clots.
Symptoms
Symptoms of a stroke can occur suddenly and without warning. For example, you may wake up and be unable to speak or to move part of your body. You may suddenly feel numbness or weakness in your face or in an arm or leg. In some cases, a stroke begins with sudden loss of consciousness. Sometimes, however, a stroke is preceded by temporary warning signs called transient ischemic attacks. It is important to see your doctor immediately if this occurs so that you can begin treatment to prevent a stroke.
Other possible symptoms of a stroke include dizziness, headache, blurred vision, difficulty speaking or understanding speech, confusion, and loss of balance and coordination. Symptoms of a stroke frequently occur along with drowsiness or nausea and vomiting. Often only one side of the body is affected, because damage is usually limited to one side of the brain, and each side of the brain controls the opposite side of the body.
Because specific areas of the brain control specific parts of the body, there may be a characteristic pattern of symptoms that indicates which area of the brain has been damaged. For example, damage to the cerebrum can affect vision or speech, while damage to the cerebellum can impair balance and coordination. A stroke that affects the brain stem (the area where the brain and spine connect) may impair swallowing, breathing, strength, balance, or sensation in various combinations. The symptoms of a stroke usually persist for at least 24 hours. A person who has had a stroke may be partially paralyzed or otherwise affected for a number of weeks before his or her condition begins to improve with consistent physical therapy (see next page).
WARNING!
Signs of a Stroke
A stroke is a medical emergency. If you have the following symptoms of a stroke, call 911 or your local emergency number immediately. Rapid treatment is vital to limit the extent of brain damage and to improve your chances of recovery. Even a mild stroke is a danger signal; it may be the first in a series of more serious strokes. When caused by stroke, various combinations of the following symptoms occur suddenly. They may be accompanied by drowsiness or nausea and vomiting, especially if there is bleeding in the brain.
• Numbness or weakness in the face, an arm or leg, or on one side of the body
• Severe headache
• Confusion
• Difficulty speaking or understanding speech
• Vision problems (such as dimness or blurred vision) in one or both eyes
• Difficulty walking or loss of balance or coordination
MY STORY
Stroke
I’m 52 and have been overweight most of my life. A few years ago I started a new job and was sent to a doctor for a complete physical. She asked a lot of questions about my health