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Stroke, also known as cerebrovascular accident (CVA), cerebrovascular insult (CVI), or brain attack, is when poor blood flow to the brain results in cell death.
- There are two main types of stroke: ischemic, due to lack of blood flow, and hemorrhagic due to bleeding. They result in part of the brain not functioning properly.
- An ischemic stroke is typically caused by blockage of a blood vessel.
- A hemorrhagic stroke is caused by bleeding either directly into the brain or into the space surrounding the brain. Bleeding may occur due to a brain aneurysm.
Thrombosis (blood clot) is a common link in the subtypes of ischemic stroke, each having a different etiology.
- In a thrombotic stroke, a blood clot (thrombus) forms inside one of the brain's arteries (e.g., carotid, middle cerebral, basilar). The clot blocks blood flow to a part of the brain. This causes brain cells in that area to stop functioning and die quickly.
- Athero-thrombotic occlusion of larger arteries is not only the most common cause of primary large vessel occlusive cerebrovascular disease, but also is the most common cause of stroke.
- The blood clot that triggers a thrombotic stroke usually forms inside an artery that already has been narrowed by atherosclerosis. This is a condition in which fatty deposits (plaques) build up inside blood vessels.
- Thrombotic strokes can affect large or small arteries in the brain. Strokes that affect large arteries block flow to greater portions of the brain. These strokes tend to cause the most disability.
- Embolic stroke, the next most common type of stroke, is also caused by a blood clot. However, in an embolic stroke, the blood clot forms somewhere else in the body, traveling through the bloodstream to the brain artery until it reaches vessels too small to let it pass. The blood clot usually comes from the heart or large arteries of the upper chest and neck.
- Most embolic strokes are due to cerebral arterial thrombosis, in which a larger thrombus (blood clot) is carried to other places in the cerebral vasculature. Cerebral emboli may also arise from other heart sources and deep vein thrombosis.
- A second important cause of embolism is an irregular heartbeat, known as atrial fibrillation. It creates conditions where clots can form in the heart, dislodge and travel to the brain.
Signs and symptoms of a stroke may include an inability to move or feel on one side of the body, problems understanding or speaking, feeling like the world is spinning, or loss of vision to one side among others. Signs and symptoms often appear soon after the stroke has occurred. If symptoms last less than one or two hours it is known as a transient ischemic attack (TIA). Hemorrhagic strokes may also be associated with a severe headache. The symptoms of a stroke can be permanent. Long term complications may include pneumonia or loss of bladder control.
The main risk factor for stroke is high blood pressure. Other risk factors include tobacco smoking, obesity, high blood cholesterol, diabetes mellitus, previous TIA, and atrial fibrillation among others. An ischemic stroke is typically caused by blockage of a blood vessel.
Diagnosis is typically with medical imaging such as a CT scan or MRI scan along with a physical exam. Other tests such as an electrocardiogram (ECG) and blood tests are done to determine risk factors and rule out other possible causes. Low blood sugar may cause similar symptoms.
Prevention includes decreasing risk factors as well as possibly aspirin, statins, surgery to open up the arteries to the brain in those with problematic narrowing, and warfarin in those with atrial fibrillation. A stroke often requires emergency care. An ischemic stroke, if detected within three to four and half hours, may be treatable with a medication that can break down the clot. Aspirin should be used. Some hemorrhagic strokes benefit from surgery. Treatment to try recover lost function is called stroke rehabilitation and ideally takes place in a stroke unit; however, these are not available in much of the world.
Stroke statistics:
- American Stroke Association - Impact of Stroke (Stroke statistics)
- American Heart Association - Heart & Stroke Statistics
- Between 1990 and 2010 the number of strokes which occurred each year decreased by approximately 10% in the developed world and increased by 10% in the developing world.
- In 2009, stroke was listed as the underlying cause of death in 128,842 persons in the U.S., resulting in an age-adjusted rate of 38.9 deaths per 100,000 population. The rate was almost twice as high among non-Hispanic blacks (73.6 per 100,000), and the rate of premature death from stroke was also higher among non-Hispanic blacks than their white counterparts (25.0 versus 10.2).
- In 2010 approximately 17 million people had a stroke and 33 million people had previously had a stroke and were still alive.
- In 2011 stroke was the second most frequent cause of death worldwide, accounting for 6.2 million deaths (~11% of the total)
- In 2013, stroke was the second most frequent cause of death after coronary artery disease, accounting for 6.4 million deaths (12% of the total).
- About 3.3 million deaths resulted from ischemic stroke while 3.2 million deaths resulted from hemorrhagic stroke.
- About half of people who have had a stroke live less than one year. Overall, two thirds of strokes occurred in those over 65 years old..
- Overall, two-thirds of strokes occurred in those over 65 years old. South Asians are at particularly high risk of stroke, accounting for 40% of global stroke deaths.[
- Nearly 800,000 (approximately 795,000) people in the United States have a stroke every year, with about three in four being first-time strokes.
- Stroke is the No. 5 cause of death in the United States, killing nearly 130,000 people a year (128,978). That’s one in every 20 deaths.
- Someone in the United States has a stroke every 40 seconds.
- Every four minutes, someone dies of stroke.
- Stroke is a leading cause of long-term disability and the leading preventable cause of disability.
- More women than men have strokes each year, in part because women live longer.
- Estimates of the overall annual incidence of stroke in US children are 6.4 per 100,000 children (0 to 15 years), with approximately half being hemorrhagic strokes.
- 87% of strokes are classified as ischemic. An ischemic stroke occurs when a clot or a mass blocks a blood vessel, cutting off blood flow to a part of the brain.
- African-Americans are more impacted by stroke than any other racial group within the American population.
People Who Died from Stroke or CVA:
Ranker - Famous People Who Died of Stroke (1047 people listed)
- Cary Grant (1904-1986) - Actor
- Winston Churchill (1874-1965) Statesman, politician, painter, journalist, orator
- Joseph Stalin (1878-1953) - Politician, soldier
- Mel Blanc (1908-1989) - Actor, comedian
- Johann Sebastian Bach (1685-1750) - Musician, Harpsichordist, Composer, Cantor, Organist
- Richard Nixon (1913-1994) - 37th President of USA, Military officer, lawyer, politician
- Charles Dickens (1812-1870) - Novelist, Author
- Gene Kelly (1912-1996) - Actor, Singer, TV producer, Film producer, choreographer
- L Ron Hubbard (1911-1986) - Religious leader, novelist, writer
- Mae West (1893-1980) - Pin-up girl, comedian, actor, singer, screenwriter
- Woodrow Wilson (1856-1924) - 28th President of USA, politician, professor, historian
- Glenn Ford (1916-2006) - Actor
- Jawaharlal Nehru (1889-1964) - Prime Minister of India, Politician, barrister, writer
- Paul Robeson (1898-1976) - Actor, athlete, singer, social activist, lawyer
- Al Capone (1899-1947) - Gangster, Mafioso
- Rue McClanahan (1934-2010) - Comedian, Author, Actor
- Patrice O’Neal (1969-2011) - Actor, Screenwriter, stand-up comedian
- Louis Pasteur (1822-1895) - Microbiologist, chemist, physician, scientist
- John Cage (1912-1992) - Actor, Film score composer, musician, author
- Nicolaus Copernicus (1473-1543) - Mathematician, diplomat, physician, artist, economist
- Anita Louise (1915-1970) - Actor
- Aaron Spelling (1923-2006) - TV producer, film producer, screenwriter, actor, singer
- Peter Lorre (1904-1964) - Actor
- Miles Davis (1926-1991) - Actor, film score composer, songwriter, musician, bandleader
- Isaac Hayes (1942-2008) - Musician, songwriter, film score composer
- Ida Lupino (1918-1995) - Actor, TV director, screenwriter, film director
- Minnie Pearl (1912-1996) - Comedian, actor
- Kirby Puckett (1960-2006) - Baseball player
- Norman Vincent Peale (1898-1993) - Author, pastor, writer, motivational speaker, preacher
- Joseph P Kennedy, Sr (1888-1969) - Businessperson, politician, diplomat, investor, film producer
- Millard Fillmore (1800-1874) - 13th President of USA, politician, lawyer
- Jay Silverheels (1912-1980) - Actor
- John Tyler (1790-1862) - 10th President of USA, politician, lawyer
Additional Reading:
- Wikipedia - Stroke
- National Stroke Association - What is Stroke?
- Mayo Clinic - Stroke
- Medical News Today - Stroke: Causes, symptoms, diagnosis & treatment (by James McIntosh, updated 2017)
- NIH - Medline Plus - Stroke, also called: brain attack, CVA
- Harvard Health Publishing - Thrombotic Stroke
- The Internet Stroke Center - Thrombosis-Related ischemic Stroke
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