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STROKE

Stroke is caused by a blocked blood vessel or bleeding in the brain. Most of these causes come from cardiovascular diseases such as hypertension.

You should consider these symptoms warning signs and consult your health care provider:

  • Sudden weakness or numbness in the face, arm, or leg on one side of the body.
  • Abrupt loss of vision, strength, coordination, sensation, speech, or the ability to understand speech.
  • Sudden dimness of vision, especially in one eye.
  • Sudden loss of balance, possibly accompanied by vomiting, nausea, fever, hiccups, or trouble with swallowing.
  • Sudden and severe headache with no other cause followed rapidly by loss of consciousness.
  • Brief loss of consciousness.
  • Unexplained dizziness or sudden falls.

DIAGNOSIS

Tests in the emergency room

The first test after a stroke is typically a CT scan, a series of X-rays that can show whether there is bleeding in the brain. This test will show whether the stroke is ischemic or hemorrhagic. You may also have an MRI.

Other initial tests recommended for ischemic stroke include:

  • Electrocardiogram (ECG, EKG) to check for heart problems.
  • Blood tests to help your doctor make choices about your treatment and to check for conditions that may cause symptoms similar to a stroke. Tests may include:
  • Complete blood count (CBC).
  • Blood sugar.
  • Electrolytes
  • Liver and kidney function.
  • Prothrombin time and INR (a test that measures how long it takes your blood to clot).

Tests you may have later

If it seems that you may have a narrowing of a carotid artery, your doctor may want you to have a:

  • Carotid ultrasound/Doppler scan to evaluate blood flow through the artery.
  • Magnetic resonance angiogram (MRA).
  • CT angiogram.
  • Carotid angiogram.

If your doctor believes that the stroke may have been caused by a problem with your heart, an echocardiogram or Holter monitoring or telemetry test may be done.

Guidelines recommend that risk factors for heart disease also be assessed after a stroke to prevent disability or death from a future heart problem. This is because many people who have had a stroke also have coronary artery disease.

 

RECOMMENDED MEDICATIONS

Your doctor will probably prescribe several medicines after you have had a stroke. Medicines to prevent blood clots are typically used, because blood clots can cause TIAs and strokes.

The types of medicines that prevent clotting are:

  • Anticoagulant medicines.
  • Antiplatelet medicines.

Cholesterol-lowering and blood-pressure-lowering medicines are also used to prevent TIAs and strokes.

Anticoagulant medicines

Anticoagulants such as warfarin (for example, Coumadin) prevent blood clots from forming and keep existing blood clots from getting bigger.

Antiplatelet medicines

Antiplatelet medicines keep platelets in the blood from sticking together.

  • Aspirin (for example, Bayer) is most often used to prevent TIAs and strokes.
  • Aspirin combined with dipyridamole (Aggrenox) is a safe and effective alternative to aspirin.
  • Clopidogrel (Plavix) may be used for people who cannot take aspirin.

Statins

Statins lower cholesterol and your risk for another stroke.

Blood pressure medicines

If you have high blood pressure, your doctor may want you to take medicines to lower it. Blood pressure medicines include:

  • Angiotensin II receptor blockers (ARBs).
  • Angiotensin-converting enzyme (ACE) inhibitors.
  • Beta-blockers.
  • Calcium channel blockers.
  • Diuretics

Other medicines

Medicines used to treat depression and pain may also be prescribed after a stroke.

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