Stroke Prevention

According to the American Heart Association, stroke is the fourth leading cause of death in the U.S., killing more than 129,000 Americans each year.

stroke occurs when blood flow to the brain is disrupted. This is caused when a blockage occurs in one of the vital blood vessels in the brain (ischemic stroke), or when a blood vessel in the brain bursts, spilling blood into surrounding tissues (hemorrhagic stroke). Even a brief interruption in blood supply can cause problems, as brain cells begin to die after just a few minutes without blood or oxygen. With the death of brain cells, a loss of brain function occurs. This may include impaired ability with movement, speech, thinking and memory, bowel and bladder, eating, emotional control and other vital body functions. A temporary disruption of flow to the brain is called a transient ischemic attack (TIA), in which symptoms may occur for a short period of time. A TIA should be considered as a warning for an impending stroke.

Treating cardiovascular disease and its risk factors are critical to stroke prevention. The Division of Cardiovascular Medicine, part of the Brigham and Women's Hospital Heart & Vascular Center, is a world leader in heart disease prevention and treatment. For almost a century, our specialists have been delivering the most innovative and comprehensive care for patients with complex disorders of the heart, blood vessels and circulation. Our cardiovascular services span the entire spectrum of patient care, ranging from cardiovascular disease prevention and detection to pharmacologic and interventional treatment. We offer patients personalized care and expertise that includes ongoing communication and education throughout treatment, outpatient care and follow-up.

For patients who are experiencing stroke symptoms, it is important to seek treatment immediately. Specialists at our Department of Neurology’s Stroke and Cerebrovascular Center deliver quick, accurate and advanced evaluation and treatment. Following treatment and rehabilitation, our cardiovascular specialists work with patients to help them prevent a stroke recurrence.

Stroke Topics

Risk Factors for Stroke

There are a number of factors that may contribute to causing a stroke, including:

Symptoms of Stroke

Symptoms of a stroke may be sudden and include:

  • Weakness or numbness of the face, arm or leg, especially on one side of the body
  • Confusion or difficulty speaking or understanding
  • Problems with vision, such as dimness or loss of vision in one or both eyes
  • Dizziness or problems with balance or coordination
  • Problems with movement or walking
  • Loss of consciousness or seizure 
  • Severe headaches with no other known cause, especially if sudden onset

All of the above warning signs may not occur with each stroke, so do not ignore any of these symptoms. Even if the symptoms go away, take action immediately.

Other, less common, symptoms of stroke may include the following:

  • Sudden nausea or vomiting not caused by a viral illness
  • Brief loss or change of consciousness, such as fainting, confusion, seizures or coma
Diagnosis of Stroke Risk Factors

At Brigham and Women’s Hospital, our cardiovascular medicine specialists provide expert evaluation and diagnosis with the aid of the latest in advanced imaging technologies. Along with a careful physical examination, your cardiologist may order one or more of the following tests or procedures to assess your stroke risk:

  • Cardiac catheterization
  • Cardiac Ultrasound (Echocardiography)
  • Carotid ultrasound examination uses ultrasound to image the arteries that supply blood to the brain.
  • Computed tomographic angiography (CTA) produces detailed images of the blood vessels supplying the brain.
  • Electrocardiogram
  • Magnetic resonance angiography (MRA) produces detailed images of the blood vessels supplying the brain.
Treatment for Stroke Risk Factors

Specialists at our Division of Cardiovascular Medicine develop individualized treatment plans for patients based on:

  • Age
  • Overall health
  • Medical history
  • Severity and form of the disease
  • Tolerance for specific medications or procedures
  • Expectations for course of the disease
  • Presence of other conditions

Treatment of stroke risk factors may involve a number of options, including:

  • Lifestyle changes such as losing weight, reducing fat and salt, controlling blood pressure, stopping smoking and abstaining from alcohol
  • Medication to dilate blood vessels and reduce the workload on the heart, decrease pressure inside the blood vessels, reduce fluid in the body, and help the heart beat stronger and more regularly
  • Carotid endarterectomy
  • Carotid angioplasty and stenting
Treatment for Stroke

For patients who suffer a stroke, specialists at our Stroke and Cerebrovascular Center deliver rapid, accurate, and advanced assessment and treatment. Stroke is an emergency, and the greatest chance for recovery from stroke occurs when treatment is started immediately.

  • Tissue plasminogen activator (tPA) medication, also used to treat heart attacks, helps to dissolve the blockage in the cerebral blood vessel that may be causing the stroke. It is important to administer this medication within six hours of the onset of symptoms in order for it to work effectively, and the earlier the drug is given before that time threshold, the better it works. This is one reason why it’s important for patients to seek treatment immediately after recognizing symptoms of stroke.
  • Thrombolytic therapy dissolves blood clots in a vein or artery. Identification and medical treatment of underlying causes and risk factors can help reduce further stroke risk.
  • Brain aneurysm surgery may be performed as part of stroke treatment. These procedures may include:
    • Brain aneurysm surgery to repair or remove a bulging portion of an artery
    • Craniectomy (removal of a portion of the skull) and hemispheric decompression to relieve pressure on the brain
    • Stereotactic radiosurgery (focused radiation) to destroy blood vessel abnormalities

Interventional procedures

  • Urgent removal of blockages and restoration of blood flow in the brain's arteries
  • Carotid angioplasty
  • Coil embolization
  • Micro-catheter embolic injection to fill malformations and decrease the risk of dangerous bleeding in patients with intracranial vascular malformations

Watch a video about catheter-based treatments for stroke

What You Should Expect

The Heart & Vascular Center is located in the Shapiro Cardiovascular Center , across the street from BWH’s main 75 Francis Street entrance. The Heart & Vascular Center brings together the full range of services in one location, fostering seamless and coordinated care for all cardiovascular patients.

If you are having surgery or a procedure, you will likely be scheduled for a visit to the Watkins Clinic for pre-operative information and tests.

The day of surgery, you care will be provided by surgeons, anesthesiologists and nurses who specialize in surgery for patients with stroke risk. After surgery, you will go to the post-surgical care unit where you will receive comprehensive care by an experienced surgical and nursing staff.

During your surgery, family and friends can wait in the Shapiro Family Center. Staff members will provide surgery updates and caregivers who leave the hospital will be contacted by cell phone.

Multidisciplinary Care

Patients benefit from the teamwork of medical cardiologists, neurologists, interventional cardiologists, cardiovascular imaging experts and radiologists, and anesthesiologists, all experts in stroke risks and prevention. They work alongside nurses, physician assistants, physical therapists, dietitians and social workers to achieve outstanding outcomes for our patients.

Resources

Learn more about stroke in our health library.

Visit the Kessler Health Education Library in the Bretholtz Center where patients and families can access computers and knowledgeable staff.

Access a complete directory of patient and family services.

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