Treatment for Stroke

In a recent study, findings suggest that a higher level of circulating oxidized LDL (lipid A from oxidized LDL) is the major cause of acute ischemic stroke in mice and that lipid A activates tissue factor. Furthermore, lipid A may play an important role in the pathogenesis of acute ischemic stroke.

Approximately 40% of all strokes are due to an identifiable cause (45% due to atherosclerosis), and in those with large arterial occlusions (>or=70%), the mortality and disability rates are very low. Therefore, it is reasonable to focus stroke prevention efforts in this group of patients. However, strokes that occur in the first hour after the onset of a stroke symptoms may still not be able to be prevented if there are no other, identifiable risk factors, or if there are other reasons to treat them.

Among participants with incident stroke, about 20% had a single event, 9% had a recurrent event, and 2 to 3% died during the first year of follow-up.

Signs of stroke of the brain can include mild/moderate/severe confusion or a lack of sensation, or vision problems including loss of eye movement. A sensation of numbness is often transient and may not be indicative of a serious complication. Aphasia is a sign of a recent stroke and may occur during the acute phase. Other signs include difficulty moving or feeling (paresis), loss of coordination (ataxia), speech problems or difficulty speaking (dysphasia) and decreased intelligence. Seizures can occur in people with epilepsy. Other signs may include a headache or a neck ache and can be indicative of cerebral palsy.

For every 1000 people with diabetes, there are 4 people with a first stroke per year. For every 1000 people with hypertension, there are 35 people with a stroke per year.

Stroke remains one of the leading causes of disability in young adults. Approximately 4-6 strokes occur per 1,000 people aged 25 to 35 years. The majority of stroke is ischaemic but a significant number of ischaemic strokes are due to embolic mechanisms.

The mean age of getting a stroke in the country under study is 75 years (range 57 to 91 years) This figure does not seem to differ according to sex, gender or nationality. There may be regional variations in ages and ages of getting a stroke, which could be linked to different risk factors.

While there is strong evidence that some people benefit from therapy for depression and anxiety, we did not see any evidence of improvements in functioning following stroke treatment in this study. We did  find tentative evidence of a benefit of treatment for depressive symptoms in the quality of life domain but that further research is needed.

The mortality rate was high in our study, and the time interval between stroke onset and hospital admission was surprisingly long (median: 27.3 hours) and exceeded the time required for complete treatment (median: 14.6 hours). The prognosis was related to the severity of stroke as indicated by the NIHSS, though death from ischemic stroke may occur after a short interval.

Stroke can be more common than previously predicted in the elderly. In a recent study, findings also suggest that the risk of stroke is increased in persons receiving antihypertensive treatment with drugs.

This retrospective pilot study shows that many patients treated for an acute stroke in New Brunswick, Canada do not have a history of tobacco smoking. More research is needed to identify and treat other causal factors for stroke that have high prevalence in our community, including obesity, lipid disorders, diabetes, and hypertension.