How to prevent stroke with simple guidelines

Dr. Moradi, a neurologist

A stroke occurs when part of the brain doesn’t get enough blood. When this occurs the cells don’t get oxygen or nutrients and they die. The best way to prevent a stroke is to live a healthy lifestyle and manage any other medical conditions you might have that may increase your risks. If you or someone you are with may be experiencing a stroke, call emergency responders immediately.

Type of brain stroke

There are 2 main types of strokes: ischaemic stroke and haemorrhagic stroke.

Ischaemic stroke

Ischaemic stroke is the most common type of stroke and is caused by a blockage of the blood vessels supplying the brain. There are 2 types of ischaemic stroke:

  • A thrombotic stroke is caused by a blood clot (thrombus) forming in one of the arteries of the head or neck, which severely reduces the blood flow. The thrombus may be a result of a build-up of fatty deposits (plaques) in the blood vessels.
  • An embolic stroke (or cerebral embolism) is caused when a blood clot that forms elsewhere in the body (for example, the chambers of the heart) travels through the circulatory system to the brain. The travelling clot is called an embolus.

Haemorrhagic stroke

A haemorrhagic stroke occurs when a blood vessel in or near the brain bursts, damaging an area of the brain.

There are 2 types:

  • subarachnoid haemorrhage, which occurs in the space around the brain; and
  • intracerebral haemorrhage, the more common type, which involves bleeding within the brain tissue itself.

Haemorrhagic strokes can be caused by problems such as high blood pressure, or by a problem with a blood vessel in or on the surface of the brain, such as an aneurysm or arteriovenous (AV) malformation.

Risk factors for stroke 

The older you get, the greater the risk of having a stroke, however, a significant number of young and middle-aged people also have strokes. Men are also more likely to have a stroke than women. People who have had a previous stroke or TIA are also more likely to have another one, as are people with a family history of stroke or other types of cardiovascular disease (such as angina or heart attack).

Risk factors for ischaemic stroke

  • high blood pressure
  • a type of irregular heartbeat known as atrial fibrillation (AF)
  • cigarette smoking
  • being overweight or obese
  • diabetes
  • high cholesterol
  • poor diet and inadequate physical activity.

Risk factors for haemorrhagic stroke

  • high blood pressure
  • smoking
  • taking anticoagulant medicines
  • having a bleeding disorder (such as thrombocytopenia or haemophilia)
  • a previous brain/head injury.

symptoms of a stroke

The symptoms of a stroke usually appear suddenly. Initially the person may feel sick and look pale and unwell. They may complain of a sudden headache or dizziness.

They may also:

  • have sudden numbness, weakness or paralysis in their face or limbs, particularly down one side of their body;
  • appear confused, having problems with concentration or memory;
  • have trouble talking or understanding what is being said to them;
  • have difficulty swallowing;
  • have vision problems;
  • have trouble walking;
  • unsteadiness or a sudden fall; or
  • have difficulty with co-ordinating their movements and keeping their balance.

Sometimes a seizure or loss of consciousness occurs. Symptoms depend on the part of the brain that is affected and the size of the stroke.

stroke diagnosed

Confirmation of diagnosis and initial treatment of strokes almost always takes place in a hospital. An early diagnosis is made by evaluating symptoms, reviewing your medical history, performing a physical examination and conducting tests.

  • a computerised tomography (CT) scan: a special X-ray which produces 2- or 3-dimensional images; or
  • a magnetic resonance imaging (MRI) scan (this test uses a large magnet, low-energy radio waves and a computer to produce 2- or 3-dimensional images).
  • An ultrasound scan of the neck may also be performed to determine whether the stroke was caused by a blocked carotid artery in the neck.
  • Other tests that may be recommended include blood tests and an electrocardiogram (ECG) .
  • Sometimes a lumbar puncture (where a doctor takes a sample of cerebrospinal fluid – the fluid that surrounds your brain and spinal cord) may be recommended to help diagnose a haemorrhagic stroke caused by a subarachnoid haemorrhage. Lumbar punctures involve inserting a small needle into the back, usually under local anaesthetic.

Prevention of stroke

Eat a healthy diet

A healthy diet will help you reduce your risks of obesity, high cholesterol, high blood pressure, and diabetes. Each of those conditions raises your risk of having a stroke. To lower the risks of developing these conditions you can:

  • Reduce your salt intake. This will lower your risk of developing high blood pressure. You can reduce your salt consumption by not sprinkling table salt onto your food, not salting pasta or rice water, and purchasing canned foods that say low sodium. Check the ingredients in processed foods. Many have a high salt content.
  • Eat a low fat diet. A fatty diet increases your risk of clogged arteries. You can easily eat less fat by choosing lean meats like poultry and fish and trimming the fat off of red meats. Drink low fat milk or skim milk instead of whole milk. Eat eggs sparingly because they are high in cholesterol. Check foods labeled “diet” or low fat- they can surprise you with sodium and fat content!
  • Control your caloric intake. Eating a high calorie diet places you at a higher risk for diabetes and obesity unless you are extremely physically active. Limit your intake of highly sugary foods like candies, cookies, and pastries. The processed sugar provides calories without the nutrients that will make you feel full. This can make you prone to overeating.
  • Increase the fruits, vegetables, and whole-grains that you eat. These foods are generally low fat and high in nutrients. They will supply you with the energy that you need without excess fat and calories.

Exercise

Exercise an excellent way to reduce your risks for strokes, diabetes, heart disease and obesity. The Centers for Disease Control and Prevention and the National Stroke Association make the following recommendations:

  • 150 minutes per week of moderate physical activity. Moderate physical activity includes things like power walking, biking, or doing water aerobics. This should be in addition to two days per week of weight training.
  • 75 minutes per week of intense physical activity. These activities cause you to work harder than the moderate activities. Examples include jogging, sprinting, swimming laps, and biking up hill. This should also be paired with weight training twice per week.
  • Do three 10 minute periods of exercise per day if you do not have the time for more. This may include walking to work, walking during your lunch break, and walking home from work. The exercise doesn’t have to be done all at the same time. Bring a friend with you to make it more enjoyable.

Quit smoking

 Smokers’ risks for strokes are twice as high as those of nonsmokers. Smoking promotes clotting, makes your blood thicker, and hardens your arteries. If you smoke and are having trouble quitting, there are many resources available to you. You can:

  • Talk to your doctor
  • Get support from family and friends
  • Avoid places where you usually smoke
  • Talk to a counselor
  • Try medications or nicotine replacement therapy
  • Go to residential treatment

Manage any medical conditions you may have

Some medical conditions increase your risk of having a stroke. If you have one of these conditions, talk to your doctor about how to best treat it and minimize your risk of having a stroke.

  • High blood pressure. High blood pressure is also called hypertension. It makes you one and a half times more likely to have a stroke. If you have high blood pressure talk to your doctor about what the best way to control it would be. Your doctor may suggest dietary changes, exercise, or medication.
  • Atrial fibrillation (AFIB). This kind of irregular heartbeat is most likely to occur in seniors or with people who have heart disease, high blood pressure or diabetes. Because of the irregular heartbeat, your blood pools in your heart. This makes it prone to clotting. If you have this condition, your doctor may suggest treatment with anticoagulant medications or electrical stimulation.
  • High cholesterol and fatty deposits in your arteries (atherosclerosis). Cholesterol is a waxy, fatty material in your blood. If you have too much it can clog your arteries and cause a heart attack or stroke. If you have high cholesterol, your doctor will likely suggest that you reduce it through dietary changes, exercise, and possibly medication.
  • There are two major types of diabetes: Type 1 where your body doesn’t make sufficient insulin and Type 2 where your body doesn’t react properly to your insulin. People with diabetes often also have high blood pressure, high cholesterol, atrial fibrillation, and difficulty controlling their weight. Your doctor may suggest that you lower your risk of a stroke by making dietary changes, taking medications, exercising, or taking insulin.
  • Carotid artery disease. This occurs when the carotid arteries get narrower. Because these vessels provide blood to your brain, this makes you more vulnerable to blockages and strokes. Your doctor will probably suggest testing your for this if you have symptoms of a stroke or significant risk factors.