Will I Have Another Stroke?

A stroke occurs when blood flow to the brain is blocked or severely decreased. The different types of stroke are an ischemic stroke, which is caused by an artery that is blocked by a blood clot or buildup of plaque; a hemorrhagic stroke, which results from a ruptured blood vessel; and a transient ischemic attack (TIA), which is due to a temporary decrease in blood flow. A stroke is a medical emergency. Preventing recurrent strokes and TIAs may be accomplished by acknowledging your risk factors, changing your lifestyle and, if prescribed by your physician, using medications or undergoing surgery.

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Recurrence Facts

• According to the National Stroke Association, 5 percent to 14 percent of people who experience a stroke will have another stroke within one year. Within five years, the risk increases to 24 percent for women and 42 percent for men. Transient ischemic attacks are a warning sign of an impending stroke, and about 35 percent of people who experience a TIA will have a stroke.

Risk Factors

• Stroke risk factors include blood pressure higher than 140/90 mmHg, atrial fibrillation, cholesterol higher than 200 mg/dl, diabetes, tobacco use and smoking, alcohol use, obesity, having high levels of homocysteine in your blood, and the use of birth control pills. Stroke risk factors you cannot control include a family or personal history of a stroke or TIA, being over 55, being male, or having fibromuscular dysplasia or patent foramen ovale (a hole in the heart). According to the National Stroke Association, certain races have a higher risk of a stroke or TIA, including African-Americans, Hispanics and Asian or Pacific Islanders.

Lifestyle Changes

• According to the Mayo Clinic, lifestyle changes to prevent a stroke include controlling high blood pressure, lowering cholesterol and saturated fat intake, quitting smoking, managing diabetes with diet and medications, losing weight if you are overweight, maintaining a healthy weight, regularly exercising at least 30 minutes a day most days of the week, managing stress, consuming alcohol in moderation, and not using illicit drugs such as cocaine.

  You should also follow a brain-healthy diet, which includes five or more daily servings of vegetables and fruits, foods rich in soluble fiber like beans or oatmeal, foods rich in calcium, soy products, and foods rich in omega-3 fatty acids like tuna and salmon.

Medications

• To prevent another stroke, your physician may prescribe certain medications like antiplatelet drugs, anticoagulants and cholesterol-lowering medications. Antiplatelet medications decrease clot formation. The most common antiplatelet drug is aspirin, which is usually taken daily under physician guidance. Other medications prescribed to decrease clot formation include Aggrenox, Plavix and Ticlid. Anticoagulant medications, also called blood thinners, work by reducing clot formation. Examples of anticoagulants are heparin and Coumadin. Cholesterol-lowering medications are usually prescribed if you are unable to lower your cholesterol by changing your diet.

Surgery

• Surgery may prevent another stroke by correcting the abnormality that caused the decreased or blocked blood flow to the brain. Surgical options depend on the type of stroke that occurred. Surgical procedures to open up a blocked artery include a carotid endarterectomy, which removes plaque in the artery; angioplasty to widen the artery; and placement of a stent, which is a mesh tube that prevents the artery from narrowing.

  Surgery to treat or prevent a hemorrhagic stroke includes an aneurysm clipping, which can prevent the aneurysm from bursting or re-bleeding; aneurysm embolization, in which a coil fills the aneurysm, sealing it from connecting arteries; and surgical arteriovenous malformation (AVM) removal, which can lower the risk of a hemorrhagic stroke.