Stroke from Carotid Stenosis
Alternate Names : Brain Attack
What can be done to prevent the condition?
A person may be able to reduce his or her risk for developing
atherosclerosis of the carotid arteries, leading to stenosis, by:
maintaining a healthy body weight
getting 30 or more minutes of moderate exercise a day for most individuals.
People with heart disease or
disabilities should be in a medically supervised exercise program.
eating a healthy diet for preventing heart
disease, containing at least 5 fruits and vegetables a day
controlling diabetes
preventing or controlling high blood pressure
preventing or controlling high cholesterol
People can also lower their risk of stroke from carotid stenosis by addressing
other risk factors for stroke. The American Heart Association guidelines for
stroke prevention address both modifiable and less well-documented or
potentially modifiable risk factors.
Measures to reduce the modifiable risk of
high blood pressure include:
measurement of blood
pressure in
adults at least every 2 years to screen for
high blood pressure
weight control
physical activity
moderation in alcohol
intake
moderate sodium intake
for those who smoke, quitting
smoking
medications to treat high blood pressure if the person's blood pressure is
over 140/90 after 3 months of these lifestyle modifications, or if the initial
blood pressure is over 180/100
Other measures to reduce an individual's modifiable risk factors for stroke may
include:
smoking cessation
using nicotine
patches, counseling, and formal smoking programs
control of blood sugar levels in a person with diabetes through medication, diet, and exercise
the use of ramipril in people with diabetes. A recent study showed that people with diabetes have a 33% lower risk of ischemic stroke if they take ramipril.
careful evaluation of asymptomatic carotid stenosis to determine the need for surgery. Coronary artery surgery, such as an endarterectomy,
may be
indicated. An endarterectomy opens the narrow portion of the artery and
increases the blood flow to the brain. People with carotid stenosis should
also work closely with their healthcare providers to control other risk factors
for stroke.
semiannual screening of children with
sickle cell anemia, using ultrasound to determine the child's risk
of
stroke
treatment of atrial
fibrillation
with blood thinners such as aspirin or warfarin, depending on the person's age
and other risk factors
monitoring of high levels of total cholesterol or LDL, as well as low
levels of HDL. Depending on the blood levels and the person's other risk
factors, medications to lower cholesterol may be given.
Measures to reduce less well-documented or potentially modifiable risks for
stroke may include:
weight reduction in overweight persons
30 or more minutes of moderate exercise a day for most individuals.
People with heart disease
or
disabilities should be in a medically supervised exercise program.
a healthy diet for preventing heart
disease,
containing at least 5 fruits and vegetables a day
for those who drink
alcohol,
drinking in moderation. The AHA defines moderate drinking as no more than 2
drinks a day for men and 1 drink a day for women.
seeking treatment for drug
abuse
monitoring of blood levels of homocysteine. For most individuals, a
well-balanced diet following the food guide pyramid will provide enough folic
acid and B vitamins to maintain a healthy homocysteine level. For people with
elevated homocysteine levels, supplements containing folic acid and B vitamins
may be recommended.
avoiding the use of oral contraceptives in women with other stroke risk
factors
Some people have early warning signs that they are at risk for strokes. The
most common warning sign is what is known as a transient ischemic
attack, or TIA. This is a type of reversible stroke that often goes
away after a few minutes. These people can often get treatment that will
prevent a stroke in the future. For instance, they may be advised to take
aspirin or have carotid artery surgery to correct a blockage in a
neck artery.
What are the long-term effects of the condition?
Strokes can cause death or permanent disability. Though many people recover
some function in the first several months after a stroke, others show no
improvement. Some people have several small strokes over time and slowly get
worse with each one.
What are the risks to others?
Strokes are not contagious and pose no risk to others.
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