Highlights About Stroke

Enawgaw Mehari, M.D.

Founder and CEO, p2p Inc.

Morehead, KY, USA

Why is stroke a medical emergency?  Both ischemic stroke and hemorrhagic stroke are medical emergency, because in case of ischemic stroke patients can benefit from intravenous thrombolysis (IVT) and mechanical thrombectomy if they present to the emergency department within the recommended time frame, 3 hours of onset. Hemorrhagic stroke is also an emergency, because it is recommended to lower blood pressure rapidly, to treat coagulation disorders, and if warranted to do surgery. Time is crucial to save the brain. The typical clinical presentation of a stroke consists of a sudden focal neurological deficit with maximum intensity at onset, such as aphasia, hemiplegia, or hemianopia. There are also other medical disorders which can present with similar clinical presentations, such as false positives and called “stroke mimics”.

Ischemic stroke is caused by occlusion or severe stenosis of a cerebral artery due to embolus or thrombosis resulting in reduced cerebral blood flow and impaired delivery of oxygen and glucose to the tissue supplied by that artery. The normal cerebral blood flow rate is 50 to 55 ml/100 gm/min. When this falls to 18 ml/100 mg/min neuronal electrical function fails. When it goes below 8 ml/100mg /min, cellular energy metabolism fails resulting to cell death. In general terms, stroke is therefore a reduction of perfusion to the brain.  Transient ischemic attack (TIA) is a transient neurologic deficit of vascular origin, mostly lasting only 10 to 20 minutes. It is equivalent to unstable angina and should be treated aggressively. The term mini stroke is misleading as it may suggest the problem is less severe than stroke. They can have also a recurrent episode and therefore it is imperative to expedite the work up to avoid potential stroke.

The management of treatable risk factors and common mechanisms of brain ischemia is important for reducing the risk of ischemic stroke. Generally, a head computed tomographic (CT) scan is obtained immediately to rule out intracranial hemorrhage from ischemic stroke. The only therapy for restoring blood flow for which there is strong evidence of clinical benefit is intravenous (IV) recombinant tissue plasminogen activator (rt-PA) given within 3 hours of onset. The major risk of this intervention is symptomatic intracranial hemorrhage, which occurs in about 6% of patients who receive IV rt- pa according to the established guidelines. The major modifiable risk factors for ischemic stroke include hypertension, diabetes mellitus, smoking, dyslipidemia, physical inactivity, atrial fibrillation and carotid artery stenosis. The risk of stroke is particularly increased in patients with two or more risk factors. TIA should be treated with all available risk reduction strategies. Currently, viable strategies include blood pressure reduction, antithrombotic therapy, statin therapy, and life style modification. Selected patients with symptomatic cervical internal carotid artery disease may benefit revascularization. There is now a notion that by effectively modifying risk factors for stroke and heart attack, death can be optional.

Suggested References 

  1. Hankey GJ. Potential new risk factors for ischemic stroke: what is their potential? Stroke 2006; 37:2181.
  2. Grysiewicz RA, Thomas K, Pandey DK. Epidemiology of ischemic and hemorrhagic stroke: incidence, prevalence, mortality, and risk factors. Neurol Clin 2008; 26:871.
  3. O’Donnell MJ, Chin SL, Rangarajan S, et al. Global and regional effects of potentially modifiable risk factors associated with acute stroke in 32 countries (INTERSTROKE): a case-control study. Lancet 2016; 388:761.
  4. Bushnell C, McCullough LD, Awad IA, et al. Guidelines for the prevention of stroke in women: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2014; 45:1545.
  5. Campbell BC, Donnan GA, Lees KR, et al. Endovascular stent thrombectomy: the new standard of care for large vessel ischemic stroke. Lancet Neurol 2015; 14:84
  6. Saver JL, Fonarow GC, Smith EE, et al. Time to treatment with intravenous tissue plasminogen activator and outcome from acute ischemic stroke. JAMA 2013; 309:2480.
  7. Harmsen P, Lappas G, Rosengren A, Wilhelmsen L. Long-term risk factors for stroke: twenty-eight years of follow-up of 7457 middle-aged men in Göteborg, Sweden. Stroke 2006; 37:1663.

49 thoughts on “Highlights About Stroke

  1. This is the suitable blog for anybody who needs to search out out about this topic. You notice so much its virtually exhausting to argue with you (not that I truly would want匟aHa). You definitely put a new spin on a subject thats been written about for years. Great stuff, simply great!

  2. I precisely wished to thank you very much once again. I do not know the things I could possibly have handled without those tricks provided by you over such question. It truly was the fearsome dilemma in my opinion, however , spending time with the professional style you dealt with it made me to cry with contentment. Now i’m happy for the help and in addition believe you comprehend what a powerful job you have been getting into instructing other individuals by way of your web blog. I’m certain you’ve never got to know all of us.

  3. I in addition to my friends ended up going through the great tips and tricks located on the blog and so all of the sudden I got a horrible suspicion I never thanked the website owner for those secrets. Most of the guys were so excited to see them and now have really been making the most of these things. I appreciate you for indeed being well considerate and then for having some extraordinary topics most people are really desperate to discover. My sincere regret for not saying thanks to sooner.

  4. Thank you for all of the efforts on this web page. Kim takes pleasure in doing research and it is simple to grasp why. We hear all regarding the dynamic form you convey vital tips and hints through the web blog and even strongly encourage participation from the others about this point plus my girl has always been understanding so much. Have fun with the remaining portion of the new year. You’re the one carrying out a useful job.

  5. Thank you a lot for giving everyone such a special opportunity to check tips from this blog. It really is very good and as well , stuffed with a great time for me and my office friends to visit your web site at the least 3 times in 7 days to learn the new things you have. Of course, I’m also usually motivated concerning the special creative ideas you serve. Some two ideas on this page are undeniably the very best we’ve had.

  6. I would like to express my love for your kindness in support of individuals that must have help on this one idea. Your special commitment to passing the message along appears to be exceptionally useful and has truly helped girls like me to reach their aims. Your own informative useful information denotes this much a person like me and substantially more to my colleagues. With thanks; from all of us.

  7. I simply wished to thank you very much yet again. I am not sure the things I would’ve undertaken without those recommendations revealed by you over this area. This was a scary circumstance in my position, however , witnessing a well-written style you treated that took me to leap for happiness. Now i’m grateful for the assistance and expect you comprehend what an amazing job that you are undertaking instructing other individuals thru your web blog. More than likely you have never got to know all of us.

  8. I have to point out my admiration for your kind-heartedness for those who really need assistance with in this theme. Your real dedication to getting the solution all-around has been definitely important and have specifically permitted regular people much like me to get to their desired goals. Your new interesting useful information means much a person like me and somewhat more to my colleagues. With thanks; from everyone of us.

  9. [url=http://www.airmax97.us.com/][b]Air Max 97[/b][/url]

    [url=http://www.max270.us.com/][b]Nike Air Max 270[/b][/url]

    [url=http://www.supplyyeezy.us.com/][b]Yeezy Supply[/b][/url]

    [url=http://www.kobebryant-jersey.us/][b]Kobe Bryant Jersey[/b][/url]

    [url=http://www.kobebryantjerseysforsale.us/][b]Kobe Bryant Jerseys For Sale[/b][/url]

    [url=http://www.kobebryantjersey24.us/][b]Kobe Bryant Jersey 24[/b][/url]

    [url=http://www.kobebryantwebsiteofficial.us/][b]Kobe Bryant Website Official[/b][/url]

    [url=http://www.yeezy-shoe.us.com/][b]Yeezy[/b][/url]

    [url=http://www.yeezymafia.us.com/][b]Yeezy[/b][/url]

    [url=http://www.nikes.us.com/][b]Nike Shoes[/b][/url]

    [url=http://www.nikeshoes.us.org/][b]Nike Shoes[/b][/url]

    [url=http://www.nfl-jerseys.us.org/][b]NFL Jerseys[/b][/url]

    [url=http://www.yeezyboost350.us.com/][b]Yeezy Boost 350[/b][/url]

    [url=http://www.yeezy.com.co/][b]Yeezy Shoes[/b][/url]

    [url=http://www.nikeoutletstoreonlineshopping.us/][b]Nike Outlet[/b][/url]

    [url=http://www.yeezy380.us/][b]Yeezy 380[/b][/url]

    [url=http://www.yeezy380.us.com/][b]Yeezy 380[/b][/url]

    [url=http://www.nikefactory.us.com/][b]Nike Outlet[/b][/url]

    [url=http://www.humanraces.us.com/][b]Human Races[/b][/url]

    [url=http://www.humanracesshoes.us/][b]Human Race Shoes[/b][/url]

    [url=http://www.basketball-jerseys.us.com/][b]Basketball Jerseys[/b][/url]

    [url=http://www.jerseysbasketball.us/][b]Basketball Jerseys[/b][/url]

    [url=http://www.jerseys-nba.us/][b]Cheap NBA Jerseys[/b][/url]

    [url=http://www.nikes-shoes.us.com/][b]Nike Outlet[/b][/url]

    [url=http://www.yeezy-shoe.us.com/][b]Yeezy Shoes[/b][/url]

    [url=http://www.yeezymafia.us.com/][b]Yeezy Mafia[/b][/url]

    [url=http://www.yeezy350v2.us/][b]Yeezy 350 V2[/b][/url]

    [url=http://www.yeezysofficialsite.us/][b]Yeezys Official Site[/b][/url]

    [url=http://www.yeezyslides.us/][b]Yeezy sliders[/b][/url]

    [url=http://www.jerseys-nba.us.com/][b]NBA Jerseys[/b][/url]

    [url=http://www.jerseysnba.us.com/][b]NBA Jerseys[/b][/url]

    [url=http://www.airjordan-1.us/][b]Air Jordan 1[/b][/url]

    [url=http://www.airjordan1.us.com/][b]Air Jordan 1[/b][/url]

    [url=http://www.jordan-1.us.com/][b]Jordan 1[/b][/url]

    [url=http://www.jordan1s.us.com/][b]Jordan 1s[/b][/url]

    [url=http://www.jordan1s.us/][b]Jordan 1s[/b][/url]

    [url=http://www.retrojordan.us.com/][b]Jordan Retro[/b][/url]

    [url=http://www.jordanretro4.us.com/][b]Jordan Retro 4[/b][/url]

    [url=http://www.jordan4-retro.us/][b]Jordan 4 Retro[/b][/url]

    [url=http://www.jordansshoess.us.com/][b]Jordans Shoes[/b][/url]

    [url=http://www.jordan4s.us/][b]Jordan 4s[/b][/url]

    [url=http://www.diorjordan1.us/][b]Dior Jordan 1[/b][/url]

    [url=http://www.airjordan1mid.us/][b]Air Jordan 1 Mid[/b][/url]

    [url=http://www.jordan11concord.us/][b]Jordan 11 Concord[/b][/url]

    [url=http://www.jordan11retro.us/][b]Jordan 11 Retro[/b][/url]

    [url=http://www.jordan1low.us/][b]Jordan 1 Low[/b][/url]

    [url=http://www.jordan11s.us/][b]Jordan 11s[/b][/url]

    [url=http://www.jordanaj1.us/][b]Jordan AJ 1[/b][/url]

    [url=http://www.nbastores.us/][b]NBA Store[/b][/url]

    [url=http://www.nbaoutletstore.us/][b]NBA Store[/b][/url]

    [url=http://www.yeezystore.us.com/][b]Yeezy[/b][/url]

    [url=http://www.yeezyssneakers.us.com/][b]Yeezy Sneaker[/b][/url]

    [url=http://www.adidasyeezyofficialwebsite.com/][b]Adidas Yeezy Official Website[/b][/url]

    [url=http://www.adidasyeezyonlinestore.us/][b]Adidas Yeezy Online Store[/b][/url]

    [url=http://www.airmaxclearancesale.us/][b]Air Max Clearance Sale[/b][/url]

    [url=http://www.nflshopofficialonlinestore.com/][b]NFL Shop Official Online Store[/b][/url]

    [url=http://www.nikeuk.uk.com/][b]Nike UK[/b][/url]

    [url=http://www.yeezy.uk.com/][b]Yeezy[/b][/url]

    [url=http://www.yeezy350.uk.com/][b]Yeezy 350[/b][/url]

    [url=http://www.adidasyeezy.uk.com/][b]Adidas Yeezy[/b][/url]

  10. I wanted to write you one tiny observation to finally say thanks yet again about the magnificent pointers you have featured in this case. It was pretty generous with people like you to provide publicly exactly what a few people would’ve made available for an e-book to help with making some money for themselves, notably seeing that you might well have tried it if you ever decided. The inspiring ideas as well served to be a fantastic way to be sure that someone else have the identical interest the same as my personal own to see many more with respect to this matter. I am sure there are a lot more pleasurable instances up front for individuals who check out your site.

  11. I and also my guys appeared to be viewing the great tactics on your web site then unexpectedly came up with a horrible suspicion I had not expressed respect to the web blog owner for those secrets. My women came consequently warmed to read all of them and have very much been taking pleasure in these things. Thank you for being really accommodating and for picking out such cool subject matter millions of individuals are really desperate to discover. Our honest regret for not saying thanks to earlier.

  12. I simply wanted to jot down a brief remark in order to say thanks to you for those stunning concepts you are sharing on this site. My time consuming internet search has at the end been paid with extremely good strategies to share with my visitors. I would declare that we readers actually are extremely endowed to dwell in a very good community with very many lovely professionals with insightful strategies. I feel pretty fortunate to have discovered your entire website page and look forward to really more entertaining minutes reading here. Thanks a lot once again for everything.

  13. I simply wished to thank you so much all over again. I am not sure what I could possibly have implemented in the absence of the smart ideas discussed by you directly on such concern. Certainly was an absolute horrifying dilemma in my position, however , understanding a new well-written form you managed the issue made me to jump with joy. I will be grateful for the information as well as hope you know what a powerful job that you’re putting in educating others thru your site. Probably you’ve never met all of us.

  14. I’m typically to running a blog and i really respect your content. The article has really peaks my interest. I am going to bookmark your website and maintain checking for new information.

  15. This is the correct weblog for anybody who wants to find out about this topic. You understand so much its virtually hard to argue with you (not that I really would want匟aHa). You definitely put a brand new spin on a topic thats been written about for years. Nice stuff, just great!

  16. There are some interesting cut-off dates in this article however I don抰 know if I see all of them middle to heart. There’s some validity however I’ll take maintain opinion until I look into it further. Good article , thanks and we would like extra! Added to FeedBurner as properly

  17. I was very happy to seek out this internet-site.I wished to thanks for your time for this glorious learn!! I positively having fun with each little bit of it and I’ve you bookmarked to check out new stuff you blog post.

  18. I’m typically to running a blog and i really respect your content. The article has actually peaks my interest. I am going to bookmark your web site and keep checking for brand spanking new information.

  19. There are definitely quite a lot of particulars like that to take into consideration. That may be a nice point to bring up. I provide the thoughts above as normal inspiration however clearly there are questions just like the one you convey up where crucial thing will probably be working in sincere good faith. I don?t know if greatest practices have emerged around issues like that, but I am certain that your job is clearly recognized as a fair game. Each boys and girls really feel the impact of just a second抯 pleasure, for the rest of their lives.

  20. Nice post. I be taught something tougher on completely different blogs everyday. It’ll all the time be stimulating to learn content material from different writers and practice a bit something from their store. I抎 choose to use some with the content material on my blog whether or not you don抰 mind. Natually I抣l offer you a hyperlink on your net blog. Thanks for sharing.

  21. Aw, this was a very nice post. In concept I would like to put in writing like this additionally ?taking time and precise effort to make a very good article?however what can I say?I procrastinate alot and in no way seem to get one thing done.

  22. Aw, this was a really nice post. In idea I would like to put in writing like this moreover ?taking time and precise effort to make an excellent article?however what can I say?I procrastinate alot and on no account seem to get one thing done.

  23. There are certainly a number of details like that to take into consideration. That is a great point to carry up. I provide the ideas above as common inspiration but clearly there are questions just like the one you deliver up the place crucial factor might be working in trustworthy good faith. I don?t know if greatest practices have emerged around issues like that, but I’m positive that your job is clearly identified as a good game. Each boys and girls really feel the impact of just a second抯 pleasure, for the remainder of their lives.

  24. Youre so cool! I dont suppose Ive learn something like this before. So nice to find anyone with some authentic ideas on this subject. realy thanks for beginning this up. this website is something that’s wanted on the internet, someone with a bit of originality. useful job for bringing one thing new to the internet!

  25. A powerful share, I just given this onto a colleague who was doing just a little evaluation on this. And he the truth is purchased me breakfast as a result of I discovered it for him.. smile. So let me reword that: Thnx for the treat! But yeah Thnkx for spending the time to discuss this, I feel strongly about it and love reading extra on this topic. If doable, as you grow to be expertise, would you mind updating your weblog with more particulars? It is extremely helpful for me. Massive thumb up for this weblog publish!

  26. Can I simply say what a relief to seek out somebody who actually knows what theyre speaking about on the internet. You positively know methods to bring a difficulty to gentle and make it important. Extra folks have to learn this and perceive this facet of the story. I cant believe youre not more standard because you definitely have the gift.

  27. Nice post. I learn one thing tougher on totally different blogs everyday. It will always be stimulating to learn content material from different writers and follow a bit something from their store. I抎 prefer to make use of some with the content on my weblog whether or not you don抰 mind. Natually I抣l provide you with a hyperlink on your internet blog. Thanks for sharing.

  28. I enjoy you because of all of the effort on this site. Betty really likes working on internet research and it’s easy to understand why. We all hear all regarding the dynamic medium you offer advantageous tips and tricks through the website and as well as recommend response from some other people on the situation then our simple princess is always learning a great deal. Take pleasure in the rest of the year. Your performing a very good job.

  29. My husband and i ended up being very glad when John managed to do his basic research from the ideas he got from your web page. It’s not at all simplistic just to choose to be freely giving points which often men and women may have been making money from. So we grasp we’ve got the website owner to appreciate for this. The type of explanations you made, the easy website navigation, the friendships you help to instill – it’s got everything amazing, and it is helping our son in addition to us feel that this matter is awesome, which is incredibly fundamental. Thank you for all!

  30. I would like to convey my affection for your kindness for men and women who absolutely need help on this field. Your very own dedication to getting the message across turned out to be wonderfully productive and have all the time enabled guys just like me to realize their targets. Your entire insightful publication can mean much a person like me and even further to my mates. Thanks a lot; from all of us.

  31. I not to mention my buddies came studying the nice things on your website and then before long I got a terrible suspicion I never expressed respect to the site owner for them. The boys were definitely absolutely happy to read all of them and have absolutely been enjoying them. Thanks for truly being quite thoughtful as well as for picking some extraordinary tips most people are really desperate to discover. My personal honest regret for not expressing gratitude to sooner.

  32. I would like to express some thanks to you just for rescuing me from this particular circumstance. After checking throughout the online world and getting ideas which were not pleasant, I figured my entire life was gone. Existing without the approaches to the difficulties you have solved through your main review is a crucial case, and the ones which might have in a negative way affected my career if I hadn’t come across the website. That expertise and kindness in playing with a lot of things was invaluable. I don’t know what I would have done if I hadn’t come upon such a step like this. I can also at this moment look forward to my future. Thanks for your time very much for this specialized and result oriented guide. I will not be reluctant to suggest the blog to anybody who needs to have direction about this subject matter.

  33. I just wanted to develop a small comment to appreciate you for all the unique guidelines you are posting at this site. My time intensive internet investigation has at the end been paid with sensible details to go over with my great friends. I would say that we visitors are undoubtedly endowed to live in a useful site with very many perfect individuals with valuable things. I feel very much privileged to have seen your website page and look forward to really more thrilling minutes reading here. Thanks again for everything.

  34. I truly wanted to send a quick word in order to say thanks to you for all of the marvelous strategies you are placing here. My particularly long internet investigation has finally been honored with pleasant details to exchange with my relatives. I ‘d suppose that we readers are undeniably fortunate to dwell in a notable site with very many marvellous people with very helpful hints. I feel very fortunate to have come across your entire weblog and look forward to some more cool minutes reading here. Thanks a lot once more for a lot of things.

  35. My wife and i felt very happy Albert managed to carry out his preliminary research from your ideas he acquired out of the blog. It is now and again perplexing to just be giving for free secrets and techniques many people may have been selling. And now we consider we need the website owner to be grateful to because of that. The explanations you made, the straightforward blog navigation, the relationships you help to instill – it’s got mostly impressive, and it is helping our son and our family feel that this content is interesting, and that’s incredibly essential. Many thanks for everything!

  36. Thank you for your whole effort on this web site. Debby takes pleasure in engaging in internet research and it’s simple to grasp why. Many of us notice all relating to the powerful ways you produce very helpful tips and hints through your web blog and even attract response from people on the point then our favorite simple princess is truly discovering a whole lot. Take advantage of the remaining portion of the new year. You are always conducting a useful job.

  37. I’m just writing to make you know what a helpful encounter my wife’s girl undergone going through your web site. She came to find a lot of issues, including what it is like to have an ideal teaching mindset to make other people clearly know just exactly some complex subject areas. You truly surpassed her expected results. Thank you for displaying the priceless, safe, explanatory and even fun tips on this topic to Tanya.

  38. I wanted to put you the very small note so as to say thank you the moment again for your personal nice knowledge you have featured on this page. It has been quite unbelievably open-handed with you to give freely what most of us might have made available as an e-book to earn some dough on their own, chiefly now that you could possibly have done it if you ever considered necessary. Those secrets as well worked to become a easy way to know that most people have similar passion the same as my very own to learn many more concerning this issue. I know there are many more pleasant periods in the future for folks who see your blog.

  39. I simply wished to appreciate you yet again. I do not know the things I could possibly have carried out in the absence of the actual ideas revealed by you regarding such a question. Entirely was the frustrating setting in my position, but understanding your skilled technique you dealt with it took me to cry over delight. Now i am thankful for this guidance and in addition sincerely hope you comprehend what a powerful job you are undertaking teaching many people through your website. I am sure you have never met all of us.

  40. I definitely wanted to send a simple note to be able to thank you for these superb solutions you are placing on this website. My extensive internet lookup has at the end of the day been rewarded with really good content to go over with my two friends. I would declare that we website visitors actually are undoubtedly blessed to dwell in a remarkable community with so many special people with good hints. I feel somewhat privileged to have come across your web pages and look forward to plenty of more brilliant minutes reading here. Thank you once more for all the details.

  41. I wish to express some appreciation to the writer just for bailing me out of this particular difficulty. Right after checking through the the net and seeing solutions which were not pleasant, I assumed my life was well over. Being alive without the presence of strategies to the problems you’ve sorted out all through this blog post is a critical case, as well as the ones which could have badly affected my career if I had not encountered your site. Your personal understanding and kindness in touching all the stuff was crucial. I am not sure what I would have done if I hadn’t discovered such a subject like this. I can at this point relish my future. Thanks for your time so much for your reliable and amazing help. I won’t think twice to suggest the blog to anyone who needs to have support on this situation.

  42. I want to show appreciation to this writer just for rescuing me from this particular situation. Because of scouting throughout the online world and meeting principles which are not helpful, I figured my life was gone. Being alive without the presence of strategies to the problems you have sorted out as a result of this site is a serious case, and the ones that would have adversely affected my career if I hadn’t noticed your web site. The understanding and kindness in taking care of the whole lot was very helpful. I’m not sure what I would have done if I had not discovered such a subject like this. I’m able to at this point relish my future. Thanks very much for this impressive and sensible help. I will not hesitate to recommend the website to any person who desires assistance about this subject.

Leave a Reply

Your email address will not be published. Required fields are marked *