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Cause and Prevention for Stroke
Hemorrhagic strokes, in which a blocked vessel bleeds, are usually due to small-vessel disease in individuals with high blood pressure. Such intracerebral hemorrhage occurs most often in the deep white matter of the brain, brainstem, and cerebellum. The incidence of such strokes has been reduced in part by the introduction of more effective treatments for hypertension. Bleeding also occurs when a defect in the wall of an artery, called an aneurysm, ruptures. When this occurs at the sites of branching of the larger arteries inside the head, blood spills into the subarachnoid space, causing subarachnoid hemorrhage. Bleeding may also occur with malformations of arteries and veins, into an infarct, and with blood diseases that impair coagulation.
Cause
The major risk factor for stroke is hypertension, with cigarette smoking and diabetes mellitus significantly increasing the risk. Transient ischemic attacks (TIAs) occur before stroke in 20 percent of patients and consist of sudden onset of one or more of the following symptoms: temporary loss of vision in one eye, unilateral numbness, temporary loss of speech or slurred speech, and localized weakness of an arm or leg. Attacks last less than 24 hours and resolve without permanent damage until the stroke occurs.
Prevention
Medications such as aspirin, which inhibit the tendency of platelets to cause clotting in the bloodstream, have proved effective in the prevention of stroke and fatal heart attacks.
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