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Stroke: Risk Factors, Symptoms, Treatment & Prevention

By Dr. Manoj Khanal in Neurology

Mar 24 , 2022 | 1 min read

The risk for future Ischaemic stroke following a primary Transient Ischaemic Attack (TIA)increases by 3-4% annually.TIA is the incidence of neurological obstruction that continues for more than 24 hours. However, silent infarction does not persist for more than 24 hours.

All patients suffering from a stroke must undergo Brain imaging (Computerised Tomography Scan/ Magnetic Resonance Imaging Scan) tests to differentiate between hemorrhagic and ischaemic events. Certain assessments are required to rule out high-risk modifiable problems such as Atrial Fibrillation.

Non-Modifiable Modifiable
Age Arterial Hypertension
Gender TIA
Race/ethnicity Prior stroke
Family History Diabetes Mellitus
Genetics Cardiac disorder

Cigarette or alcohol consumption

Elevated levels of Fibrinogen

Obesity

Use of birth control pills

Low serum Folate


  1. Hypertension

The most significant intervention for secondary management of Ischaemic stroke is to treat Hypertension. The occurrence of Hypertension in patients with a recent Ischaemic attack is estimated to be around 70%.


  1. Type 2 Diabetes Mellitus (T2DM)

T2DM augments the risk of Ischaemic stroke by 2-4 times. T2DM also increases mortality and morbidity following stroke. The causative reasons for the occurrence of stroke secondary to T2DM may be governed by Cardiac Embolism, Cerebrovascular Atherosclerosis, or Rheological irregularities.


  1. High Blood Cholesterol

High cholesterol levels in the blood lead to stroke. Cholesterol-lowering agents result in a 28% decrease in fatal or non-fatal stroke as well as TIA’s.


  1. Non-valvular Atrial Fibrillation (AF)

Non-valvular AF augments the overall risk for stroke to about 5-6 times. The major causes that contribute to an increased risk for embolism in Non-valvular AF include Arterial Hypertension, TIA, Heart failure, Diabetes, and age (more than 75 years).


  1. Cigarette Smoking

The significant risk factor for the occurrence of Ischaemic stroke for all ages is 'cigarette smoking'; along with a prevalent risk factor of carotid atherosclerosis in males. Smoking enhances stroke risk to about 2-3 fold. Some effective intervention for smoking cessation includes proper counseling or utilisation of nicotine replacement products.


  1. Alcohol Consumption

A J-shaped relation is observed between alcohol intake and Ischaemic stroke; light to moderate alcohol usage (up to 2 drinks per day) uniformly distributed during the week delivers a lowered stroke risk, while heavy alcohol intake has been linked with an increased risk of total stroke. Exclusion or decrease in alcohol intake is advisable for heavy drinkers.


Treatment options

Medical Surgical
Antiplatelets Cardio-embolic cause
Anticoagulants Symptomatic Carotid Artery Stenosis
Statins
Antihypertensive treatment
Diabetes management
Control other risk factors
Lifestyle modifications