You can contact us here
Stroke and Women
How Stroke Affects Women
Stroke is a leading cause of death for women. Stroke also kills more women than men each year. Get the facts about how stroke affects women and how to know if it's happening to you.
Woman suffering stroke and cross-section of Brain with Ischemic Stroke
Image by TheVisualMD
Normal Brain, Hemorrhagic Stroke, and Ischemic Stroke
Interactive by TheVisualMD
Stroke kills about twice as many women as breast cancer each year. In fact, stroke is the third leading cause of death for women. Stroke also kills more women than men each year. A stroke can leave you permanently disabled. But many strokes are preventable and treatable. Every woman can take steps to prevent stroke by knowing her risk factors and making healthy changes.
Source: Office on Women's Health (OWH), U.S. Department of Health and Human Services
How Stroke Occurs
Image by TheVisualMD
A stroke is sometimes called a "brain attack." Stroke happens when blood flow to a part of the brain stops or is blocked by a blood clot or plaque, and brain cells begin to die.
Source: Office on Women's Health (OWH), U.S. Department of Health and Human Services
Brain angiography with contrast
Interactive by TheVisualMD
The CNS is crucial to the operation of the body, and any compromise in the brain and spinal cord can lead to severe difficulties. The CNS has a privileged blood supply, as suggested by the blood-brain barrier. The function of the tissue in the CNS is crucial to the survival of the organism, so the contents of the blood cannot simply pass into the central nervous tissue. To protect this region from the toxins and pathogens that may be traveling through the blood stream, there is strict control over what can move out of the general systems and into the brain and spinal cord. Because of this privilege, the CNS needs specialized structures for the maintenance of circulation. This begins with a unique arrangement of blood vessels carrying fresh blood into the CNS. Beyond the supply of blood, the CNS filters that blood into cerebrospinal fluid (CSF), which is then circulated through the cavities of the brain and spinal cord called ventricles.
A lack of oxygen to the CNS can be devastating, and the cardiovascular system has specific regulatory reflexes to ensure that the blood supply is not interrupted. There are multiple routes for blood to get into the CNS, with specializations to protect that blood supply and to maximize the ability of the brain to get an uninterrupted perfusion.
The major artery carrying recently oxygenated blood away from the heart is the aorta. The very first branches off the aorta supply the heart with nutrients and oxygen. The next branches give rise to the common carotid arteries, which further branch into the internal carotid arteries. The external carotid arteries supply blood to the tissues on the surface of the cranium. The bases of the common carotids contain stretch receptors that immediately respond to the drop in blood pressure upon standing. The orthostatic reflex is a reaction to this change in body position, so that blood pressure is maintained against the increasing effect of gravity (orthostatic means “standing up”). Heart rate increases—a reflex of the sympathetic division of the autonomic nervous system—and this raises blood pressure.
The internal carotid artery enters the cranium through the carotid canal in the temporal bone. A second set of vessels that supply the CNS are the vertebral arteries, which are protected as they pass through the neck region by the transverse foramina of the cervical vertebrae. The vertebral arteries enter the cranium through the foramen magnum of the occipital bone. Branches off the left and right vertebral arteries merge into the anterior spinal artery supplying the anterior aspect of the spinal cord, found along the anterior median fissure. The two vertebral arteries then merge into the basilar artery, which gives rise to branches to the brain stem and cerebellum. The left and right internal carotid arteries and branches of the basilar artery all become the circle of Willis, a confluence of arteries that can maintain perfusion of the brain even if narrowing or a blockage limits flow through one part (image).
After passing through the CNS, blood returns to the circulation through a series of dural sinuses and veins (image). The superior sagittal sinus runs in the groove of the longitudinal fissure, where it absorbs CSF from the meninges. The superior sagittal sinus drains to the confluence of sinuses, along with the occipital sinuses and straight sinus, to then drain into the transverse sinuses. The transverse sinuses connect to the sigmoid sinuses, which then connect to the jugular veins. From there, the blood continues toward the heart to be pumped to the lungs for reoxygenation.
Dural Sinuses and Veins
The outer surface of the CNS is covered by a series of membranes composed of connective tissue called the meninges, which protect the brain. The dura mater is a thick fibrous layer and a strong protective sheath over the entire brain and spinal cord. It is anchored to the inner surface of the cranium and vertebral cavity. The arachnoid mater is a membrane of thin fibrous tissue that forms a loose sac around the CNS. Beneath the arachnoid is a thin, filamentous mesh called the arachnoid trabeculae, which looks like a spider web, giving this layer its name. Directly adjacent to the surface of the CNS is the pia mater, a thin fibrous membrane that follows the convolutions of gyri and sulci in the cerebral cortex and fits into other grooves and indentations (Figure).
Meningeal Layers of Superior Sagittal Sinus
The layers of the meninges in the longitudinal fissure of the superior sagittal sinus are shown, with the dura mater adjacent to the inner surface of the cranium, the pia mater adjacent to the surface of the brain, and the arachnoid and subarachnoid space between them. An arachnoid villus is shown emerging into the dural sinus to allow CSF to filter back into the blood for drainage.
Like a thick cap covering the brain, the dura mater is a tough outer covering. The name comes from the Latin for “tough mother” to represent its physically protective role. It encloses the entire CNS and the major blood vessels that enter the cranium and vertebral cavity. It is directly attached to the inner surface of the bones of the cranium and to the very end of the vertebral cavity.
There are infoldings of the dura that fit into large crevasses of the brain. Two infoldings go through the midline separations of the cerebrum and cerebellum; one forms a shelf-like tent between the occipital lobes of the cerebrum and the cerebellum, and the other surrounds the pituitary gland. The dura also surrounds and supports the venous sinuses.
The middle layer of the meninges is the arachnoid, named for the spider-web–like trabeculae between it and the pia mater. The arachnoid defines a sac-like enclosure around the CNS. The trabeculae are found in the subarachnoid space, which is filled with circulating CSF. The arachnoid emerges into the dural sinuses as the arachnoid granulations, where the CSF is filtered back into the blood for drainage from the nervous system.
The subarachnoid space is filled with circulating CSF, which also provides a liquid cushion to the brain and spinal cord. Similar to clinical blood work, a sample of CSF can be withdrawn to find chemical evidence of neuropathology or metabolic traces of the biochemical functions of nervous tissue.
The outer surface of the CNS is covered in the thin fibrous membrane of the pia mater. It is thought to have a continuous layer of cells providing a fluid-impermeable membrane. The name pia mater comes from the Latin for “tender mother,” suggesting the thin membrane is a gentle covering for the brain. The pia extends into every convolution of the CNS, lining the inside of the sulci in the cerebral and cerebellar cortices. At the end of the spinal cord, a thin filament extends from the inferior end of CNS at the upper lumbar region of the vertebral column to the sacral end of the vertebral column. Because the spinal cord does not extend through the lower lumbar region of the vertebral column, a needle can be inserted through the dura and arachnoid layers to withdraw CSF. This procedure is called a lumbar puncture and avoids the risk of damaging the central tissue of the spinal cord. Blood vessels that are nourishing the central nervous tissue are between the pia mater and the nervous tissue.
DISORDERS OF THE…
MeningesMeningitis is an inflammation of the meninges, the three layers of fibrous membrane that surround the CNS. Meningitis can be caused by infection by bacteria or viruses. The particular pathogens are not special to meningitis; it is just an inflammation of that specific set of tissues from what might be a broader infection. Bacterial meningitis can be caused by Streptococcus, Staphylococcus, or the tuberculosis pathogen, among many others. Viral meningitis is usually the result of common enteroviruses (such as those that cause intestinal disorders), but may be the result of the herpes virus or West Nile virus. Bacterial meningitis tends to be more severe.
The symptoms associated with meningitis can be fever, chills, nausea, vomiting, light sensitivity, soreness of the neck, or severe headache. More important are the neurological symptoms, such as changes in mental state (confusion, memory deficits, and other dementia-type symptoms). A serious risk of meningitis can be damage to peripheral structures because of the nerves that pass through the meninges. Hearing loss is a common result of meningitis.
The primary test for meningitis is a lumbar puncture. A needle inserted into the lumbar region of the spinal column through the dura mater and arachnoid membrane into the subarachnoid space can be used to withdraw the fluid for chemical testing. Fatality occurs in 5 to 40 percent of children and 20 to 50 percent of adults with bacterial meningitis. Treatment of bacterial meningitis is through antibiotics, but viral meningitis cannot be treated with antibiotics because viruses do not respond to that type of drug. Fortunately, the viral forms are milder.
Cerebrospinal fluid (CSF) circulates throughout and around the CNS. In other tissues, water and small molecules are filtered through capillaries as the major contributor to the interstitial fluid. In the brain, CSF is produced in special structures to perfuse through the nervous tissue of the CNS and is continuous with the interstitial fluid. Specifically, CSF circulates to remove metabolic wastes from the interstitial fluids of nervous tissues and return them to the blood stream. The ventricles are the open spaces within the brain where CSF circulates. In some of these spaces, CSF is produced by filtering of the blood that is performed by a specialized membrane known as a choroid plexus. The CSF circulates through all of the ventricles to eventually emerge into the subarachnoid space where it will be reabsorbed into the blood.
There are four ventricles within the brain, all of which developed from the original hollow space within the neural tube, the central canal. The first two are named the lateral ventricles and are deep within the cerebrum. These ventricles are connected to the third ventricle by two openings called the interventricular foramina. The third ventricle is the space between the left and right sides of the diencephalon, which opens into the cerebral aqueduct that passes through the midbrain. The aqueduct opens into the fourth ventricle, which is the space between the cerebellum and the pons and upper medulla (image).
Cerebrospinal Fluid Circulation
As the telencephalon enlarges and grows into the cranial cavity, it is limited by the space within the skull. The telencephalon is the most anterior region of what was the neural tube, but cannot grow past the limit of the frontal bone of the skull. Because the cerebrum fits into this space, it takes on a C-shaped formation, through the frontal, parietal, occipital, and finally temporal regions. The space within the telencephalon is stretched into this same C-shape. The two ventricles are in the left and right sides, and were at one time referred to as the first and second ventricles. The interventricular foramina connect the frontal region of the lateral ventricles with the third ventricle.
The third ventricle is the space bounded by the medial walls of the hypothalamus and thalamus. The two thalami touch in the center in most brains as the massa intermedia, which is surrounded by the third ventricle. The cerebral aqueduct opens just inferior to the epithalamus and passes through the midbrain. The tectum and tegmentum of the midbrain are the roof and floor of the cerebral aqueduct, respectively. The aqueduct opens up into the fourth ventricle. The floor of the fourth ventricle is the dorsal surface of the pons and upper medulla (that gray matter making a continuation of the tegmentum of the midbrain). The fourth ventricle then narrows into the central canal of the spinal cord.
The ventricular system opens up to the subarachnoid space from the fourth ventricle. The single median aperture and the pair of lateral apertures connect to the subarachnoid space so that CSF can flow through the ventricles and around the outside of the CNS. Cerebrospinal fluid is produced within the ventricles by a type of specialized membrane called a choroid plexus. Ependymal cells (one of the types of glial cells described in the introduction to the nervous system) surround blood capillaries and filter the blood to make CSF. The fluid is a clear solution with a limited amount of the constituents of blood. It is essentially water, small molecules, and electrolytes. Oxygen and carbon dioxide are dissolved into the CSF, as they are in blood, and can diffuse between the fluid and the nervous tissue.
The choroid plexuses are found in all four ventricles. Observed in dissection, they appear as soft, fuzzy structures that may still be pink, depending on how well the circulatory system is cleared in preparation of the tissue. The CSF is produced from components extracted from the blood, so its flow out of the ventricles is tied to the pulse of cardiovascular circulation.
From the lateral ventricles, the CSF flows into the third ventricle, where more CSF is produced, and then through the cerebral aqueduct into the fourth ventricle where even more CSF is produced. A very small amount of CSF is filtered at any one of the plexuses, for a total of about 500 milliliters daily, but it is continuously made and pulses through the ventricular system, keeping the fluid moving. From the fourth ventricle, CSF can continue down the central canal of the spinal cord, but this is essentially a cul-de-sac, so more of the fluid leaves the ventricular system and moves into the subarachnoid space through the median and lateral apertures.
Within the subarachnoid space, the CSF flows around all of the CNS, providing two important functions. As with elsewhere in its circulation, the CSF picks up metabolic wastes from the nervous tissue and moves it out of the CNS. It also acts as a liquid cushion for the brain and spinal cord. By surrounding the entire system in the subarachnoid space, it provides a thin buffer around the organs within the strong, protective dura mater. The arachnoid granulations are outpocketings of the arachnoid membrane into the dural sinuses so that CSF can be reabsorbed into the blood, along with the metabolic wastes. From the dural sinuses, blood drains out of the head and neck through the jugular veins, along with the rest of the circulation for blood, to be reoxygenated by the lungs and wastes to be filtered out by the kidneys (image).
Components of CSF Circulation | ||||||
|---|---|---|---|---|---|---|
| Lateral ventricles | Third ventricle | Cerebral aqueduct | Fourth ventricle | Central canal | Subarachnoid space | |
| Location in CNS | Cerebrum | Diencephalon | Midbrain | Between pons/upper medulla and cerebellum | Spinal cord | External to entire CNS |
| Blood vessel structure | Choroid plexus | Choroid plexus | None | Choroid plexus | None | Arachnoid granulations |
Central Nervous SystemThe supply of blood to the brain is crucial to its ability to perform many functions. Without a steady supply of oxygen, and to a lesser extent glucose, the nervous tissue in the brain cannot keep up its extensive electrical activity. These nutrients get into the brain through the blood, and if blood flow is interrupted, neurological function is compromised.
The common name for a disruption of blood supply to the brain is a stroke. It is caused by a blockage to an artery in the brain. The blockage is from some type of embolus: a blood clot, a fat embolus, or an air bubble. When the blood cannot travel through the artery, the surrounding tissue that is deprived starves and dies. Strokes will often result in the loss of very specific functions. A stroke in the lateral medulla, for example, can cause a loss in the ability to swallow. Sometimes, seemingly unrelated functions will be lost because they are dependent on structures in the same region. Along with the swallowing in the previous example, a stroke in that region could affect sensory functions from the face or extremities because important white matter pathways also pass through the lateral medulla. Loss of blood flow to specific regions of the cortex can lead to the loss of specific higher functions, from the ability to recognize faces to the ability to move a particular region of the body. Severe or limited memory loss can be the result of a temporal lobe stroke.
Related to strokes are transient ischemic attacks (TIAs), which can also be called “mini-strokes.” These are events in which a physical blockage may be temporary, cutting off the blood supply and oxygen to a region, but not to the extent that it causes cell death in that region. While the neurons in that area are recovering from the event, neurological function may be lost. Function can return if the area is able to recover from the event.
Recovery from a stroke (or TIA) is strongly dependent on the speed of treatment. Often, the person who is present and notices something is wrong must then make a decision. The mnemonic FAST helps people remember what to look for when someone is dealing with sudden losses of neurological function. If someone complains of feeling “funny,” check these things quickly: Look at the person’s face. Does he or she have problems moving Face muscles and making regular facial expressions? Ask the person to raise his or her Arms above the head. Can the person lift one arm but not the other? Has the person’s Speech changed? Is he or she slurring words or having trouble saying things? If any of these things have happened, then it is Time to call for help.
Sometimes, treatment with blood-thinning drugs can alleviate the problem, and recovery is possible. If the tissue is damaged, the amazing thing about the nervous system is that it is adaptable. With physical, occupational, and speech therapy, victims of strokes can recover, or more accurately relearn, functions.
The CNS has a privileged blood supply established by the blood-brain barrier. Establishing this barrier are anatomical structures that help to protect and isolate the CNS. The arterial blood to the brain comes from the internal carotid and vertebral arteries, which both contribute to the unique circle of Willis that provides constant perfusion of the brain even if one of the blood vessels is blocked or narrowed. That blood is eventually filtered to make a separate medium, the CSF, that circulates within the spaces of the brain and then into the surrounding space defined by the meninges, the protective covering of the brain and spinal cord.
The blood that nourishes the brain and spinal cord is behind the glial-cell–enforced blood-brain barrier, which limits the exchange of material from blood vessels with the interstitial fluid of the nervous tissue. Thus, metabolic wastes are collected in cerebrospinal fluid that circulates through the CNS. This fluid is produced by filtering blood at the choroid plexuses in the four ventricles of the brain. It then circulates through the ventricles and into the subarachnoid space, between the pia mater and the arachnoid mater. From the arachnoid granulations, CSF is reabsorbed into the blood, removing the waste from the privileged central nervous tissue.
The blood, now with the reabsorbed CSF, drains out of the cranium through the dural sinuses. The dura mater is the tough outer covering of the CNS, which is anchored to the inner surface of the cranial and vertebral cavities. It surrounds the venous space known as the dural sinuses, which connect to the jugular veins, where blood drains from the head and neck.
Source: CNX OpenStax
Aorta cross section
Image by TheVisualMD
There are three major branches of the aortic arch: the brachiocephalic artery, the left common carotid artery, and the left subclavian (literally “under the clavicle”) artery. As you would expect based upon proximity to the heart, each of these vessels is classified as an elastic artery.
The brachiocephalic artery is located only on the right side of the body; there is no corresponding artery on the left. The brachiocephalic artery branches into the right subclavian artery and the right common carotid artery. The left subclavian and left common carotid arteries arise independently from the aortic arch but otherwise follow a similar pattern and distribution to the corresponding arteries on the right side.
Each subclavian artery supplies blood to the arms, chest, shoulders, back, and central nervous system. It then gives rise to three major branches: the internal thoracic artery, the vertebral artery, and the thyrocervical artery. The internal thoracic artery, or mammary artery, supplies blood to the thymus, the pericardium of the heart, and the anterior chest wall. The vertebral artery passes through the vertebral foramen in the cervical vertebrae and then through the foramen magnum into the cranial cavity to supply blood to the brain and spinal cord. The paired vertebral arteries join together to form the large basilar artery at the base of the medulla oblongata. This is an example of an anastomosis. The subclavian artery also gives rise to the thyrocervical artery that provides blood to the thyroid, the cervical region of the neck, and the upper back and shoulder.
The common carotid artery divides into internal and external carotid arteries. The right common carotid artery arises from the brachiocephalic artery and the left common carotid artery arises directly from the aortic arch. The external carotid artery supplies blood to numerous structures within the face, lower jaw, neck, esophagus, and larynx. These branches include the lingual, facial, occipital, maxillary, and superficial temporal arteries. The internal carotid artery initially forms an expansion known as the carotid sinus, containing the carotid baroreceptors and chemoreceptors. Like their counterparts in the aortic sinuses, the information provided by these receptors is critical to maintaining cardiovascular homeostasis
The internal carotid arteries along with the vertebral arteries are the two primary suppliers of blood to the human brain. Given the central role and vital importance of the brain to life, it is critical that blood supply to this organ remains uninterrupted. Recall that blood flow to the brain is remarkably constant, with approximately 20 percent of blood flow directed to this organ at any given time. When blood flow is interrupted, even for just a few seconds, a transient ischemic attack (TIA), or mini-stroke, may occur, resulting in loss of consciousness or temporary loss of neurological function. In some cases, the damage may be permanent. Loss of blood flow for longer periods, typically between 3 and 4 minutes, will likely produce irreversible brain damage or a stroke, also called a cerebrovascular accident (CVA). The locations of the arteries in the brain not only provide blood flow to the brain tissue but also prevent interruption in the flow of blood. Both the carotid and vertebral arteries branch once they enter the cranial cavity, and some of these branches form a structure known as the arterial circle (or circle of Willis), an anastomosis that is remarkably like a traffic circle that sends off branches (in this case, arterial branches to the brain). As a rule, branches to the anterior portion of the cerebrum are normally fed by the internal carotid arteries; the remainder of the brain receives blood flow from branches associated with the vertebral arteries.
The internal carotid artery continues through the carotid canal of the temporal bone and enters the base of the brain through the carotid foramen where it gives rise to several branches (Figure 20.26 and Figure 20.27). One of these branches is the anterior cerebral artery that supplies blood to the frontal lobe of the cerebrum. Another branch, the middle cerebral artery, supplies blood to the temporal and parietal lobes, which are the most common sites of CVAs. The ophthalmic artery, the third major branch, provides blood to the eyes.
The right and left anterior cerebral arteries join together to form an anastomosis called the anterior communicating artery. The initial segments of the anterior cerebral arteries and the anterior communicating artery form the anterior portion of the arterial circle. The posterior portion of the arterial circle is formed by a left and a right posterior communicating artery that branches from the posterior cerebral artery, which arises from the basilar artery. It provides blood to the posterior portion of the cerebrum and brain stem. The basilar artery is an anastomosis that begins at the junction of the two vertebral arteries and sends branches to the cerebellum and brain stem. It flows into the posterior cerebral arteries. Table 20.6 summarizes the aortic arch branches, including the major branches supplying the brain.
Figure 20.26 Arteries Supplying the Head and Neck The common carotid artery gives rise to the external and internal carotid arteries. The external carotid artery remains superficial and gives rise to many arteries of the head. The internal carotid artery first forms the carotid sinus and then reaches the brain via the carotid canal and carotid foramen, emerging into the cranium via the foramen lacerum. The vertebral artery branches from the subclavian artery and passes through the transverse foramen in the cervical vertebrae, entering the base of the skull at the vertebral foramen. The subclavian artery continues toward the arm as the axillary artery.
Figure 20.27 Arteries Serving the Brain This inferior view shows the network of arteries serving the brain. The structure is referred to as the arterial circle or circle of Willis.
Aortic Arch Branches and Brain Circulation
| Vessel | Description |
|---|---|
| Brachiocephalic artery | Single vessel located on the right side of the body; the first vessel branching from the aortic arch; gives rise to the right subclavian artery and the right common carotid artery; supplies blood to the head, neck, upper limb, and wall of the thoracic region |
| Subclavian artery | The right subclavian artery arises from the brachiocephalic artery while the left subclavian artery arises from the aortic arch; gives rise to the internal thoracic, vertebral, and thyrocervical arteries; supplies blood to the arms, chest, shoulders, back, and central nervous system |
| Internal thoracic artery | Also called the mammary artery; arises from the subclavian artery; supplies blood to the thymus, pericardium of the heart, and anterior chest wall |
| Vertebral artery | Arises from the subclavian artery and passes through the vertebral foramen through the foramen magnum to the brain; joins with the internal carotid artery to form the arterial circle; supplies blood to the brain and spinal cord |
| Thyrocervical artery | Arises from the subclavian artery; supplies blood to the thyroid, the cervical region, the upper back, and shoulder |
| Common carotid artery | The right common carotid artery arises from the brachiocephalic artery and the left common carotid artery arises from the aortic arch; each gives rise to the external and internal carotid arteries; supplies the respective sides of the head and neck |
| External carotid artery | Arises from the common carotid artery; supplies blood to numerous structures within the face, lower jaw, neck, esophagus, and larynx |
| Internal carotid artery | Arises from the common carotid artery and begins with the carotid sinus; goes through the carotid canal of the temporal bone to the base of the brain; combines with the branches of the vertebral artery, forming the arterial circle; supplies blood to the brain |
| Arterial circle or circle of Willis | An anastomosis located at the base of the brain that ensures continual blood supply; formed from the branches of the internal carotid and vertebral arteries; supplies blood to the brain |
| Anterior cerebral artery | Arises from the internal carotid artery; supplies blood to the frontal lobe of the cerebrum |
| Middle cerebral artery | Another branch of the internal carotid artery; supplies blood to the temporal and parietal lobes of the cerebrum |
| Ophthalmic artery | Branch of the internal carotid artery; supplies blood to the eyes |
| Anterior communicating artery | An anastomosis of the right and left internal carotid arteries; supplies blood to the brain |
| Posterior communicating artery | Branches of the posterior cerebral artery that form part of the posterior portion of the arterial circle; supplies blood to the brain |
| Posterior cerebral artery | Branch of the basilar artery that forms a portion of the posterior segment of the arterial circle of Willis; supplies blood to the posterior portion of the cerebrum and brain stem |
| Basilar artery | Formed from the fusion of the two vertebral arteries; sends branches to the cerebellum, brain stem, and the posterior cerebral arteries; the main blood supply to the brain stem |
Source: CNX OpenStax
This browser does not support the video element.
This browser does not support the video element.
Stroke Differences with Men and Women
Image by TheVisualMD
Stroke affects women differently than men in several ways.
Source: Office on Women's Health (OWH), U.S. Department of Health and Human Services
Two types of stroke: Ischemic (L) and Hemorrhagic (R)
Image by Scientific Animations, Inc.
There are two types of stroke:
Both types of stroke can cause brain cells to die. Depending on which part of the brain the stroke affects, you may have problems with your speech, movement, balance, vision, or memory.
If you think you are having a stroke, call 911.
Source: Office on Women's Health (OWH), U.S. Department of Health and Human Services
Transient Ischemic Attack - Short Summary
Image by TheVisualMD
A "mini-stroke" is also called a transient ischemic attack (TIA, pronounced "T-I-A"). A TIA happens when, for a short time, less blood than normal gets to the brain. You may have some stroke symptoms, or you may not notice any symptoms.
A TIA usually lasts only a few minutes, although it can last up to several hours. Many people do not even know they have had a stroke. A TIA can be a warning sign of a full stroke in the future, or you can have another mini-stroke at a later time.
If you think you are having any type of stroke, call 911.
Source: Office on Women's Health (OWH), U.S. Department of Health and Human Services
Brain Inflammation
Image by VSRao
How stroke affects you depends on:
A mild stroke can cause little or no brain damage. A major stroke can cause severe brain damage and even death. Some effects of stroke may improve with time and rehabilitation.
A stroke can happen in different parts of the brain. The brain is divided into four main parts:
A stroke in the right half of the brain can cause:
A stroke in the left half of the brain can cause:
A stroke in the cerebellum can cause:
Strokes in the brain stem are very harmful. Since impulses that start in the brain must travel through the brain stem on their way to the arms and legs, patients with a brain stem stroke may also develop paralysis.
Source: Office on Women's Health (OWH), U.S. Department of Health and Human Services
Women's Risk Factors for Stroke
Image by TheVisualMD
A stroke can happen to anyone. Some women are more at risk because of certain health problems, family health history, age, and habits. These are called risk factors.
You can't change some risk factors, like your age, race or ethnicity, or family history. The good news is that you can control many other stroke risk factors, such as high blood pressure, diabetes, smoking, and unhealthy eating.
Source: Office on Women's Health (OWH), U.S. Department of Health and Human Services
face showing signs of stroke (facial droop)
Image by Another-anon-artist-234
Strokes happen fast and are a medical emergency. If you think you or someone else may be having a stroke, use the F.A.S.T. test:
F—Face: Look in the mirror and smile, or ask the person to smile. Does one side of the face droop?
A—Arms: Raise both arms. Does one arm drift downward?
S—Speech: Repeat a simple phrase, like "Hello, my name is ____." Is the speech slurred or strange?
T—Time: Act fast. If you see any of these signs, call 911 right away. Some treatments for stroke work only if given in the first 3 hours (or up to 4½ hours for some people) after symptoms appear.
Source: Office on Women's Health (OWH), U.S. Department of Health and Human Services
Cerebral Angiography
Interactive by TheVisualMD
Stroke is a medical emergency. Tests for stroke usually start when you're in the ambulance, before you get to the hospital. This is one reason why it's important to call 911 for a stroke, rather than have someone drive you to the hospital. The goals of the tests are to figure out whether you've had a stroke, what type of stroke you've had, and what caused the stroke. This will help your doctors plan your treatment.
After you call 911 and the ambulance arrives, an ambulance worker will start the stroke exam. A doctor will continue the exam at the hospital. The ambulance worker or doctor will:
At the hospital, you will probably get at least one imaging test that allows your doctor to see inside your brain, see how much damage was done and where the stroke happened. Some imaging tests you may get include:
There is no blood test that can diagnose a stroke. However, in the hospital, your doctor or nurse may do a series of blood tests to learn the cause of your stroke symptoms:
Source: Office on Women's Health (OWH), U.S. Department of Health and Human Services
Coagulation Factors Test
Also called: Factor Assays, Blood Clotting Factors, Clotting Factors, Coagulation Factor Tests
Coagulation factor tests measure the levels of the proteins in the blood that help control bleeding and help determine if one or more of your coagulation factors are increased, normal, or decreased.
Fibrinogen Test
Also called: Coagulation Factor I, Factor I, Hypofibrinogenemia test
Fibrinogen, also called coagulation factor I, is a protein produced by the liver. When bleeding is detected in the body, fibrinogen is released along with other coagulation factors to form blood clots and stop the bleeding. Too much or too little fibrinogen can lead to serious health problems.
Factor II Activity Test
Also called: Coagulation factor II, Prothrombin Assay, Prothrombin
When a wound occurs in any part of the body, several factors (proteins) which are involved in the normal blood clotting process become active to stop the bleeding. A factor II activity test is used to measure the activity of prothrombin, which is one of the proteins that help your blood to clot.
Factor V Activity Test
Also called: Factor V Assay, Coagulation Factor V, Labile factor, Proaccelerin, Ac-globulin
When a wound occurs in any part of the body, several factors (proteins) which are involved in the normal blood clotting process become active to stop the bleeding. A factor V (pronounced factor five) activity test is used to measure the activity of the coagulation factor V, which is one of the proteins that help your blood to clot.
Factor VII Test
Also called: Coagulation Factor VII, Stable Factor, Proconvertin, Autoprothrombin, Factor VII Activity
When a wound occurs in any part of the body, several factors (proteins) which are involved in the normal blood clotting process become active to stop the bleeding. A factor VII (pronounced factor seven) test is used to measure the activity of the coagulation factor VII, which is one of the proteins that help your blood to clot.
Factor VIII Test
Also called: Antihemophilia Factor A, Hemophilic factor A, Coagulation factor VIII
When a wound occurs in any part of the body, several factors (proteins) which are involved in the normal blood clotting process become active to stop the bleeding. This test is used to measure the activity of the coagulation factor VIII, which is one of the proteins that help your blood to clot. This is useful to diagnose a condition known as hemophilia A.
Factor IX Test
Also called: Christmas factor assay, Hemophilic factor B, Coagulation factor IX, factor IX hemophilia, FIX, factor IX deficiency test
When a wound occurs in any part of the body, several factors (proteins) which are involved in the normal blood clotting process become active to stop the bleeding. A factor IX (pronounced factor nine) test is used to measure the activity of the coagulation factor IX, which is one of the proteins that help your blood to clot. If you are lacking this...
Factor X Test
Also called: Factor X Assay, Factor X Activity, Stuart Prower Factor, Coagulation Factor X
When a wound occurs in any part of the body, several factors (proteins) which are involved in the normal blood clotting process become active to stop the bleeding. A factor X (pronounced factor ten) test is used to measure the activity of the coagulation factor X, which is one of the proteins that help your blood to clot.
Factor XI Test
Also called: Coagulation Factor XI
When a wound occurs in any part of the body, several factors (proteins) which are involved in the normal blood clotting process become active to stop the bleeding. A factor XI (pronounced factor eleven) test is used to measure the activity of the coagulation factor XI, which is one of the proteins that help your blood to clot.
Factor XII Test
Also called: Coagulation factor XII, Factor XII Assay, Factor XII Activity, Hageman Factor, Surface Factor
When a wound occurs in any part of the body, several factors (proteins) which are involved in the normal blood clotting process become active to stop the bleeding. A factor XII (pronounced factor twelve) test is used to measure the activity of the coagulation factor XII, which is one of the proteins that help your blood to clot.
Factor XIII Test
Also called: Factor XIII Assay, Factor XIII Activity, Fibrin-stabilizing factor, Coagulation Factor XIII
When a wound occurs in any part of the body, several factors (proteins) which are involved in the normal blood clotting process become active to stop the bleeding. A factor XIII (pronounced factor thirteen) test is used to measure the activity of the coagulation factor XIII, which is one of the proteins that help your blood to clot.
Electrolyte Panel
Also called: Electrolytes, Lytes
An electrolyte panel measures the level of the body's main electrolytes. Electrolytes are electrically charged minerals that help control many important functions in the body. Levels that are too high or too low can indicate a serious health problem.
Sodium Blood Test
Also called: Sodium, Hyponatremia Test, Hypernatremia Test
A sodium blood test measures the amount of sodium in your blood. If your sodium blood levels are too high or too low, it may mean that you have a problem with your kidneys, dehydration, or another medical condition.
Chloride Blood Test
Also called: Chloride, Hypochloremia Test, Hyperchloremia Test
A chloride test measures the chloride in your blood. Chloride is a mineral that helps maintain the acid-base balance in your body. The test is usually part of a routine blood screening or to help determine if there is a problem with your body's electrolyte or acid-base (pH) balance.
Potassium Blood Test
Also called: Potassium, Hypokalemia Test, Hyperkalemia Test
A potassium blood test measures the potassium levels in your blood. It is often included in a series of routine blood tests called an electrolyte panel. Too much or too little potassium may indicate a serious medical problem.
Carbon Dioxide Blood Test
Also called: Carbon Dioxide, CO2, Bicarbonate, Metabolic Alkalosis Test, Metabolic Acidosis Test
A carbon dioxide (CO2) blood test measures the amount of carbon dioxide is in the blood in your veins. Too much or too little CO2 in the blood can indicate a health problem. The test is most often done as part of an electrolyte or metabolic panel.
Lipid Tests
Also called: Lipid Panel, Lipid Profile, Lipid Testing, Lipoprotein Profile
Lipid tests measure triglycerides, a type of fat found in the bloodstream, and cholesterol, a waxy, fat-like substance found in your blood and every cell of your body. High levels of triglycerides and/or a type of cholesterol, called LDL can put you at risk for heart disease.
This browser does not support the video element.
This browser does not support the video element.
This browser does not support the video element.
Triglycerides Test
Also called: TRIG
A triglycerides test measures the amount of triglycerides in your blood. High triglyceride levels may put you at risk for heart disease. The test is usually part of a lipid profile.
This browser does not support the video element.
Cholesterol Test
Also called: Cholesterol Levels, Blood Cholesterol, Total Cholesterol
A cholesterol test is a blood test that measures the amount of each type of cholesterol and certain fats in your blood. Cholesterol is needed to carry out functions such as hormone and vitamin production. High cholesterol can put you at risk for heart disease.
This browser does not support the video element.
This browser does not support the video element.
This browser does not support the video element.
This browser does not support the video element.
This browser does not support the video element.
High-Density Lipoprotein Test
Also called: HDL, HDL-C, HDL Cholesterol, High-Density Lipoprotein Cholesterol
HDL, or high-density lipoprotein, is the "good" cholesterol. It helps to remove bad cholesterol from your arteries, so a higher HDL level is better.
This browser does not support the video element.
This browser does not support the video element.
This browser does not support the video element.
Low Density Lipoprotein Test
Also called: LDL, LDL-C, LDL Cholesterol, Low-Density Lipoprotein Cholesterol
LDL, or low-density lipoprotein, is the "bad" cholesterol. A high LDL level can lead to a buildup of cholesterol in your arteries. Too much LDL is linked to heart disease and stroke.
This browser does not support the video element.
Low Density Lipoprotein: Clogged Arteries (Atherosclerosis) / Plaque in Coronary Artery, close up
VLDL Cholesterol Test
Also called: VLDL-C, VLDL, Very Low Density Lipoprotein
VLDL stands for very low-density lipoprotein. Lipoproteins are particles that carry fat in the bloodstream. Like LDL cholesterol, VLDL cholesterol is considered a type of "bad" cholesterol. Testing for VLDL cholesterol can be used to assess a person's cardiovascular risk.
This browser does not support the video element.
Non-HDL Cholesterol Test
Also called: Non-HDL-C, Non-High Density Lipoprotein Cholesterol
Under certain conditions, the risk of developing coronary heart disease (strokes, heart attack) cannot be properly assessed only by looking at the lipids test results. In these cases, the non-HDL cholesterol can be used to assess of how high a person's cardiovascular risk is.
Total Cholesterol/HDL Ratio
Also called: TC/HDL ratio, Cholesterol ratio
The total cholesterol to HDL cholesterol ratio is a number that is helpful in predicting atherosclerosis, the process of fatty buildup in the walls of the arteries. The number is obtained by dividing total cholesterol by HDL (good) cholesterol.
This browser does not support the video element.
Blood Glucose Test
Also called: Blood Sugar Level, Glucose Test, Random Plasma Glucose, Random Glucose, Random Blood Glucose (RPG)
A blood glucose test measures the amount of glucose (sugar) in your blood. It may be used to help diagnose or monitor diabetes. The test can involve a finger prick or a blood draw from your vein.
This browser does not support the video element.
This browser does not support the video element.
This browser does not support the video element.
This browser does not support the video element.
This browser does not support the video element.
Cerebrospinal Fluid Analysis
Also called: CSF Analysis, Spinal Fluid Analysis
A cerebrospinal fluid (CSF) analysis is a group of tests that help diagnose diseases and conditions affecting the brain and spinal cord.
Platelet Count
Also called: Platelets, PLT Count, Platelet Adequacy, Thrombocyte Count, Thrombocytopenia Test, Thrombocytosis Test, Platelet count
A platelet count test measures the number of platelets in your blood. Platelets, also known as thrombocytes, are small blood cells that are essential for blood clotting. Platelets may be counted to monitor or diagnose diseases, or to look for the cause of too much bleeding or clotting.
This browser does not support the video element.
Complete Blood Count
Also called: CBC, Full Blood Count, Blood Cell Count, Hemotology Panel
A complete blood count (CBC) is often part of a routine exam. It is used to measure different parts and features of your blood. A CBC can help detect a variety of disorders including infections, anemia, diseases of the immune system, and blood cancers.
This browser does not support the video element.
This browser does not support the video element.
This browser does not support the video element.
This browser does not support the video element.
This browser does not support the video element.
Red Blood Cell (RBC) Count
Also called: Erythrocyte Count, RBC Count, Red Blood Count, Red Blood Cell Count, Red Count
A red blood cell (RBC) count is a blood test that measures the number of red blood cells in your blood. Red blood cells carry oxygen from your lungs to the rest of your body. An abnormal RBC count can be a sign of a serious health problem.
This browser does not support the video element.
This browser does not support the video element.
This browser does not support the video element.
White Blood Count (WBC)
Also called: WBC, WBC Blood Test, White Blood Count, White Blood Cell Count, Leukocyte Count, Leukopenia Test, Leukocytosis Test
A white blood count measures the number of white cells in your blood. White blood cells are part of the immune system. A count that is too high or too low can indicate an infection, immune system disorder, or another health problem.
This browser does not support the video element.
Hemoglobin Blood Test
Also called: Hemoglobin, Hgb
A hemoglobin test measures the levels of hemoglobin in your blood. Hemoglobin is an iron-rich protein in red blood cells that carries oxygen. Abnormal levels may mean you have anemia or another blood disorder.
This browser does not support the video element.
This browser does not support the video element.
Hematocrit Blood Test
Also called: Hematrocit, HCT, Crit, Packed Cell Volume, PCV
Hematocrit is a blood test that measures how much of a person's blood is made up of red blood cells. Hematocrit levels that are too high or too low can be a sign of a blood disorder, dehydration, or other medical conditions that affect your blood.
This browser does not support the video element.
This browser does not support the video element.
MCV (Mean Corpuscular Volume) Test
Also called: MCV, MCV Blood Test, Mean Corpuscular Volume, Mean RBC Volume
A mean corpuscular volume (MCV) blood test measures the size of your red blood cells. If blood cells are too small or too large, it may indicate a blood disorder.
Electrocardiogram
Also called: EKG, ECG
An electrocardiogram (EKG) is a test that measures electrical signals in your heart. An abnormal EKG can be a sign of heart damage or disease.
This browser does not support the video element.
cerebral angioma
Image by © Michel Royon / Wikimedia Commons
Radiography of the vascular system of the brain after injection of a contrast medium.
Source: National Center for Biotechnology Information, U.S. National Library of Medicine / NIH
Carotid Ultrasound
Also called: Carotid Ultrasonography, CUS, Carotid Duplex, Carotid Doppler Ultrasound, Carotid Artery Stenosis
Carotid ultrasound uses an ultrasound machine to detect plaque buildup in the carotid arteries in the neck and see whether the buildup is blocking blood flow to the brain. Test results help your doctor plan treatment to remove the plaque and help prevent a stroke.
Treating Stroke
Image by TheVisualMD
The treatment you receive for your stroke depends upon the type of stroke you had and how quickly you receive medical care.
The first-choice treatment for the most common type of stroke (ischemic stroke) is a clot-busting drug called tissue plasminogen activator (tPA, pronounced "T-P-A"). It is usually injected into one of your veins. This drug travels in the blood to your brain and breaks up the clot.
To work properly and safely, tPA should be given within 3 hours (but can be given up to 4 ½ hours) from the time your stroke started. In fact, the sooner tPA is given, the better it works. Before you can get tPA, you need to be tested to make sure you're not having a hemorrhagic stroke because tPA can make hemorrhagic strokes worse. This is why it is so important for a person having a stroke to call 911 quickly.
Some people with ischemic stroke can't get tPA. They might have gotten to the hospital too late or have another medical condition. These people will receive a different treatment:
Hemorrhagic strokes are very dangerous and have fewer treatment options. Treatment usually involves trying to control the bleeding and reduce pressure with drugs or surgery. The type of treatment you'll receive depends on what caused the bleeding and whether the bleeding is inside or outside your brain tissue. The main options are:
After stroke treatment, you might also need rehabilitation to recover from the damage the stroke did to your brain.
Source: Office on Women's Health (OWH), U.S. Department of Health and Human Services
Ambulance
Image by Luciano de Graaf
A stroke is a medical emergency. It can cause lasting brain damage, long-term disability, and even death. If you notice the symptoms of stroke, call 911 right away. The sooner you get treatment, the better your chances of surviving and making a full recovery.
Prepare for a stroke ahead of time. Learn your risk factors for stroke. All older women are at higher risk of stroke. If you are at high risk of stroke, or are a caregiver for an older person, write down the following and keep this list in your wallet or on your refrigerator:
Take action. If you notice any stroke symptoms, don't wait.
Do not take aspirin. Aspirin can make some kinds of stroke worse.
Source: Office on Women's Health (OWH), U.S. Department of Health and Human Services
Preventing a Stroke
Image by TheVisualMD
You can take steps to manage health problems and lower your risk of stroke.
High blood pressure, also called hypertension, is the most important risk factor for stroke. Blood pressure is the force your blood makes against your artery walls when your heart beats. If this force (pressure) is too high, it can damage your arteries.
You are more likely to have high blood pressure if you have a family history of high blood pressure. Other risk factors for high blood pressure include eating unhealthy food often, not exercising, and having overweight or obesity.
In the United States, non-Hispanic black women are at the highest risk of high blood pressure. This may be because they are more likely to have obesity or diabetes, which can cause high blood pressure. Research has also found a gene common in people who are African-American that increases sensitivity to salt. In people who have this gene, just one extra half a teaspoon of salt a day could raise blood pressure. Also, studies show that blood pressure levels are higher among people who are African-American even after controlling for other factors, and some of this difference may be due to the effects of discrimination in the United States.
High blood pressure usually shows no symptoms. The only way to know you have it is to get your blood pressure measured. Measure your blood pressure to find out your numbers:
To lower your risk of stroke, try to lower your blood pressure to less than 120 systolic/80 diastolic.
Many women — more than men — get "white coat hypertension." This means that your anxiety or stress level goes up when you are at the doctor's office, and this can make your blood pressure go up. If medical visits increase your stress level, ask your doctor for a monitor to wear at home to get a more accurate blood pressure reading.
Having other types of heart disease is a major risk factor for stroke. This is because heart disease, which can include blood vessel diseases, affects all the vessels in your body. Some conditions also make blood clots more likely.
Common heart problems that increase your risk of stroke include:
Cholesterol is a waxy, fat-like substance that is found in all cells of your body. Your body makes all the cholesterol you need. You also get cholesterol and saturated fat in foods such as meat and dairy products. Fruits and vegetables do not have any cholesterol or saturated fat.
The extra fat from the foods you eat can clog your arteries. A blood test can measure your levels of:
There are no symptoms of high cholesterol. The only way to know whether you have high cholesterol is to talk to your doctor about a blood test. Your doctor can prescribe medicines and talk with you about other changes, like getting more physical activity and making heart-healthy eating choices, to help lower your cholesterol and triglyceride levels and your risk of stroke.
Having overweight or obesity raises your chance of stroke, especially when you carry extra body fat around your waist (apple-shaped body) rather than around your hips and thighs (pear-shaped body).
Women with an apple-shaped body may have a higher risk of stroke than women with a pear-shaped body.
Postmenopausal women with a high blood triglyceride level and a waist size larger than 35 inches are more likely to have a stroke than postmenopausal women with normal cholesterol levels and a waist size of 35 inches or less.
To lower your risk of stroke, your body mass index (BMI) should be between 18.5 and 24.9. A BMI between 25 and 29.9 is considered overweight. A BMI of 30 or higher is considered obese. Find your BMI using this BMI calculator from the Centers for Disease Control and Prevention.
Losing weight lowers your risk of stroke because your risk of high blood pressure, diabetes, high cholesterol, and metabolic syndrome goes down.
Women with diabetes are more likely to die after a stroke than men with diabetes. If they do survive, their risk of future health problems may be higher.
Uncontrolled diabetes can damage your arteries. Diabetes also makes you more likely to get high blood pressure and get blood clots that can cause a stroke.
Slightly more than 1 in 4 people with diabetes did not know they had it when they were diagnosed. The only way to know for sure whether you have diabetes is to get a blood test.
Metabolic syndrome is the name for a group of risk factors that happen together and are related to your metabolism. Metabolism is the process your body uses to convert food into energy. Having metabolic syndrome doubles your risk of heart disease. Metabolic syndrome is more common in women than men.
Having metabolic syndrome raises your risk of stroke. You have metabolic syndrome if you have any 3 of these 5 risk factors:
If you have metabolic syndrome, you can take steps to control your risk factors. Your doctor will check your cholesterol, blood pressure, and blood glucose regularly to find out your risk of metabolic syndrome.
Excessive, or extra, blood clotting is when blood clots form too easily or break apart too slowly. Blood clots can narrow arteries and veins or block blood flow completely. This can lead to stroke, heart attack, or damage to the kidneys, lungs, or other parts of the body.
Women are at higher risk of blood clots in the years they can have children (ages 15 to 44) than men of the same age.Some women also have gene mutations (changes in the genes you are born with) that make their blood more likely to clot and put them at higher risk of stroke.
Your family health history, pregnancy, and certain medicines can cause excessive blood clotting. Medicines with the hormone estrogen, such as hormonal birth control or menopausal hormone therapy, can also raise your risk of blood clots. Everyday habits like healthy eating and physical activity can make clots less likely to form. Some people with this condition might also need medicine to prevent clots.
Lupus and rheumatoid arthritis are health problems that affect more women than men. Lupus and rheumatoid arthritis are autoimmune disorders. This means they cause your immune system to attack the tissues and organs in your body, rather than just fighting off infections. Sometimes your heart and blood vessels are the tissues and organs that are attacked.
Because of this damage, you're more likely to have a stroke. If you have lupus or rheumatoid arthritis, treatment can also lower your risk of stroke.
C-reactive protein (CRP) is made by the body and released into the blood in response to swelling. Swelling (or inflammation) is how your body reacts to heal infections or cuts. Swelling can also happen over time in response to high stress levels or poor eating habits. Swelling for infections or cuts will raise your CRP levels for a short time, but swelling that continues for a long time can mean your arteries are damaged, which puts you at risk of stroke.
Women usually have higher CRP levels than men. Also, Hispanic and African-American women have the highest CRP levels.
If you are at borderline risk of stroke, your doctor might test your CRP levels to use as a "tiebreaker." The test will help your doctor decide whether you need to take steps to lower your CRP levels and help prevent stroke. This may include changing your eating habits, getting more physical activity, or taking medicine to treat high blood pressure or high cholesterol.
Source: Office on Women's Health (OWH), U.S. Department of Health and Human Services
Head & Neck Aneurysms
Image by TheVisualMD
Factors outside your control can raise your risk of stroke. Learn what you can do to offset that risk.
As a woman ages, her risk of stroke goes up each year by 10%.
Many women take menopausal hormone therapy to help relieve menopause symptoms such as hot flashes. Results from a large study called the Women's Health Initiative showed that women taking menopausal hormone therapy with estrogen plus progesterone had a higher risk of stroke, serious blood clots, heart attacks, and other serious health problems. The risks were found to be much higher for women 60 years and older.
If you decide to use menopausal hormone therapy, talk to your doctor. The Food and Drug Administration advises women who want to try menopausal hormone therapy to use the lowest dose that works for the shortest time needed.
Having already had a stroke is the biggest risk factor for having another stroke.
Your family history also puts you at risk of a stroke. Your risk of stroke is higher if one of your parents, especially your mother, had a stroke.
If stroke runs in your family, it may be because your family carries genes that raise your risk. An example would be a gene that makes your blood more likely to clot. Talk to your doctor about your family health history.
Women who are black and non-Hispanic are more likely to have a stroke and die from stroke than white women. The reason for this is not totally clear. It is partly because many of the other risk factors for stroke are more common in black women than white women, including diabetes, obesity, high blood pressure, and high cholesterol. Black women are also less likely to get to the hospital in time for treatment with tPA, a clot-busting drug that must be given within 3 to 4½ hours of symptoms starting. Black women are also less likely to be treated with tPA if they do get to the hospital in time.
Some of these risk factors are also more common among women who are American Indian/Alaska Native and Hispanic. No matter your racial or ethnic group, you can take the same steps as any other woman to control your risk factors for stroke.
During and soon after pregnancy, your risk of stroke is higher. Although pregnancy-related stroke is not common, the number of women who have a stroke during or soon after pregnancy is going up. This is likely because more women have other risk factors for stroke, including heart disease, overweight and obesity, and high blood pressure, during pregnancy.
The increased risk of stroke during pregnancy comes from several changes that happen to your body during pregnancy, such as increased blood clotting. Your body also makes more blood during pregnancy. After birth, these changes reverse rapidly, and this can trigger a stroke.
Some women are more at risk of pregnancy-related stroke. You may be more at risk if you already have risk factors for stroke, such as high blood pressure, and you:
The best way to lower the risk of stroke during pregnancy is to control your stroke risk factors before you get pregnant.
Some health problems can happen during pregnancy and raise your risk of stroke later in life:
Having a migraine with aura (seeing bright flashing lights or spots that aren't real) raises your risk of stroke, especially if you are younger than 55 or if you smoke. Women on hormonal birth control pills who have migraine with aura are also at risk of stroke. Researchers are studying whether migraine raises stroke risk for women on other forms of hormonal birth control, like the patch or ring.
However, the overall risk of stroke for otherwise healthy women who get migraine is still low. The type of stroke that happens most often in women with migraine is also less serious. If you have migraine, talk to your doctor about your stroke risk.
Source: Office on Women's Health (OWH), U.S. Department of Health and Human Services
Women's Aging Arteries
Interactive by TheVisualMD
You don't need to become a super athlete or go on a very strict diet to protect your heart and lower your risk of heart disease and stroke. Every woman can take steps every day toward a more heart-healthy lifestyle. And the best part is that being more heart-healthy also lowers your risk of other diseases like cancer and diabetes.
For the most health benefits, you need to get enough aerobic activity to get your heart pumping and do muscle-strengthening activities every week. (Always check with your doctor before starting any regular exercise you are not used to doing.)
You should get at least 30 minutes a day of moderate-intensity aerobic activity, like brisk walking, on most days of the week. The 30 minutes of heart-pumping activity don't have to be all at one time. You can break it up into 10-minute activities throughout the day.
The Physical Activity Guidelines suggest that each week, women get at least:
OR
OR
AND
Making unhealthy food choices can lead to weight gain. But that is not the only risk. Unhealthy eating affects your arteries, blood pressure, glucose level, and many other parts of your heart health. Talk to your doctor or nurse about a heart-healthy eating plan that lowers your risk of heart attack and stroke.
Reaching and staying at a healthy weight will lower your risk of heart disease and stroke. If you already have heart disease, a healthy weight will help you control your disease and prevent heart attack. A slow and steady weight loss is the best way to lose weight and keep it off. Talk to your doctor about how much weight you need to lose and the best ways to do it.
Ask your doctor to check your blood pressure, cholesterol (total, HDL, LDL, and triglycerides) and blood sugar levels. Most insurance plans must cover these tests at no cost to you. These tests will give you important information about your heart health. Your doctor can tell you what your numbers mean and what you need to do to protect your heart.
All women need to know the symptoms of heart attack and stroke and what to do. Make sure your friends and loved ones know how to recognize the symptoms too. If you think you are having a heart attack or stroke, call 911.
Knowing the symptoms and getting help quickly can help you survive a heart attack or stroke and make a full recovery.
If you smoke, get the help you need to quit.
If you drink alcohol, do so in moderation. For women, this means no more than one drink per day.
"One drink" is:
If you don't already drink, don't start drinking for any reason. Moderate drinking is also linked to breast cancer, violence, and injuries. No amount of alcohol is safe during pregnancy.
Stress, anxiety, depression, and lack of sleep can raise your risk of heart disease. Take care of yourself with these steps:
Source: Office on Women's Health (OWH), U.S. Department of Health and Human Services
Walking with an orthosis after a stroke
Image by Orthokin
Stroke is a life-changing event. How long it takes you to recover depends on many factors, including the type of stroke you had, the area of your brain affected, and the amount of brain injury. The recovery process begins at the hospital as soon as you are medically stable. Often, this is within a day of having the stroke. Your doctor will talk to you about next steps. This will involve changes in your everyday habits, medicines, rehabilitation, or surgeries to lower the risk of another stroke.
The first step is to learn all you can about your condition and what to expect during recovery.
Ask your doctor, nurses, or physical or occupational therapist questions about your treatment and rehabilitation. Other stroke survivors can also help with practical tips. You can use the stroke resources on this website.
If you've had a stroke, you're at high risk of having another. As you recover from your stroke, take steps to prevent a second one:
Stroke rehabilitation is a program to help you recover from stroke. Almost all stroke survivors benefit from rehabilitation. However, many women do not join a rehabilitation program for reasons that are not clear. Many women are older at the time of their stroke and often go to assisted-living facilities or hospice after a stroke rather than to a rehabilitation program.1
Most insurance plans must cover stroke rehabilitation, although you may need to pay a copayment, coinsurance, and meet your deductible first. Find out what your insurance will cover, and what benefits you can receive from government programs or from your employer.
After a stroke, you will often recover some function in the first few months. This is part of the body's natural healing process. Women who get stroke rehabilitation:
Also, think about what, if anything, you will need from caregivers at home and what they are able to provide. Who is available to help with your care? How much time can they spend taking care of you? Can they provide financial support?
Set realistic, measureable goals for recovery in each area of your life your stroke affected. Keep in mind that stroke recovery is usually fast in the first few months. Then it may slow down. Having goals will help to motivate you to keep making progress.
Write down your long-term goals and create a timeline for achieving them. Break each one down into steps to make short-term goals.
A stroke can often make you feel powerless. Part of recovery is figuring out how to live as independently as possible. Know that you are likely to face challenges as you adjust to the differences in how your body works.
The road to stroke recovery is often a long one, but focusing on your progress can help you reach your goals.
Source: Office on Women's Health (OWH), U.S. Department of Health and Human Services
Get free access to in-depth articles and track your personal health.
Send this HealthJournal to your friends or across your social medias.