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A stroke occurs when the blood supply to part of the brain is suddenly interrupted due to the presence of a blood clot (ischemic stroke) or when a blood vessel in the brain bursts, spilling blood into the spaces surrounding brain cells (hemorrhagic stroke). Brain cells die when they no longer receive oxygen and nutrients from the blood or when they are damaged by sudden bleeding into or around the brain. This results in temporary or permanent neurologic impairment. Ischemic stroke, also known as cerebral infarction, accounts for 80 percent of all strokes, while hemorrhagic stroke accounts for the other 20 percent. In addition, some people suffer transient ischemic attacks (TIAs), which are mini-strokes that last only 5 to 20 minutes. In almost all TIAs, the symptoms go away within an hour. An estimated 550,000 people in the United States suffer a stroke each year, making this one of the most serious of all health problems. Half of stroke sufferers are left disabled, with many undergoing years of rehabilitation.

Signs and Symptoms

Symptoms of stroke appear suddenly. If you notice any of these signs and symptoms, seek emergency medical help immediately for yourself or for someone you are with.

bulletNumbness or weakness of the face, arm, or leg, especially on one side of the body
bulletConfusion, trouble talking, or difficulty understanding speech
bulletTrouble seeing in one or both eyes
bulletTrouble walking, dizziness, or loss of balance or coordination; sudden severe headache with no known cause

What Causes It?

Ischemic stroke results from the following causes.

bulletA clot (embolus) forms in a part of the body other than the brain, travels through blood vessels, and becomes wedged in a brain artery.
bulletA blood clot (thrombus) forms in a brain artery and stays attached to the artery wall until it grows large enough to block blood flow

Hemorrhagic stroke results from the following causes.

bulletA bleeding aneurysm—a weak or thin spot on an artery wall that over time has stretched or ballooned out under pressure from blood flow. The wall ruptures and blood spills into the space surrounding brain cells.
bulletArtery walls lose their elasticity and become brittle and thin, prone to cracking
bulletArteriovenous malformation (AVM)—a tangle of defective blood vessels and capillaries within the brain that have thin walls that can rupture

Who's Most At Risk?

Individuals with the following characteristics or health conditions are at a higher-than-average risk for developing a stroke.

bulletMore men suffer strokes than women
bulletAfrican or Japanese Americans are at higher risk
bulletTIAs, history of stroke
bulletAge (risk increases with age)
bulletHeart disease
bulletTraumatic injury
bulletSubstance abuse (cocaine, alcohol)
bulletHigh total serum cholesterol (for older patients)
bulletIncreased blood viscosity (thickness)
bulletUse of oral contraceptives, especially in smokers

What to Expect at Your Provider's Office

If you or someone you know experiences symptoms associated with stroke, call 911 emergency immediately. There are now effective therapies for stroke that must be administered at a hospital within the first three hours after stroke symptoms appear. At the hospital, a health care provider will make a diagnosis and guide you in determining which treatment or combination of therapies will work best for you. He or she will do a complete neurological exam and run a battery of tests, such as blood tests, an electrocardiogram, and a test to measure the severity of the stroke. Imaging techniques such as CT scans, magnetic resonance imaging (MRI), and magnetic resonance angiography(MRA) may be used to reveal the cause of the stroke and pinpoint blockages or reveal malformations.

Treatment Options


Daily use of aspirin may reduce recurrence of stroke. Proper treatment of conditions that lead to stroke, such as atrial fibrillation or diabetes, can also reduce the risk of having one.

Treatment Plan

The primary goal in treating stroke patients is to prevent any neurological impairment from becoming irreversible. The therapeutic window is extremely short, making it crucial for an individual to seek treatment immediately upon noticing signs or symptoms.

Drug Therapies

A wide range of therapeutic measures may be administered to stroke patients, depending on the type and location of stroke and the extent of damage suffered. Many of these involve restoring proper blood flow to the brain.

Your provider may also prescribe medications, such as the following.

bulletAntithrombotics, to prevent the formation of blood clots that can become lodged in a cerebral artery and cause strokes; these include antiplatelet drugs and anticoagulants
bulletThrombolytic agents, to halt the stroke by dissolving the blood clot that is blocking blood flow to the brain
bulletNeuroprotectants, to protect the brain from secondary injury caused by stroke

Surgical and Other Procedures

Surgery can be used to prevent stroke, to treat acute stroke, or to repair vascular damage or malformations in and around the brain. There are two major types of surgery for stroke prevention and treatment.

bulletCarotid endarterectomy involves removing fatty deposits (plaque) from the inside of one of the carotid arteries, which are located in the neck and are the main suppliers of blood to the brain.
bulletEC/IC bypass surgery restores blood flow to a blood-deprived area of brain tissue by rerouting a healthy artery in the scalp to the area of brain tissue affected by a blocked artery.

Complementary and Alternative Therapies

The goals of complementary and alternative therapies are to prevent strokes, treat risk factors (hypertension, diabetes, and cardiovascular disease), and prevent recurrences.


Nutritional tips include the following.

bulletEat a diet high in fiber, potassium, and magnesium
bulletDecrease saturated fats and sodium
bulletAvoid alcohol (it increases risk of hemorrhagic stroke)
bulletUse garlic and onion (help regulate lipids and prevent atherosclerosis, which is fat deposits inside the arteries)

Potentially beneficial nutritional supplements include the following.

bulletFolate (400 to 800 IU a day)
bulletEssential fatty acids; a mix of omega-6 (evening primrose) and omega-3 (flaxseed) may be optimal (2 tablespoons oil a day or 1,000 to 1,500 IU two times a day)
bulletVitamin E: 400 to 1,600 IU a day
bulletCoenzyme Q10: 10 to 50 mg a day
bulletVitamin C: 1,000 mg three times a day
bulletBromelain: 250 mg three times a day between meals


The use of certain herbal remedies may be helpful.

bulletGingko biloba, for depression and/or dementia following a stroke (60 to 80 mg three times a day). It may also be used for arterial occlusive disease. For hemorrhagic stroke patients, check with your health care provider before using.
bulletHawthorn (Crataegus species), for heart and vascular conditions
bulletMistletoe (Viscum album), to treat and prevent atherosclerosis

Herbs may be used as dried extracts (pills, capsules, or tablets), teas, or tinctures (alcohol extraction, unless otherwise noted). Dose for teas is 1 heaping tsp. herb/cup water steeped for 10 minutes (roots need 20 minutes).


An experienced homeopath can prescribe a regimen for treating stroke that is designed especially for you. Some of the most common acute remedies are listed below.

bulletAcontitum napellus for numbness and/or paralysis after a cerebral accident
bulletBelladonna for stroke that leaves person very sensitive to any motion, with vertigo and trembling
bulletKali bromatum for stroke resulting in restlessness, wringing of the hands or other repeated gestures, insomnia, and night terrors
bulletNux vomica for cerebral accident with paresis (muscular weakness caused by disease of the nervous system), expressive aphasia (language disorder), convulsions, and great irritability

Acute dose is three to five pellets of 12X to 30C every one to four hours until symptoms are relieved.


Acupuncture may be helpful for rehabilitation.

Prognosis/Possible Complications

There are many possible complications associated with stroke.

bulletCognitive (thinking) deficits
bulletSpeech problems
bulletEmotional difficulties
bulletDaily living problems

About 70 percent of stroke sufferers survive. They often undergo a long period of rehabilitation, involving physical and occupational therapies. About 80 percent of stroke patients can walk and 60 percent achieve self-care, while 25 percent experience moderate to severe impairment.

Following Up

Following hospitalization, stroke patients must be carefully monitored for potential recurrence.

Supporting Research

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Dambro MR. Griffith's 5-Minute Clinical Consult. 1999 ed. Baltimore, Md: Lippincott Williams & Wilkins, Inc.; 1999.

Fauci AS, Braunwald E, Isselbacher KJ, et al, eds. Harrison's Principles of Internal Medicine. 14th ed. New York, NY: McGraw-Hill; 1998.

Gruenwald J, Brendler T, Jaenicke C, eds. PDR for Herbal Medicines. Montvale, NJ: Medical Economics Company; 1998:779-81, 1219-22.

Kane E. Stroke. American Association of Naturopathic Physicians. Accessed at on July 29, 1999.

Kaplan HW, ed. Comprehensive Textbook of Psychiatry. 6th ed. Baltimore, Md: Williams & Wilkins; 1995.

Morrison R. Desktop Guide to Keynotes and Confirmatory Symptoms. Albany, Calif: Hahnemann Clinic Publishing; 1993:3-6, 58-62, 198-199, 272-276.

Rakel RE, ed. Conn's Current Therapy. 50th ed. Philadelphia, Pa: W.B. Saunders; 1998.

Rosen P, ed. Emergency Medicine: Concepts and Clinical Management. 4th ed. St. Louis, Mo: Mosby-Year Book; 1998.

Swain RA, St Clair L. The role of folic acid in deficiency states and prevention of disease. J Fam Pract. 1997;44(2):138-144.