Stroke Awareness Foundation Blog

A naturally occurring substance shrank the size of stroke-induced lesions in the brains of experimental mice — even when administered as much as 12 hours after the event, Stanford University School of Medicine researchers have shown. The substance, alpha-B-crystallin (a major structural protein that is constantly created in the heart and other tissues, including the brain), acts as a brake on the immune system, lowering levels of inflammatory molecules whose actions are responsible for substantial brain damage above and beyond that caused by the initial oxygen deprivation of a stroke.

The finding, which will be published online today in Proceedings of the National Academy of Sciences, is of great potential significance. Every year brings nearly 800,000 new stroke patients in North America. “That’s one every 40 seconds,” said Gary Steinberg, MD, PhD, director of Stanford’s Institute for Neuro-Innovation and Translational Neurosciences and one of the study’s two senior authors.

The largest single cause of severe neurological disability and the third-leading cause of death in the United States, stroke accounts for an estimated $74 billion annually in related costs, including treatment and additional assistance for the three of every four stroke patients whose ability to perform the activities of daily life is impaired. Strokes are caused by a sudden drop in the flow of blood to the brain resulting from a clot or, less often, bleeding. One of every three stroke patients is under the age of 65. In all, there are 5.4 million stroke survivors in the United States and 15 million worldwide.

The only currently approved drug for stroke — tissue plasminogen activator, or tPA — dissolves clots that keep oxygenated blood from reaching brain tissue. To be effective, tPA must be administered within about 4.5 hours after the stroke. But patients’ brains must first be scanned to rule out the possibility that the stroke was caused by bleeding, which tPA would exacerbate, rather than by blockage

Alpha-B-crystallin appears to act as a sponge, sopping up those bad actors and stopping inflammation from making a bad situation worse. Growing evidence suggests that alpha-B-crystallin can help curb inflammatory activity in the brain.

Four out of five families will be somehow affected by stroke over the course of a lifetime, and it is the leading cause of disability among adults in the U.S. Here are some risk factors, some that you cannot control, and others that you can!

What Are the Risk Factors of Stroke I Can’t Control?

• Increasing Age: Stroke affects people of all ages, but the older you are, the greater your stroke risk.
• Gender: In most age groups, more men than women have stroke, but more women die from stroke.
• Heredity and Race: People whose close blood relations have had a stroke have higher risk of stroke. African Americans and Hispanic Americans have the highest risk of stroke.
• Prior Stroke: Someone who has had a stroke is at a higher risk of having another one.

What Risk Factors Can I Change or Treat?

• High Blood Pressure: This is the single most important risk factor for stroke because it’s the No. 1 cause of stroke. Know your blood pressure and have it checked at least once every two years. If it’s consistently 140/90 or above, it’s high. Talk to your doctor about how to control it.
• Tobacco Use: Don’t smoke cigarettes or use other forms of tobacco. Tobacco use damages blood vessels.
• Diabetes Mellitus: Having diabetes increases your risk for stroke because it can cause disease of blood vessels in the brain. The risk of stroke is 2 1/2 times higher in people with diabetes.
• High Blood Cholesterol: High blood cholesterol increases the risk of clogged arteries. If an artery leading to the brain becomes blocked, a stroke can result.
• Physical Inactivity and Obesity: Being inactive, obese, or both can increase your risk of cardiovascular disease.
• Excessive Alcohol Intake: Drinking an average of more than one drink per day for women or more than two drinks a day for men raises blood pressure. Binge drinking can lead to stroke.
• Illegal Drug Use: Intravenous drug use carries a high risk of stroke. Cocaine use has also been linked to stroke.
• Poor Diet: Care about what you put in your body! Eat healthy and exercise regularly!
• Lack of Stroke Knowledge: Fewer than half of all individuals over 50 are actually aware of what stroke is, its signs and symptoms, and the importance of seeking immediate medical attention. Know the signs and call 911 immediately.

Emotional distress, especially anxiety, frustration, and depression are common problems after stroke regardless of the age it occurs. Many who experience this have no prior history of depression, and experts are still unsure if it is caused by biological factors provoked by the brain injury or if it is a secondary psychological response to the physical, cognitive, and social impairments produced by the stroke. The first thing that a caregiver or a family member can do is make sure that the stroke victim sees a professional for evaluation and potential treatment for depression. The important thing to remember is that depression is a common and understandable response to the loss and impairment that is produced by the stroke. Taking care of a loved one who has had a stroke can be difficult, so seek professional psychological aid and stay hopeful!

Although stroke is far more common among older adults than among young people, stroke can occur at all ages. The rising rates of obesity, diabetes, and high blood pressure in young adults could be to blame for the growing trend of stroke under age 50. Although ischemic stroke makes up nearly 85% of all strokes, intracerebral and subarachnoid hemorrhages are more common in young adults.

An intracerebral hemorrhage occurs when a diseased blood vessel within the brain bursts, allowing blood to leak inside the brain. The sudden increase in pressure within the brain can cause damage to the brain cells surrounding the blood. The most common cause of this type of hemorrhage is high blood pressure (hypertension). Because high blood pressure by itself often causes no symptoms, many people who experience this are not aware they even have high blood pressure, or that it needs to be treated. Signs include an intense headache and loss of consciousness.

A subarachnoid hemorrhage occurs when a blood vessel just outside the brain ruptures. The area of the skull surrounding the brain (the subarachnoid space) rapidly fills with blood. This hemorrhage is most often caused by abnormalities of the arteries at the base of the brain, called cerebral aneurysms. These are small areas of rounded or irregular swellings in the arteries. Where the swelling is most severe, the blood vessel wall becomes weak and prone to rupture. The signs of subarachnoid hemorrhages include sudden, intense headaches, neck pain, and nausea or vomiting. Sometimes this is described as the worst headache of one’s life. The sudden buildup of pressure outside the brain may also cause rapid loss of consciousness.

It is common for stroke survivors and their spouses to wonder when intimacy can be brought back into their relationships. There is no right answer. It is usually best for the couple to talk to their primary care physician: First to find out if it’s safe, and second, each situation is unique to the individual, the couple and the circumstances. Many couples do end up talking to a neuropsychologist which can be extremely helpful.