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Stroke 

In the United States, about 795,000 people suffer a stroke each year. Someone has a stroke every 40 seconds, and every 4 minutes someone dies from stroke. There are more than 140,000 deaths each year from stroke 

Stroke is also the leading cause of serious long-term disability in the United States. There are over 7 million stroke survivors live in United States and two-thirds of them are currently disabled. Around 25% of people who recover their first stroke will have another within 5 years.

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Symptoms and Signs:

To recognize early symptoms and onset of stroke, remember BEFAST. Loss of balance, vision problems, facial asymmetry, weakness in an arm or leg, and slurred speech or any other neurological deficit should alert one to think of stroke and because time is of essence in the management of stroke, it is important to act FAST and call for help. 

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Stroke Prevention:

Good news is that 80% of stroke is preventable. In order to prevent stroke, all risk factors for ischemic (accounting for over 85% stroke) as well as hemorrhagic (accounting for about 15%) stroke must be controlled. 

Strategies to reduce stroke risk:

  1. Reduce cardiovascular risk

    • Maintain normal blood pressure ​

    • Maintain normal cholesterol

    • Strive for healthy aging 

    • Avoid excessive alcohol used 

    • Look for secondary causes such as abnormal heart rhythm and get preventative treatment. Most common abnormal heart rhythm which can lead o stroke is atrial fibrillation. 

  2. Reduce diabetes risk

    • Maintain a normal body weight​

    • Avoid high sugar and carbs 

    • Get routine diabetes screening 

  3. Stop smoking

  4. Adopt a healthy lifestyle  

    • Eat a whole foods plant based diet​

    • Exercise on a regular basis

    • Adopt stress reduction techniques

    • Main good sleep habits

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Stroke in the absence of common and obvious risk factors:

About 20-30% stroke occurs in the absence of common or obvious risk factors. Some of these risk factors or predisposing conditions are listed below. Knowledge of these risk factors and predisposing conditions and subsequent screening, evaluation and intervention to mitigate risk. 

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  1. Autoimmune diseases - Immune mediated inflammatory diseases such as lupus, rheumatoid arthritis, sjogren disease, vasculitis and many other disorders can increase the risk of stroke. 

  2. Connective tissue disorders  - These include conditions such as Marfan syndrome and Ehlers Danlos syndrome which are hereditary conditions.

  3. Chronic infections - Certain infections such as syphilis, tuberculosis and chronic viral or parasitic infections can increase the risk of stroke. 

  4. Cancer and metastatic disease - Cancer, specially metastatic cancer can increase clot formation and therefore can increase the risk of stroke. 

  5. Clotting disorders - Certain clotting disorders can increase the risk of stroke. Specific conditions include protein C, S, factor V leiden and antithrombin 3 deficiency. 

  6. Illicit drugs/substances - Illicit substances such as cocaine, heroin, amphetamine etc. can increase stroke risk. 

  7. Structural anomalies - Congenital conditions which involve the vasculature supplying to the brain can also increase the risk of stroke. 

  8. Cryptogenic stroke - This is a situation where no identifiable cause is found out. 

  9. PFO - patent forman ovale - 20-25 % healthy population has PFO or a structural  defect in heart. Most people do not get stroke merely because of the presence of PFO but their risk increases in the presence of an underlying disorder such as atrial fibrillation, clotting disorder etc. 

  10. Pregnancy - Although rare, certain complications of pregnancy can also increase risk of stroke. This is perhaps because pregnancy is a hypercoagulable or clot enhancing condition. 

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