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Stroke (Cerebrovascular Accident)

A stroke occurs if the flow of oxygen-rich blood to a portion of the brain is blocked. Without oxygen, brain cells start to die after a few minutes. Sudden bleeding in the brain also can cause a stroke if it damages brain cells.

PubMed Health Glossary
(Source: NIH - National Heart, Lung, and Blood Institute)

About Cerebrovascular Accident (Stroke)

A stroke occurs if the flow of oxygen-rich blood to a portion of the brain is blocked. Without oxygen, brain cells start to die after a few minutes. Sudden bleeding in the brain also can cause a stroke if it damages brain cells.

If brain cells die or are damaged because of a stroke, symptoms occur in the parts of the body that these brain cells control. Examples of stroke symptoms include sudden weakness; paralysis or numbness of the face, arms, or legs (paralysis is an inability to move); trouble speaking or understanding speech; and trouble seeing.

A stroke is a serious medical condition that requires emergency care. A stroke can cause lasting brain damage, long-term disability, or even death.

If you think you or someone else is having a stroke, call 9-1-1 right away. Do not drive to the hospital or let someone else drive you. Call an ambulance so that medical personnel can begin life-saving... Read more about Stroke

What works? Research summarized

Evidence reviews

Rehabilitation at Home After Early Supported Discharge (ESD) for Elderly Patients After Stroke [Internet]

Anticoagulants for preventing stroke in patients with nonrheumatic atrial fibrillation and a history of stroke or transient ischaemic attack

Anticoagulants are beneficial and safe for preventing a second stroke in people with nonrheumatic atrial fibrillation and recent cerebral ischaemia. Nonrheumatic atrial fibrillation (NRAF) is a heart rhythm disorder commonly found in patients who have had a stroke. Patients with NRAF have an irregular heart beat and this can cause the formation of a blood clot in the left atrium of the heart . This clot may break away and block a cerebral artery causing a stroke. Patients who have had a stroke in the presence of NRAF have a high risk of another stroke. Anticoagulant drugs, such as warfarin, make the blood 'thinner' and prevent the formation of blood clots and hence could prevent stroke. However, anticoagulant drugs may also cause bleeding in the brain and this complication could offset any benefits. This review identified two trials in which patients with NRAF who had a stroke were treated with anticoagulant therapy. These studies show that anticoagulants safely reduce the risk of recurrent stroke by two‐thirds, despite a higher chance of major extracranial bleeds. There was no increased risk of intracranial bleeds.

Anticoagulants versus antiplatelet therapy for preventing stroke in patients with nonrheumatic atrial fibrillation and a history of stroke or transient ischemic attack

Anticoagulants are more effective than antiplatelet drugs to prevent a second stroke in people with atrial fibrillation. Nonrheumatic atrial fibrillation (NRAF) is a heart rhythm disorder commonly found in patients who have had a stroke. Patients with NRAF have an irregular heart beat. This can cause the formation of a blood clot in the left atrium of the heart. This clot may break away and block a cerebral artery, thus causing a stroke. Patients who have had a stroke in the presence of NRAF have a high risk of another stroke. Anticoagulant drugs, such as warfarin, make the blood 'thinner' and prevent the formation of blood clots and hence could prevent stroke. However, anticoagulant drugs may also cause bleeding in the brain and this complication could offset any benefits. Aspirin may be a safer alternative. This review identified two trials in which patients with NRAF who had a stroke were treated with anticoagulants or antiplatelet therapy. These studies show that anticoagulants are superior to antiplatelet agents to reduce the risk of recurrent stroke.

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Summaries for consumers

Anticoagulants for preventing stroke in patients with nonrheumatic atrial fibrillation and a history of stroke or transient ischaemic attack

Anticoagulants are beneficial and safe for preventing a second stroke in people with nonrheumatic atrial fibrillation and recent cerebral ischaemia. Nonrheumatic atrial fibrillation (NRAF) is a heart rhythm disorder commonly found in patients who have had a stroke. Patients with NRAF have an irregular heart beat and this can cause the formation of a blood clot in the left atrium of the heart . This clot may break away and block a cerebral artery causing a stroke. Patients who have had a stroke in the presence of NRAF have a high risk of another stroke. Anticoagulant drugs, such as warfarin, make the blood 'thinner' and prevent the formation of blood clots and hence could prevent stroke. However, anticoagulant drugs may also cause bleeding in the brain and this complication could offset any benefits. This review identified two trials in which patients with NRAF who had a stroke were treated with anticoagulant therapy. These studies show that anticoagulants safely reduce the risk of recurrent stroke by two‐thirds, despite a higher chance of major extracranial bleeds. There was no increased risk of intracranial bleeds.

Anticoagulants versus antiplatelet therapy for preventing stroke in patients with nonrheumatic atrial fibrillation and a history of stroke or transient ischemic attack

Anticoagulants are more effective than antiplatelet drugs to prevent a second stroke in people with atrial fibrillation. Nonrheumatic atrial fibrillation (NRAF) is a heart rhythm disorder commonly found in patients who have had a stroke. Patients with NRAF have an irregular heart beat. This can cause the formation of a blood clot in the left atrium of the heart. This clot may break away and block a cerebral artery, thus causing a stroke. Patients who have had a stroke in the presence of NRAF have a high risk of another stroke. Anticoagulant drugs, such as warfarin, make the blood 'thinner' and prevent the formation of blood clots and hence could prevent stroke. However, anticoagulant drugs may also cause bleeding in the brain and this complication could offset any benefits. Aspirin may be a safer alternative. This review identified two trials in which patients with NRAF who had a stroke were treated with anticoagulants or antiplatelet therapy. These studies show that anticoagulants are superior to antiplatelet agents to reduce the risk of recurrent stroke.

Interventions for apraxia of speech following stroke

No evidence was found for the treatment of apraxia of speech, a communication disorder that can affect stroke patients. Patients with apraxia of speech know what they want to say, but are unable to carry out the speech movements due to their inability to programme the required sequence. For example, a patient may be able to say goodbye when leaving someone (automatic), but not when asked to say goodbye out of context (volitional). Several types of treatment interventions have been identified; however, we were unable to find any clinical trials of these.

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Terms to know

Blood
A tissue with red blood cells, white blood cells, platelets, and other substances suspended in fluid called plasma. Blood takes oxygen and nutrients to the tissues, and carries away wastes.
Brain
The part of the central nervous system that is contained within the skull (cranium).
Hemorrhage
In medicine, loss of blood from damaged blood vessels. A hemorrhage may be internal or external, and usually involves a lot of bleeding in a short time.
Oxygen
A colorless, odorless gas. It is needed for animal and plant life. Oxygen that is breathed in enters the blood from the lungs and travels to the tissues.

More about Stroke

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Also called: Brain attack

Other terms to know: See all 4
Blood, Brain, Hemorrhage

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