Health Encyclopedia

Stroke secondary to atherosclerosis

Definition

Stroke secondary to atherosclerosis refers to loss of neurologic functions (brain attack), which occurs because of atherosclerosis.

Causes, incidence, and risk factors

Stroke secondary to atherosclerosis affects about 2 out of 1,000 people, or approximately 50% of all those who have strokes.

Atherosclerosis (hardening of the arteries) occurs when sticky, fatty substances called plaque build up in the inner lining of the arteries. The plaque may slowly block or narrow an artery or trigger a clot (thrombus). Clots can lead to stroke.

Risks for stroke secondary to atherosclerosis include:

History of high blood pressure (hypertension)
Peripheral vascular disease
Smoking
Transient ischemic attacks or other cerebrovascular disease
High cholesterol
High levels of homocysteine
Diabetes
Obesity
Sedentary lifestyle
Kidney disease requiring dialysis

Symptoms

Weakness or total inability to move a body part
Numbness, loss of sensation
Tingling or other abnormal sensations
Decreased or loss of vision, which may be partial and/or temporary
Language difficulties (aphasia)
Inability to recognize or identify sensory stimuli (agnosia)
Loss of memory
Facial paralysis
Eyelid drooping
Vertigo (abnormal sensation of movement)
Loss of coordination
Swallowing difficulties
Personality changes
Mood and emotion changes
Urinary incontinence (lack of control over bladder)
Lack of control over the bowels
Consciousness changes:
- Sleepiness
- Stupor
- Lethargy
- Coma
- Unconsciousness

Signs and tests

Testing is the same as for stroke. Blood tests may show high cholesterol levels.

Other tests and procedures that may be performed include:

Head CT scan
Head MRI
ECG (electrocardiogram)
Echocardiogram (looks for a cardiac embolus)
Carotid duplex (ultrasound)
Transcranial Doppler (looks at blood vessels inside the brain)

Treatment

Go to the emergency room as quickly as possible if you believe you have had or may be having a stroke. Stroke is an acute, serious condition that should be treated immediately. The most important factor in effective treatment for stroke is arriving at the hospital as early as possible from the onset of symptoms.

The most effective treatment for stroke is intravenous rtPA. This medicine works to dissolve the clot causing the stroke. If received within 3 hours of the first stroke symptoms, the drug can help prevent permanent problems. There is risk of serious bleeding with this treatment so it cannot be used in all cases.

Patients who can't be treated with clot-busting drugs will receive supportive treatments such as medicines to control blood pressure and high cholesterol, fluids, and medicines to prevent complications such as infections.

Patients may also need physical therapy following stroke. Diet changes may be recommended.

A carotid endarterectomy (removal of plaque from the carotid arteries) may be needed by some people to prevent new strokes.

Expectations (prognosis)

Twenty-five percent of people who have a stroke recover most or all of their function.

However, stroke and its complications can cause death.

Complications

Pressure sores
Permanent loss of movement or sensation of a part of the body
Orthopedic complications, fractures, contractures, muscle spasticity
Permanent loss of cognitive functions
Disruption of communication, decreased social interaction
Decreased ability to function or care for self
Decreased life span
Multi-infarct dementia
Side effects of medications

Calling your health care provider

Go to the emergency room or call the local emergency number (such as 911) if symptoms occur indicating a stroke.

Prevention

The prevention of stroke secondary to atherosclerosis includes control of risk factors. Hypertension, diabetes, heart disease, and other risk factors should be treated as appropriate.

If you smoke, you should stop.

Treatment of TIA can prevent some strokes.

Aspirin therapy (81mg a day or 100mg every other day) is now recommended for stroke prevention in women under 65 as long as the benefits outweigh the risks. It should be considered for women over age 65 only if their blood pressure is controlled and the benefit is greater than the risk of gastrointestinal bleeding and brain hemorrhage.

References

Mosca L, Banka CL, Benjamin EJ, et al. Evidence-Based Guidelines for Cardiovascular Disease Prevention in Women: 2007 Update. Circulation. 2007; Published online before print February 19, 2007.

Review Date:2/20/2007
Reviewed By:Updated by: A.D.A.M. Editorial Team: Greg Juhn, M.T.P.W., David R. Eltz, Kelli A. Stacy. Previously reviewed by Daniel Kantor, M.D., Director of the Comprehensive MS Center, Neuroscience Institute, University of Florida Health Science Center, Jacksonville, FL. Review provided by VeriMed Healthcare Network. (April 2006)

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