Are You at Risk for a Stroke?

Stroke screening and other preventive measures explained

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

Certain lifestyle and genetic factors can greatly increase the risk for stroke. The good news is that routine screening may be able to help.

The American Heart Association estimates that 1 out of 6 people will experience a stroke in his or her lifetime.

In some cases, a stroke may be preventable. However, some stroke risk factors can't be avoided.

"The main way to stay on top of stroke is by staying on top of risk factors," said Chaouki Khoury, MD, director of neurology education and research at Baylor University Medical Center in Dallas and an associate professor of neurology at Texas A&M, in an interview with dailyRx News.

The presence of stroke risk factors does not mean that a person will necessarily have a stroke. The absence of these risk factors also does not mean that a person cannot have a stroke.

Dr. Khoury gave some advice on when to screen for stroke.

Different Strokes

A stroke is a condition in which the blood flow to the brain stops and brain cells quickly begin to die.

Most strokes — around 85 percent, according to the Mayo Clinic — are ischemic strokes. The cause of an ischemic stroke is a blood clot that has blocked a blood vessel in the brain.

The cause of a hemorrhagic stroke — a less common type of stroke — is a blood vessel that breaks and bleeds into the brain.

Weakness, numbness or loss of coordination, often on one side of the body, are among the symptoms of stroke. Stroke patients may also have severe headaches or trouble speaking, understanding speech and seeing.

A stroke is a medical emergency.

"The longer you wait, the more brain cells are dying," Dr. Khoury said. "So you need to call 911 as soon as these things happen."

Stroke Screening

"In terms of screening for strokes, there is no screening for stroke itself," Dr. Khoury said. "You screen for the risk factors of stroke."

According to the Mayo Clinic, the risk factors for stroke include medical issues like high blood pressure, high cholesterol and diabetes.

Being overweight, heavy drinking and physical inactivity may also increase stroke risk. These factors can cause blood vessel damage, increase blood pressure and make blood more likely to clot — all potential risk factors for stroke.

"People need to be screened for blood pressure, and that is something you do routinely at your annual physical," Dr. Khoury said. "People need to be checked for diabetes, and depending on what their symptoms are, depending on their family history, that is something their primary care physician would decide on."

Cholesterol needs to be monitored as well — something that may be also routinely checked by a doctor as a patient ages, according to Dr. Khoury.

Cholesterol is a compound found in most body tissues, including the blood and the nerves. Cholesterol has two forms: HDL ("good") cholesterol and LDL ("bad") cholesterol.

"It's basically your primary care provider who is going to be the one screening you for the risk factors of stroke, but there is no scan that you can do to screen for stroke itself," Dr. Khoury said.

Exceptions to the Rule

There may be some cases that call for more specific stroke-prevention screening. These typically involve concern over hemorrhagic strokes. Hemorrhagic strokes may develop due to aneurysms (bulging or weak areas in an artery) in the brain.

"For hemorrhagic strokes, those who have a family history of aneurysms or malformations and stuff like that can be screened by looking at their blood vessels," Dr. Khoury said. "It is not routinely recommended to do that — it depends on what your symptoms are."

A patient's doctor may recommend further steps, such as endovascular coiling — which helps prevent blood flow to an aneurysm. This is meant to stop it from bursting and keep a stroke from occurring, according to Johns Hopkins Medicine (JHM).

JHM noted that this procedure is not without risk, and may lead to serious complications — including infection and even stroke.

Another procedure called carotid endarterectomy — which removes plaque that has built up in the arteries — may also be used to prevent stroke.

"This buildup of plaques (atherosclerosis) may restrict blood flow to your brain," according to the Mayo Clinic. "Removing plaques causing the narrowing in the artery can improve blood flow in your carotid artery and reduce your risk of stroke."

The Mayo Clinic noted that this procedure is also not without risk and is only recommended in certain cases, such as when a patient's arteries are more than 60 percent blocked.

Whether a patient has special risk factors or a family history of stroke, or if the patient just wants to be aware of stroke risk factors — communication with a doctor is key.

"The good news is that strokes can be treated and prevented, and many fewer Americans die of stroke now than even 15 years ago," according to the Mayo Clinic.

Review Date: 
May 13, 2015