According to the Centers for Disease Control and Prevention (CDC)Trusted Source, over 795,000 people in the United States have a stroke every year, and around 610,000 are first strokes. In 2019, stroke was the leading cause of mortality globally, accounting for 11% of deaths. There are three main types of stroke. The first and most […]
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Cancer Cancer is one of our nation’s most feared diseases, with more than 1.6 million new cases diagnosed each year. But thanks to National Institute of Health (NIH) research, this number is now falling. Between 1991 and 2014, #cancer death rates went down 25 percent. NIH research has transformed the way we think about cancer […]
According to the Centers for Disease Control and Prevention (CDC)Trusted Source, over 795,000 people in the United States have a stroke every year, and around 610,000 are first strokes. In 2019, stroke was the leading cause of mortality globally, accounting for 11% of deaths. There are three main types of stroke. The first and most […]
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Cancer Cancer is one of our nation’s most feared diseases, with more than 1.6 million new cases diagnosed each year. But thanks to National Institute of Health (NIH) research, this number is now falling. Between 1991 and 2014, #cancer death rates went down 25 percent. NIH research has transformed the way we think about cancer […]
According to the Centers for Disease Control and Prevention (CDC)Trusted Source, over 795,000 people in the United States have a stroke every year, and around 610,000 are first strokes.
In 2019, stroke was the leading cause of mortality globally, accounting for 11% of deaths.
There are three main types of stroke. The first and most common, accounting for 87% of cases, is an ischemic stroke. It occurs when blood flow through the artery that supplies oxygen to the brain becomes blocked.
The second is a hemorrhagic stroke, caused by a rupture in an artery in the brain, which in turn damages surrounding tissues.
The third type of stroke is a transient ischemic attack (TIA, which is sometimes called a “ministroke.” It happens when blood flow is temporarily blocked to the brain, usually for no more than 5 minutes.
While stroke is very common, it is often misunderstood. To help us dispel myths on the topic and improve our understanding, we got in touch with Dr. Rafael Alexander Ortiz, chief of Neuro-Endovascular Surgery and Interventional Neuro-Radiology at Lenox Hill Hospital.
1. Stroke is a problem of the heart
Although stroke risk is linked to cardiovascular risk factors, strokes happen in the brain, not the heart.
“Some people think that stroke is a problem of the heart,” Dr. Ortiz told MNT. “That is incorrect. A stroke is a problem of the brain, caused by the blockage or rupture of arteries or veins in the brain, and not the heart.”
Some people confuse stroke with a heart attack, which is caused by a blockage in blood flow to the heart, and not the brain.
2. Stroke is not preventable
“The most common risk factors [for stroke] include hypertension, smoking, high cholesterol, obesity, diabetes, trauma to the head or neck, and cardiac arrhythmias,” said Dr. Ortiz.
Many of these risk factors can be modified by lifestyle. Exercising regularly and eating a healthy diet can reduce risk factors such as hypertension, high cholesterol, obesity, and diabetes.
Other risk factors include alcohol consumption and stress. Working to reduce or remove these lifestyle factors may also reduce a person’s risk of stroke.
3. Stroke does not run in families
Single-gene disorders such as sickle cell disease increase a person’s risk for stroke.
Genetic factors including a higher risk for high blood pressure and other cardiovascular risk factors may also indirectly increase stroke risk.
As families are likely to share environments and lifestyles, unhealthy lifestyle factors are likely to increase stroke risk among family members, especially when coupled with genetic risk factors.
4. Stroke symptoms are hard to recognize
The most common symptoms for stroke form the acronym “F.A.S.T.“:
F: face dropping, when one side of the face becomes numb and produces an uneven “smile”
A: arm weakness, when one arm becomes weak or numb and, when raised, drifts slowly downward
S: speech difficulty, or slurred speech
T: time to call 911
Other symptoms of stroke include:
numbness or weakness in the face, arm, leg, or one side of the body
confusion and trouble speaking or understanding speech
difficulty seeing in one or both eyes
difficulty walking, including dizziness, loss of balance and coordination
severe headaches without a known cause
5. Stroke cannot be treated
“There is an incorrect belief that strokes are irreversible and can’t be treated,” explained Dr. Ortiz.
“Emergency treatment of a stroke with injection of a clot busting drug, minimally invasive mechanical thrombectomy for clot removal, or surgery can reverse the symptoms of a stroke in many patients, especially if they arrive to the hospital early enough for the therapy (within minutes or hours since the onset of the symptoms),” he noted.
“The longer the symptoms last, the lower the likelihood of a good outcome. Therefore, it is critical that at the onset of stroke symptoms — ie. trouble speaking, double vision, paralysis or numbness, etc — an ambulance should be called (911) for transport to the nearest hospital,” he continued.
Research also shows that those who arrive within 3 hours of first experiencing symptoms typically have less disability 3 months afterward than those who arrived later.
6. Stroke occurs only in the elderly
Age is a significant risk factor for stroke. Stroke risk doubles every 10 years after age 55. However, strokes can occur at any age.
One study examining healthcare data found that 34% of stroke hospitalizations in 2009 were under age 65.
A review in 2013 points out that “approximately 15% of all ischemic strokes occur in young adults and adolescents.”
The researchers noted that stroke risk factors including hypertension, diabetes, obesity, lipid disorders, and tobacco use were among the most common co-existing conditions among this age group.
7. All strokes have symptoms
Not all strokes have symptoms, and some research suggests that symptom-free strokes are far more common than those with symptoms.
One study found that out of the over 11 million strokes in 1998, 770,000 presented symptoms, whereas close to 11 million were silent.
Evidence of these so-called silent strokes appears on MRI scans as white spots from scarred tissue following a blockage or ruptured blood vessel.
Often, silent strokes are identified when patients receive MRI scans for symptoms including headaches, cognitive issues, and dizziness.
Although they occur without symptoms, they should be treated similarly to strokes with symptoms. Silent strokes put people at risk of future symptomatic strokes, cognitive decline, and dementia.
8. A ministroke is not so risky
“The term ministroke has been used incorrectly as some think that it is related to small strokes that carry low risk,” said Dr. Ortiz. “That statement is incorrect, as a ministroke is a transient ischemic attack (TIA).”
“It is not a small stroke, but a premonition that a large stroke can occur. Any symptom of acute stroke, transient or persistent, needs emergency workup and management to prevent a devastating large stroke,” he added.
9. Stroke always causes paralysis
Stroke is a leading cause of long-term disability, but not everyone who has a stroke will experience paralysis or weakness. Research shows that stroke leads to reduced mobility in over half of stroke survivors aged 65 and over.
However, the long-term impacts of stroke vary on many factors, such as the amount of brain tissue affected and the area affected. Damage to the left brain, for example, will affect the right side of the body and vice versa.
If the stroke occurs in the left side of the brain, effects may include:
paralysis on the right side of the body
speech and language problems
slow and cautious behavior
memory loss.
If it affects the right side of the brain, paralysis may also occur, this time on the left side of the body. Other effects may include:
vision problems
quick and inquisitive behavior
memory loss.
10. Stroke recovery happens fast
Recovery from stroke can take months, if not years. However, many may not fully recover. The American Stroke Association says that among stroke survivors:
10% will make an almost complete recovery
another 10% will require care in a nursing home or another long-term facility
25% will recover with minor impairments
40% will experience moderate to severe impairments
Research suggests there is a critical time window between 2–3 months after stroke onset, during which intensive motor rehabilitation is more likely to lead to recovery. Some may also be able to spontaneously recover during this period.
Beyond this window, and beyond the 6-month mark, improvements are still possible although are likely to be significantly slower.
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Cancer is one of our nation’s most feared diseases, with more than 1.6 million new cases diagnosed each year. But thanks to National Institute of Health (NIH) research, this number is now falling. Between 1991 and 2014, #cancer death rates went down 25 percent.
NIH research has transformed the way we think about cancer from affecting specific parts of the #body to a much more precise understanding of the molecular cause. For example, the drug pembrolizumab is one of a new class of cancer drugs that works by engaging a patient’s immune system to attack his or her tumors. Doctors already use this drug to treat some patients with several specific cancer types, including lung cancer and head and neck cancer. And, very recently, it became the first cancer therapy approved by the Food and Drug Administration (FDA) to treat any type of tumor, regardless of its location in the body, as long as the tumor has specific genetic features that make it much more likely to shrink after treatment with the drug. This is just one example of how genomics has revolutionized our understanding of cancer (see Precision Oncology, p.18).
Despite gains, there is much work to do. Many clinical trials are testing new targeted treatments, as well as combinations of different cancer therapies. With other federal agencies, NIH is participating in the Cancer MoonshotSM, a bold initiative to accelerate cancer research that aims to make more therapies available to more patients while also improving our ability to prevent cancer and detect it at an early stage.
Good Health for All
Many people in America are more likely to get certain #diseases and to die from them, compared to the general population. One of NIH’s greatest challenges is to understand and eliminate profound disparities in health outcomes for these individuals. We know the causes of health disparities are many. They include biological factors that affect disease risk; but most of the causes turn out to be non-biological factors such as socioeconomics, culture, and environment. Teasing apart health outcomes that differ among racial/ethnic groups is providing clues. For example, NIH research shows that among cigarette smokers, African Americans and Native Hawaiians are more susceptible to lung cancer than Whites, Japanese Americans, and Hispanics. Scientists are also intrigued by the “Hispanic paradox,” in which U.S. Hispanics often experience similar or better health outcomes across a range of diseases compared with non-Hispanic Whites. Understanding this advantage may help us identify contributing factors and effective interventions.
