Doctor insights on:
Cortical Vs Subcortical Stroke
Brain MRI findings. Tiny nonspecific periventricular and subcortical white matter. Possiblities mini strokes, vasculaties, ms. I shuffle my feet & drop?
White matter changes that are nonspecific are sometimes over reported or under-reported on MRI studies. They may be misread and really suggest MS, they may be a finding with no clinical relevance. Usually it is the latter.
It sounds like the brain MRI did not help that much. So you shuffle your feet and drop? What do you mean by drop? Do you have numbness? Why was the brain MRI done? ...Read more
Eeg interpretations: It is really difficult to interpret the squiggles on an eeg. Much more difficult than the squiggles of an ekg. You really have to sit down with your neurologist and have a discussion about your condition which is much more important than the meaning of the wiggles on the paper, and have a discussion about your prognosis (outlook). ...Read more
What is the meaning of chronic ischemic changes in bilateral frontparietal sub cortical white matter. What is the medicne for this?
Ischemic: A dry stroke is due to a cut off or reduction in circulation to a portion of the brain, usually due to closure of a blood vessel from a blood clot. This is different from a "wet stroke" in which a blood vessel break or is disrupted, causing bleeding or hemorrhage into the brain. ...Read more
Brain attack: 2 kinds of stroke: ischemic or hemorrhagic. Ischemic (either thrombotic or embolic) is like a clogged drain in your house. Hemorrhagic is like a burst pipe. In either case, you don't get water flowing where you need it. Same w/stroke - you lose blood flow to vital areas in your brain (are there non-vital areas?). Without blood flow, brain dies. So if you think you're having a stroke, call 911. ...Read more
Stroke: Once a stroke occurs the focus needs to be on rehab and prevention. The sooner you begin rehab, the more likely you are to regain abilities. Also proper blood pressure and cholesterol control as well as improved lifestyle - ie improved diet/exercise are needed to prevent another from happening. This should all be done under the watchful eye of your physician - may benefit from medicine as well. ...Read more
Absolutely: You can have a vascular occlusion within the eye which can affect the sight in that particular eye. You can have a stroke in the visual cortex which can block portions of your vision. Strokes have also affected color vision, facial recognition, visual memory and other visually related functions. These conditons are best analyzed by a neuro-ophthalmologist. ...Read more
Prevention is best: Although tpa (alteplase) is important, best to avoid need for this. Be mindful of risks, such as hypertension, diabetes, high blood fats, smoking, some illicit drugs (cocaine, etc), hyperhomocysteinemia, obesity, concurrent heart disease. Preventatives include the antiplatelet drugs, such as clopidogrel, aggrenox, and to a lesser extent aspirin. Some new anticoagulants can be considered. ...Read more
No: A stroke means some brain cells have died, usually after loss of blood supply. Lost cells can't be replaced. Bigger stroke = more disability. However, our brains are flexible (esp when younger). Often remaining cells can adapt + we see variable improvement during rehab. I don't know any pills proven to speed this up, but u have to look for specific studies, not just general claims for supplements. ...Read more
Depends: Strokes are more common in men under 75 and women above 75. And african americans are twice as likely to have a stroke. Some other factors for stroke include: high blood pressure, history of previous strokes, women who smoke while on hormonal birth control, diabetes, heart disease such as atrial fibrillation, high cholesterol and atherosclerosis. ...Read more
Yes: Tia happens when blood supply to a certain area of the brain gets cut off temporarily. This causes a neurologic deficit - weakness, numbness, visual deficit or difficulty with speech. While TIA usually resolves, it indicates that there is a problem with your heart or blood vessels that can cause another TIA o stroke. It is heard to predict size of stroke from a tia, but it can certainly be large. ...Read more
See below: Thorough neurologic examination is the first step in diagnosing a stroke or tia. A neurologist may develop concern based on typical neurologic defecits. If indicated, MRI is the best test for identifying or ruling out a stroke. If the symptoms are similar to a stroke but there is no stroke on MRI and/or the symptoms resolve, it is more likely to have been a transient ischemic attack (tia). ...Read more
TIAs: Can occur every few minutes. These are crescendo tias. Very dangerous to have multiple frequent tias. High risk of stroke. Please see your doctor soon or go to er. See stroke. Org for more info. ...Read more
Think "FAST": The acronym "fast" summarizes what to look for and what do if you think someone is having a stroke: 1)face-ask the person to smile. Does one side of the face droop? 2) arms-ask the person to raise both arms. Does one arm drift downward? 3) speech-ask the person to repeat a simple phrase. Is their speech slurred or strange? 4) time-if you observe any of these signs, call 9-1-1 immediately. ...Read more
Several: A stroke that affects broca's area in the dominant hemisphere will affect expressive speech and possibly comprehension. This can be due to ischemic stroke eg a plaque rupture and/or blood clot, hemorrhagic (bleeding) or embolic (drifting blood clot) types of stroke. A stroke of other (posterior) areas may garble the speech but not affect language otherwise. ...Read more
Location dependent: This depends upon the location of the stroke. It could include weakness, language difficulties, sensory abnormalities and visual loss. Other possibilites include personality change, neglect of one side of the body, transient visual hallucinations, inability to swallow, facial weakness and numbness, gait disorders, tremors and spasticity. The list is not all inclusive. ...Read more
The answer varies:
There is not a single answer to this question.
It may be a person can survive more than ten strokes, or die after just one. It really depends on where they are, how large they are, and whether any bleeding or recovery occurs. ...Read more
Actually common: With our current stroke treatment medications and rehab steps, we not only can prevent many strokes, but also can restore patients to improved functioning. A number of patients experience several very small "lacunar" lesions which cause impairment but not death. ...Read more