Stroke

Strokes are the leading cause of disability in adults.

Strokes, or Cerebrovascular Accidents (CVAs), can cause significant cognitive dysfunction.  However, because size and location of a stroke can vary from person to person, the cognitive profile of persons with strokes can be very different.  Indeed, CVAs are perhaps the most heterogeneous of all neuropschological disorders.  Dr. Lopez is specialized in neuropsychological assessments and can determine the extent of cognitive loss secondary to stroke and predictive recovery if any.

Although strokes are typically associated with cognitive loss, they may also affect mood.  Indeed, Anosodiaphoria is a term used to describe a patient’s indifference or inability to experience an emotional reaction to his or her paralyzing symptoms of stroke.  This strange phenomenon shrouds public health efforts against stroke. Most commonly, strokes are associated with depression, indeed most patient’s who have had a stroke experience depression.  Dr. Jeannette Corredor specializes in Cognitive behavioral therapy (CBT), a type of psychotherapy, or talk therapy, that helps people change negative thinking styles and behaviors that may contribute to their depression.

The term “stroke” is ubiquitous and often misunderstood.  Stroke is a brain attack:  a sudden brain catastrophe caused by disease affecting the brain’s blood vessels, which results in the death of brain tissue.

There are two major types of stroke: a “dry” stroke and a “wet” stroke.  A “dry”, or ischemic, stroke is the more common type and is generally caused by a lack of blood flow to a given area due to downstream blockage of a blood vessel (like a clot).  The affected blood vessels are riddled with atherosclerosis, a disease that hardens the walls. When a blood clot or a piece of an atherosclerotic plaque (a cholesterol and calcium deposit on the wall of the artery) breaks loose, it can travel through the circulation and lodge in an artery of the brain, plugging it up and stopping the flow of blood.  This is referred to as an embolic stroke.  A blood clot can form in a chamber of the heart when the heart beats irregularly, as in atrial fibrillation; such clots usually stay attached to the inner lining of the heart but they may break off, travel through the blood stream, form a plug (embolus) in a brain artery and cause a stroke.

“Wet”, or hemorrhagic, strokes, are caused by excess blood in a given area of the brain.  This type of stroke is caused by the rupture of blood vessel wall and is usually more severe than its “dry” counterpart.  Brain hemorrhages caused by ruptured aneurysms (widening and weakening of the blood vessels) are another form of “wet” stroke.

Strokes may be preventable, but due to gaps in knowledge, patients and doctors don’t take the appropriate steps.  Most strokes are caused by treatable factors like high blood pressure, high cholesterol, diabetes, obesity, irregular heartbeat, and tobacco smoke.  The warning signs and symptoms of stroke aren’t exclusive to this condition, but the manner in which they appear is.  Symptoms of stroke don’t appear slowly and progress over a period of time; they strike suddenly and without warning.  Cardinal symptoms include: sudden numbness or weakness in one or both sides of the body; sudden difficulty speaking or understanding speech; confusion; sudden loss of vision in one or both eyes; sudden dizziness or loss of balance; and sudden severe headache without a known cause.

Transient Ischemic Attacks (TIA) or transient stroke symptoms that resolve within twenty-four hours could be warning signs of a future, larger ischemic event and should be watched carefully.  There is also a significant risk of recurrent stroke, after the initial full-blown stroke.  The probability of this is dependent on the causal event.  In addition to treating the medical condition that initiated the stroke, there are certain antistroke drugs that can help reduce the risk of recurrent stroke.

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