Stroke

It is best to prevent stroke. If your doctor has prescribed drugs for high blood pressure, diabetes, or high cholesterol, take them regularly to decrease your risk of stroke. Quit smoking, exercise, eat a balanced diet, keep a healthy weight, and drink in moderation.

Any suspected stroke is a true medical emergency. Getting to the hospital right away can be a life-saver. The right treatment may stop the stroke in its tracks. This can prevent death, disability, and a second stroke.

Treatment depends on the type of stroke, how severe it is, and how soon the person arrives in the emergency department. Emergency treatment may include drugs, surgery, and other procedures.

A very important part of emergency care is the drug called tissue plasminogen activator (t-PA, Activase). When given within three hours of the first symptoms, it busts any blood clot in the blood vessel that is causing stroke, and makes recovery more likely.

Other drugs can prevent stroke in some people. If you are at risk, your doctor may prescribe drugs that stop blood cells from sticking together in a blood clot (called antiplatelet drugs).

• Aspirin (ASA) is the antiplatelet drug most frequently prescribed. The doctor may choose to prescribe aspirin along with another antiplatelet drug called dipyridamole (Asasantine). Some people experience side effects such as stomach upset.
• Clopidogrel (Plavix) has a slight advantage over aspirin for preventing stroke in patients with narrowing of the blood vessels in the arms and legs. Ticlopidine (Ticlid) is similar to clopidogrel.

Other drugs prevent blood clots from forming and prevent existing clots from getting bigger.

• Warfarin (Coumadin) is recommended to reduce the risk of stroke in patients with heart conditions (e.g., atrial fibrillation). To ensure that your dose of warfarin is just right, your doctor will require frequent blood testing. A serious possible side effect of warfarin is bleeding. To prevent bleeding, heparin (given by injection) is used during the beginning stages of treatment.

Speak to your pharmacist before taking any herbal preparations or changing your diet as these may change the effect of warfarin.

For further information on treating and preventing stroke, visit the Heart and Stroke Foundation of Canada (http://ww2.heartandstroke.ca), The Thrombosis Interest Group of Canada (http://tigc.org), and the Mayo Clinic (http://mayoclinic.com/invoke.cfm?id=DS00150)