Having diabetes for a decade or more dramatically increases the risk for ischemic stroke, report researchers. The new study, published online March 1 in the journal Stroke, found diabetes increases risk 3% each year and triples at 10 years. "We were not surprised to see an increased risk," senior investigator Mitchell Elkind, MD, from Columbia University Medical Center in New York City, told Medscape Me... (read more)
A compound found in oranges, grapefruit, and other citrus fruit may modestly reduce stroke risk among women, an observational study determined. Women with the highest levels of flavanone in their diet were 19% less likely to have an ischemic stroke during 14 years of follow-up than those with the least flavanone intake (P=0.04), Aedín Cassidy, PhD, of the University of East Anglia in Norwich, England, and colleagues foun... (read more)
Breathing in particulate matter, even at levels deemed safe by Environmental Protection Agency (EPA) standards, may raise the risk for acute ischemic stroke and for cognitive decline, 2 new studies suggest. In an accompanying commentary, Rajiv Bhatia, MD, MPH, from the San Francisco Department of Public Health in California, notes that the reported association between ambient fine particulate matter, d... (read more)
Swedish scientists this week may have provided yet another reason to love chocolate, suggesting that women who have a couple of small chocolate bars every week were 20 percent less prone to debilitating strokes than those who eat none. "Even consuming a relatively small amount of chocolate had quite a large impact on stroke risk," said Susanna Larsson, from Sweden's National Institute of Environm... (read more)
In an ischemic stroke, blood supply to part of the brain is decreased, leading to dysfunction of the brain tissue in that area. There are four reasons why this might happen: thrombosis (obstruction of a blood vessel by a blood clot forming locally); embolism (obstruction due to an embolus from elsewhere in the body, see below); systemic hypoperfusion (general decrease in blood supply, e.g., in shock); venous thrombosis.
Stroke without an obvious explanation is termed "cryptogenic" (of unknown origin); this constitutes 30-40% of all ischemic strokes.
There are various classification systems for acute ischemic stroke. The Oxford Community Stroke Project classification (OCSP, also known as the Bamford or Oxford classification) relies primarily on the initial symptoms; based on the extent of the symptoms, the stroke episode is classified as total anterior circulation infarct (TACI), partial anterior circulation infarct (PACI), lacunar infarct (LACI) or posterior circulation infarct (POCI). These four entities predict the extent of the stroke, the area of the brain affected, the underlying cause, and the prognosis. The TOAST (Trial of Org 10172 in Acute Stroke Treatment) classification is based on clinical symptoms as well as results of further investigations; on this basis, a stroke is classified as being due to (1) thrombosis or embolism due to atherosclerosis of a large artery, (2) embolism of cardiac origin, (3) occlusion of a small blood vessel, (4) other determined cause, (5) undetermined cause (two possible causes, no cause identified, or incomplete investigation).
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