Subarachnoid hemorrhage 299

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oral contraceptives also increase the risk of stroke in women under 50; however, the older high-dose pills were far more dangerous than today's low-dose versions. Several studies have suggested an increased risk for low-dose pills, but others have found a significant risk only in women who smoke as well as take the pill. Women who smoke, use birth control pills, and have migraines appear to have an even greater chance of having a stroke.

Scientists do not yet understand why, but African Americans and Hispanics have a higher incidence of stroke; one reason could be that African Americans are more prone to high blood pressure.

Pregnancy is yet another risk factor; stroke is 13 times more common during the nine months of pregnancy because of changes in blood consistency. Pregnancy-related high blood pressure may predispose a woman to stroke.

Finally, a history of untreated transient ischemic attacks (TIAs), is a risk factor of stroke; one third of those who have had a TIA will have a stroke within five years. Small doses of aspirin daily (as little as one-tenth of a tablet) may lessen that risk. The anticlotting drug Ticlid, approved by the U.S. Food and Drug Administration, is slightly more effective but has been associated with potentially serious side effects.

For more information, contact the national STROKE ASSOCIATION or the NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE (for addresses, see Appendix I). (See also cerebrovascular ACCIDENT.)

Stroke Clubs International A support group whose active members are stroke patients; associate members are those interested in the problems of stroke patients. The group is interested in uniting stroke patients to help each other, to teach them and their families about the nature of stroke and how to overcome problems, to help find jobs, and to provide hope and encouragement. The group maintains a list of more than 900 clubs throughout the United States. Founded in 1968, the club publishes the Stroke Club International Bulletin. For address, see Appendix I.

Sturge-Weber Foundation A support group for those with sturge-weber syndrome and their families, concerned professionals, and supporters; the group serves as an information clearinghouse on the syndrome, which is a congenital neurological disorder characterized by facial port-wine stains, seizures, glaucoma, and loss of motor control. The group also maintains a speakers' bureau, compiles statistics, and funds research. Founded in 1986, the group publishes a quarterly newsletter. For address, see Appendix I.

Sturge-Weber syndrome A rare congenital condition that affects the brain and the skin. A malformation of blood vessels in the brain may cause weakness on the opposite side of the body, mental retardation, and epilepsy. There is usually a large port-wine birthmark covering one side of the face, usually involving an upper eyelid or forehead.

In the brain, excessive blood vessel growth develops on the back region of the brain, on the same side as the port-wine stain. These growths, called angiomas, often lead to seizures that usually begin by age one. The convulsions usually appear on the side of the body opposite the port-wine stain, and vary in severity. A weakening or loss of the use of one side of the body opposite the port-wine stain also may develop. Developmental delay of movement and cognitive skills may also occur to varying degrees. In about 30 percent of patients, increased pressure within the eye (glaucoma) can occur at birth or develop later. Enlargement of the eye also can occur. The glaucoma and enlargement is usually restricted to the eye that has the port-wine stain.

Treatment

Lasers can lighten or remove port-wine stains in children as young as one month of age. Anticon-vulsants are used to control the seizures, and surgery and/or eye drops are used to control the glaucoma.

subarachnoid hemorrhage A type of brain hemorrhage in which a blood vessel ruptures, spreading blood over the surface of the brain. This is a fairly unusual type of stroke that usually affects a younger patient who is less likely to suffer from widespread cerebrovascular disease.

About 8 percent of all stroke patients have this type of hemorrhage, which is usually caused by the rupture of an intercranial aneurysm bleeding into the subarachnoid space around the brain. Common sites for these ruptures include the anterior communicating artery lying between the frontal lobes, the middle cerebral artery, and the posterior communicating artery.

Less commonly, the hemorrhage might be caused by a ruptured angioma (an abnormal proliferation of blood vessels within the brain).

This type of hemorrhage usually occurs spontaneously, and is not usually caused by any type of head injury—but it may following on the heels of unaccustomed physical exertion.

A patient who loses consciousness after such a stroke may regain consciousness, but recurrent strokes are common and may be fatal.

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