Women and Stroke

Stroke is the third leading cause of death for women. In comparison, stroke is the fifth leading cause of death for men. In general, women live longer than men, so having a stroke stroke will cause a more negative impact on their lives. More women will:

• Live alone when they have a stroke
• Be more likely to live in a long term health care facility after a stroke
• Have a worse recovery after stroke

Knowing the warning signs of strokes will help you recognize them if one happens to you or a loved one. If you recognize the symptoms, get to the hospital immediately when the first symptoms appear.

You may be tempted to downplay your symptoms and not want to go to the hospital. This is normal. But the earlier you get to a hospital, the better your chances of survival.

• Sudden numbness or weakness in the face, arm, or leg, especially on one side of the body
• Sudden confusion, understanding or trouble speaking
• Sudden trouble seeing out of one or both eyes
• Sudden trouble walking, dizziness, loss of balance or coordination
• Sudden several headache with no known cause

There are several stroke risk factors that women cannot change:

• Age: Your chance of having a stroke doubles for each decade after you turn age 55. Women have more strokes much later in life than men.
• Race: Black men and women are at increased risk of stroke because they tend to have a higher incidence of high blood pressure, a major cause of strokes.
• Diabetes: Having diabetes doubles a woman’s risk of ischemic stroke but not a man’s. Diabetes weakens blood vessel walls, making them easier to rupture or block.
• Previous Stroke: If you already have had one stroke or transient ischemic attack (TIA), your odds of having another stroke increase dramatically.

There are several stroke risk factors that can be changed.

• Lower Your Blood Pressure: High blood pressure is the single most important factor in causing strokes. Losing weight, eating a low-salt, low-fat diet, and exercise, and for more severe cases, taking medicine can reduce blood pressure.
• Improve Your Diet: Lots of vegetables, fruits, and whole grain foods reap lots of benefits. According to the Nurses’ Health Study, eating five servings of fruits and vegetables a day is associated with a 30 percent lower risk of stroke in healthy women and men.
• Stop Smoking: Smoking increases your blood pressure, reduces the oxygen supply throughout your body, and increases the odds of your blood clotting.

• Computed tomography or CT scan is the best way to determine if a stroke was caused by a ruptured artery. A CT scan also can show the location and size of a damaged area. Magnetic resonance imaging (MRI) is similar to a CT scan, but instead of using X-rays, it uses a magnetic field to create a signal that a computer can translate into a message. MRIs can diagnose strokes caused by blockages or ruptures.
• Carotid ultrasound uses sound waves to find the location and extent of blockages in the carotid arteries in your neck. These arteries supply blood to your brain, so a clot in one of them can cause a stroke.
• Cerebral angiography. If an ultrasound finds a blocked carotid artery, cerebral angiography is used to get more information. This procedure produces an image of the arteries in your brain and your neck so your doctor knows the location and extent of blockages in these areas. Doctors can also diagnose blood vessel abnormalities.
• Carotid endarterectomy. Removes plaque from the artery.

1. Transient Ischemic Attack (TIA)

Transient ischemic attack (TIA) is a small stroke that is caused by when blood flow to the brain is temporarily stopped—it is caused by a small clot that dissolves quickly, thus allowing blood to flow again.

• TIAs can last seconds to hours; most last two to 15 minutes.
• There can be one or several over a few days or weeks.

TIAs are early warnings of a stroke to come—perhaps in days or months. Call 911 immediately if you experience any of these systems.

• Temporary blindness in one or both eyes
• Numbness or weakness in an arm or leg
• Difficulty speaking or understanding words correctly
• Sudden severe headache with no known cause
• Unexplained dizziness, unsteadiness or sudden falls, especially with any of the other signs

2. Ischemic Stroke

An ischemic stroke, the most common stroke, happens when an artery bringing blood to your brain is completely blocked. Brain tissues die and parts of one side of your body become weak or numb for days or weeks or even permanently.

• Causes of Ischemic Strokes
  • Most are caused by atherosclerosis, the buildup of fatty deposits inside artery walls. Blood clots can form along walls damaged or narrowed by these deposits.
  • Clots also can flow from other areas and get stuck in a narrowed artery.
  • Pieces of plaque can break free and travel to the brain.
• Treatment. Treatment usually begins in the emergency room so doctors can diagnose the type of stroke you are having. You may be given drugs to dissolve a possible clot. If your brain swells (edema) from blood leaking from damaged vessels, you may receive medications to reduce this swelling. Once a patient becomes stable, doctors may prescribe medications to improve blood flow to the brain over the long-term.
  • Anticoagulants (blood thinners)
  • Aspirin
  • Other medications

3. Hemorrhagic Stroke

Hemorrhagic Stroke is a stroke that results from an artery rupturing in the brain, causing tissues in that area to die. While less common than ischemic strokes, this stroke usually is more severe.

• Types of Hemorrhagic Strokes
  • Aneurysms. A weakened part of a blood vessel ruptures.
  • Subarachnoid hemorrhage. Blood leaks between the brain and the skull wall.
  • Intracerebral hemorrhage. Bleeding occurs deep within the brain
• Hemorrhagic Stroke Symptoms
  • A sudden, extremely severe headache is main symptom
  • Weakness
  • Dizziness
  • Confusion
  • Extreme sensitivity to light
  • Stiff neck
  • Paralysis or unconsciousness in severe cases
• Diagnosis—Doctors use symptoms, CT scans and a test called a lumbar puncture (tests to find blood in the spinal cord fluid) to determine if it is a hemorrhagic stroke.
• Treatment—Limiting brain damage is the primary treatment goal for hemorrhagic stroke. Monitoring blood pressure and draining blood from the brain to reduce swelling and prevent damage are two priorities. A subarachnoid hemorrhage requires immediate surgery to repair the ruptured vessel.
• Results—The effects of a stroke vary among individuals, depending on the area of the brain affected and severity of the stroke. Common effects include the following.
  • Vision difficulties
  • Speech difficulties
  • Paralysis in parts of the body
  • Loss of consciousness
• Recovery—Most people can resume many of their usual activities once they go home from the hospital. About 20 percent of people who have strokes continue to need help with some tasks; another 15 percent become dependent on others. Stroke patients can benefit from
  • Physical therapy. Keep joints of paralyzed limbs flexible.
  • Occupational therapy. Teaches ways to adapt to new tasks.
  • Speech therapy. Helps with speaking and understanding of language, including learning new ways to communicate.
  • Support groups. Can help with recovery, learning new behaviors, and countering depression.
  • UT Medical Center’s Rehabilitation Services offers each of these recovery methods/tools.

High blood pressure or hypertension is when your blood presses too hard against the walls of your blood vessels and heart, making your heart work harder than usual. High blood pressure is called the “silent killer” because it seldom causes symptoms but can gradually damage tissues and organs, leading to heart failure, stroke or kidney failure.

In young adulthood, more men than women get high blood pressure, but as women age, they catch up and surpass men with this condition. The disease is more common in Hispanic and black women than any other group. Because it is relatively easy to treat, it is important for you to have your blood pressure monitored on a frequent basis.

Treatments for stroke vary depending on the type of stroke, health of the patient and rehabilitation needs, etc. UT Medical Center’s Brain and Spine Institute offers many services and procedures to help stroke patients fully or partially recover from stroke damage.