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Stroke

What is a stroke?A stroke happens when there is a loss of blood flow to part of the brain. Your brain cells cannot get the oxygen and nutrients they need from blood, and they start to die within a few minutes. This can cause lasting brain damage, long-term disability, or even death.If you think that you or someone else is having a stroke, call 911 right away. Immediate treatment may save someone's life and increase the chances for successful rehabilitation and recovery.What are the types of stroke?There are two types of stroke:Ischemic stroke is caused by a blood clot that blocks or plugs a blood vessel in the brain. This is the most common type; about 80 percent of strokes are ischemic.Hemorrhagic stroke is caused by a blood vessel that breaks and bleeds into the brainAnother condition that's similar to a stroke is a transient ischemic attack (TIA). It's sometimes called a "mini-stroke." TIAs happen when the blood supply to the brain is blocked for a short time. The damage to the brain cells isn't permanent, but if you have had a TIA, you are at a much higher risk of having a stroke.Who is at risk for a stroke?Certain factors can raise your risk of a stroke. The major risk factors includeHigh blood pressure. This is the primary risk factor for a stroke.Diabetes.Heart diseases.Atrial fibrillation and other heart diseases can cause blood clots that lead to stroke.Smoking. When you smoke, you damage your blood vessels and raise your blood pressure.A personal or family history of stroke or TIA.Age. Your risk of stroke increases as you get older.Race and ethnicity. African Americans have a higher risk of stroke.There are also other factors that are linked to a higher risk of stroke, such asAlcohol and illegal drug useNot getting enough physical activityHigh cholesterolUnhealthy dietHaving obesityWhat are the symptoms of stroke?The symptoms of stroke often happen quickly. They includeSudden numbness or weakness of the face, arm, or leg (especially on one side of the body)Sudden confusion, trouble speaking, or understanding speechSudden trouble seeing in one or both eyesSudden difficulty walking, dizziness, loss of balance or coordinationSudden severe headache with no known causeIf you think that you or someone else is having a stroke, call 911 right away.How are strokes diagnosed?To make a diagnosis, your health care provider willAsk about your symptoms and medical historyDo a physical exam, including a check of Your mental alertnessYour coordination and balanceAny numbness or weakness in your face, arms, and legsAny trouble speaking and seeing clearly Run some tests, which may include Diagnostic imaging of the brain, such as a CT scan or MRIHeart tests, which can help detect heart problems or blood clots that may have led to a stroke. Possible tests include an electrocardiogram (EKG) and an echocardiography. What are the treatments for stroke?Treatments for stroke include medicines, surgery, and rehabilitation. Which treatments you get depend on the type of stroke and the stage of treatment. The different stages areAcute treatment, to try to stop a stroke while it is happeningPost-stroke rehabilitation, to overcome the disabilities caused by the strokePrevention, to prevent a first stroke or, if you have already had one, prevent another strokeAcute treatments for ischemic stroke are usually medicines:You may get tPA, (tissue plasminogen activator), a medicine to dissolve the blood clot. You can only get this medicine within 4 hours of when your symptoms started. The sooner you can get it, the better your chance of recovery.If you cannot get that medicine, you may get medicine that helps stop platelets from clumping together to form blood clots. Or you may get a blood thinner to keep existing clots from getting bigger.If you have carotid artery disease, you may also need a procedure to open your blocked carotid arteryAcute treatments for hemorrhagic stroke focus on stopping the bleeding. The first step is to find the cause of bleeding in the brain. The next step is to control it:If high blood pressure is the cause of bleeding, you may be given blood pressure medicines.If an aneurysm if the cause, you may need aneurysm clipping or coil embolization. These are surgeries to prevent further leaking of blood from the aneurysm. It also can help prevent the aneurysm from bursting again.If an arteriovenous malformation (AVM) is the cause of a stroke, you may need an AVM repair. An AVM is a tangle of faulty arteries and veins that can rupture within the brain. An AVM repair may be done through SurgeryInjecting a substance into the blood vessels of the AVM to block blood flowRadiation to shrink the blood vessels of the AVM Stroke rehabilitation can help you relearn skills you lost because of the damage. The goal is to help you become as independent as possible and to have the best possible quality of life.Prevention of another stroke is also important, since having a stroke increases the risk of getting another one. Prevention may include heart-healthy lifestyle changes and medicines.Can strokes be prevented?If you have already had a stroke or are at risk of having a stroke, you can make some heart-healthy lifestyle changes to try to prevent a future stroke:Eating a heart-healthy dietAiming for a healthy weightManaging stressGetting regular physical activityQuitting smokingManaging your blood pressure and cholesterol levelsIf these changes aren't enough, you may need medicine to control your risk factors.NIH: National Institute of Neurological Disorders and Stroke

Stroke FDA Approved Drugs

AGGRENOX [AspirinC9H8O4 : DipyridamoleC24H40N8O4]
RX
-
25mg : 200mg (oral capsule, extended release)
Boehringer IngelheimNov 22, 1999
  • To reduce the risk of stroke in patients who have had transient ischemia of the brain or completed ischemic stroke due to thrombosis.
efficacy
0.0  (0)
side effects
0.0  (0)
danger
0.0  (0)

UNK

ALTACE [RamiprilC23H32N2O5]
RX
-
1.25mg (oral capsule)
10mg (oral capsule)
2.5mg (oral capsule)
King PharmsJan 28, 1991
  • Method of reducing risk of myocardial infarction, stroke and death.
efficacy
0.0  (0)
side effects
0.0  (0)
danger
0.0  (0)

UNK

BRILINTA [TicagrelorC23H28F2N6O4S]
RX
-
60mg (oral tablet)
90mg (oral tablet)
Astrazeneca PharmsSep 3, 2015
  • Method of inhibiting platelet aggregation.
  • Reduction of the rate of cardiovascular death, myocardial infarction, and stroke in patients with a history of myocardial infarction.
  • Reduction of the rate of cardiovascular death, myocardial infarction, and stroke in patients with acute coronary syndrome or a history of myocardial infarction.
  • Reduction of the rate of thrombotic events in patients with acute coronary syndrome.
  • Treatment of an arterial thrombotic complication in a patient with coronary artery, cerebrovascular or peripheral vascular disease.
  • Treatment of arterial thrombotic complications selected from the group consisting of unstable angina, thrombotic or embolic stroke, transient ischaemic attacks, peripheral vascular disease and myocardial infarction.
  • Treatment of myocardial infarction and stroke in patients with acute coronary syndrome or a history of myocardial infarction.
  • Treatment of myocardial infarction in patients with acute coronary syndrome or a history of myocardial infarction.
  • Treatment of myocardial infarction.
  • Treatment of post-myocardial infarction.
  • Treatment of stable and unstable angina.
  • Treatment of stroke in patients with acute coronary syndrome or a history of myocardial infarction.
  • Treatment of stroke.
  • Treatment of thrombotic stroke.
efficacy
0.0  (0)
side effects
0.0  (0)
danger
0.0  (0)

UNK

ELIQUIS [ApixabanC25H25N5O4]
RX
-
2.5mg (oral tablet)
Bristol Myers SquibbDec 28, 2012
  • Prophylaxis of deep vein thrombosis (dvt).
  • Prophylaxis of deep vein thrombosis and pulmonary embolism.
  • Prophylaxis of pulmonary embolism.
  • Reduce the risk of recurrent deep vein thrombosis (dvt).
  • Reduce the risk of recurrent pulmonary embolism.
  • Reducing the risk of stroke and systemic embolism.
  • Reducing the risk of stroke.
  • Treatment of deep vein thrombosis (dvt).
  • Treatment of pulmonary embolism (pe).
efficacy
0.0  (0)
side effects
0.0  (0)
danger
0.0  (0)

UNK

MICARDIS [TelmisartanC33H30N4O2]
RX
-
20mg (oral tablet)
40mg (oral tablet)
80mg (oral tablet)
Boehringer IngelheimApr 4, 2000
  • Reduction of cardiac tissue damage associated with myocardial infarction.
  • Treatment or prevention of stroke.
efficacy
0.0  (0)
side effects
0.0  (0)
danger
0.0  (0)

UNK

XARELTO [RivaroxabanC19H18ClN3O5S]
RX
-
10mg (oral tablet)
15mg (oral tablet)
20mg (oral tablet)
Janssen PharmsJul 1, 2011
  • Following initial 6 months treatment for deep vein thrombosis (dvt) and/or pulmonary embolism (pe), reduction in the risk of recurrence of dvt and of pe with once daily, rapid-release tablet administered for at least five consecutive days.
  • Prophylaxis of deep vein thrombosis (dvt).
  • Prophylaxis of deep vein thrombosis, which may lead to pulmonary embolism in patients undergoing knee or hip replacement surgery, with once daily, rapid-release tablet administered for at least five consecutive days.
  • Reduce the risk of stroke in patients with nonvalvular atrial fibrillation with once daily, rapid-release tablet administered for at least five consecutive days.
  • Reducing the risk of stroke and systemic embolism.
  • Reduction in the risk of recurrence of deep vein thrombosis (dvt) and pulmonary embolism.
  • Treatment of deep vein thrombosis (dvt).
  • Treatment of deep vein thrombosis with once daily, rapid-release tablet administered for at least five consecutive days.
  • Treatment of pulmonary embolism (pe).
  • Treatment of pulmonary embolism with once daily, rapid-release tablet administered for at least five consecutive days.
efficacy
0.0  (0)
side effects
0.0  (0)
danger
0.0  (0)

UNK


WARNING: Consult a licensed physician in the appropriate field for medical treatment and drug prescription. Do not self medicate.



WARNING: All medicines, drugs, plants, chemicals or medicial precedures below are for historical reference only. Many of these treatments are now known to be harmful and possibly fatal. Do not consume any plant, chemical, drug or otherwise without first consulting a licensed physician that practices medine in the appropriate field.

Felter's Materia Medica on Stroke

PODOPHYLLUM
   The dried rhizome and roots of Podophyllum peltatum, Linné (Nat. Ord. Berberidaceae). Rich woods and thickets of North America. Dose, 5 to 30... / ...in. It is contraindicated by pinched features, and small, wiry pulse, or when the pulse has a sharp stroke. Action and Toxicology.—Applied continuously podophyllum and its resin cause irritation and...1


WARNING: All medicines, drugs, plants, chemicals or medicial precedures below are for historical reference only. Many of these treatments are now known to be harmful and possibly fatal. Do not consume any plant, chemical, drug or otherwise without first consulting a licensed physician that practices medine in the appropriate field.

Physician's Therapeutics Memoranda on Stroke

APOPLEXY, CEREBRAL
   Blood pressure must be reduced by ve-nesection, if the case ad mits it, by action of a rapid... / ...ttack, use nerve sedatives and keep the patient on a low diet, strictly prohibiting stimulants. To cause absorption of clot (a week or more after the stroke) potassium iodide in full doses. The paralysis is to be treated on general principles by massage, pas sive exercise, electricity, strychnine, t...2

SUNSTROKE
   Distinguished between thermic fever, with high temperature and laboring heart, and heat exhaustion, with surface cool and circulation depressed. In the former case apply cold to surface, watching the effect, and using friction to draw blood to the surface. Bleeding may do good, but antipyretic remedies are of no use. In heat ex haustion apply heat to the surface.2


References

1) Felter, Harvey Wickes, 1922, The Eclectic Materia Medica, Pharmacology and Therapeutics, Cincinnati, Ohio.
2) Nelson, Baker & Co., 1904, Physician's Handy Book of Materia Medica and Therapeustics, Detroit, Michigan.