Stroke is an event that changes life for a person, his/her family and society. Stroke is the leading cause of disability and the third cause of death in the United States. Approximately 780,000 new and recurrent strokes occur annually.

Dr. Pikula presents her research on the BMC
Young Stroke Registry at the 2014 NERCC
Research and Education Symposium.

After a stroke occurs, the most effective way to prevent a recurrent stroke (secondary prevention) is to treat risk factors. Vascular risk factors include diverse diseases and conditions that have been associated with increased risk of stroke.

There are risk factors that can be modified and others that are non-modifiable. Treatment focuses on influencing modifiable risk factors, including hypertension, diabetes, hyperlipidemia, smoking, physical inactivity, obesity and carotid artery disease.

When a patient has a stroke, the next step after acute treatment is provided is to attempt to identify the most likely cause of the stroke. Patients undergo different tests including imaging of the brain with computerized tomography (CT), and/or head magnetic resonance imaging (MRI) and of the blood vessels of the neck and head with angiography (CTA, MRA, and angiogram), Transcranial Doppler, and/or carotid ultrasound, and of the heart with TTE and/or TEE. In addition, several blood tests are obtained to evaluate blood sugar, lipid levels, and other conditions that may increase the risk of stroke. The type of tests recommended will vary for each patient, depending on the individual circumstances. Identification of the stroke type and mechanism will lead to specific therapies in most cases.

Regardless of the type of stroke, assessment for the presence of modifiable vascular factors is done in every patient. If present, effective treatment of these risk factors will reduce the risk of recurrent stroke. However, effective treatment implies achieving therapeutic goals, which in turn depends on patient understanding of treatments, compliance with medications and recommendations, and close follow up with a vascular neurologist and primary care physician.

The benefit of treating risk factors may vary, depending on the type of stroke.

Quality Improvement Project: Stroke Education