Stroke Health Article

Clinical trials

As of mid-2004, there were numerous open clinical trials for stroke, including:

• "Adjunctive Drug Treatment for Ischemic Stroke Patients," "E-Selectin Nasal Spray to Prevent Stroke Recurrence," "Improving Motor Learning in Stroke Patients," "Aspirin or Warfarin to Prevent Stroke," "Hand Exercise and Upper Arm Anesthesia to Improvements Hand Function in Chronic Stroke Patients," "Preliminary Study of Transcranial Magnetic Stimulation for Stroke Rehabilitation," and "Using fMRI to Understand the Roles of Brain Areas for Fine Hand Movements" are all sponsored by the National Institute of Neurological Disorders and Stroke.
• "Preventing Post-Stroke Depression" is sponsored by the National Institute of Mental Health (NIMH).
• "Walking Therapy in Hemiparetic Stroke Patients Using Robotic-Assisted Treadmill Training" is sponsored by the United States Department of Education.
• "Brain Processing of Language Meanings" is sponsored by Warren G. Magnuson Clinical Center.

Updated information on these and other ongoing trials for the study and treatment of stroke can be found at the National Institutes of Health Web site for clinical trials at <http://www.clinicaltrials.org>.

Prognosis

Stroke is fatal for about 27% of white males, 52% of black males, 23% of white females, and 40% of black females. Stroke survivors may be left with significant deficits. Emergency treatment and comprehensive rehabilitation can significantly improve both survival and recovery.

Prevention

Damage from stroke may be significantly reduced through emergency treatment. Knowing the symptoms of stroke is as important as knowing those of a heart attack. Patients with stroke symptoms should seek emergency treatment without delay, which may mean dialing 911 rather than their family physician.

The risk of stroke can be reduced through lifestyle changes, including:

• stopping smoking
• controlling blood pressure
• getting regular exercise
• keeping weight down
• avoiding excessive alcohol consumption
• getting regular checkups and following the doctor's advice regarding diet and medicines

Treatment of atrial fibrillation may significantly reduce the risk of stroke. Preventive anticoagulant therapy may benefit those with untreated atrial fibrillation. Warfarin (Coumadin) has proven to be more effective than aspirin for those with higher risk.

Screening for aneurysms may be an effective preventive measure in those with a family history of aneurysms or autosomal polycystic kidney disease, which tends to be associated with aneurysms.

BOOKS

Caplan, L. R., M. L. Dyken, and J. D. Easton. American Heart Association Family Guide to Stroke Treatment, Recovery, and Prevention. New York: Times Books, 1996.

Warlow, C. P., et al. Stroke: A Practical Guide to Management. Boston: Blackwell Science, 1996.

Weiner F., M. H. M. Lee, and H. Bell. Recovering at Home After a Stroke: A Practical Guide for You and Your Family. Los Angeles: The Body Press/Perigee Books, 1994.

PERIODICALS

Selman, W. R., R. Tarr, and D. M. D. Landis. "Brain Attack: Emergency Treatment of Ischemic Stroke." American Family Physician 55 (June 1997): 2655–2662.

Wolf, P. A., and D. E. Singer. "Preventing Stroke in Atrial Fibrillation." American Family Physician (December 1997).

ORGANIZATIONS

National Stroke Association. 9707 E. Easter Lane, Englewood, Co. 80112. (800) 787-6537. (June 3, 2004). <http://www.stroke.org>.

American Heart Association. 7320 Greenville Ave. Dallas, TX 75231. (214) 373-6300. (June 3, 2004). <http://www.americanheart.org>.

Richard Robinson