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Why You Should Undergo Stroke Screening


  • High blood pressure is the main cause of strokes. Those with high blood pressure are up to eight times more likely to suffer a stroke than those without high blood pressure.
  • A stroke is an extremely serious occurrence which requires emergency medical attention. If the patient is not immediately given proper treatments, the stroke may result in a disability, dependence or even death.
  • The stroke screening process is not only able to identify the certain location of any blood vessel abnormality, but is also detailing blood circulation in those areas to identify and prevent a stroke risk before any symptoms appear.


Brain functions rely on oxygen and nutrients gleaned from the bloodstream. When there is a blockage, a constriction or a break in the blood vessels supplying the brain, it can disrupt the blood supply and affect brain function, leading to brain cells being destroyed and a severe reduction in brain functioning capabilities.

A stroke is an extremely serious condition that requires urgent medical treatment. The faster treatment is provided, the lower the risk of brain damage is. However, if urgent treatment is not sought, it could lead to the patient being left with a permanent disability, paralysis or loss of life.


Strokes can be categorized into two main forms – ischemic strokes and hemorrhagic strokes. Of these, ischemic strokes are the more common of the two, making up around 70% of all strokes, while hemorrhagic strokes make up the remaining 30% of cases.

Some forms of ischemic strokes are caused by high blood lipid levels, resulting in growing in  amounts of fat sticking to blood vessel walls until the point where blood flow is restricted. Other types of ischemic strokes happen as a result of blood clots, which tend to be caused by either a clot in the brain’s blood vessel system itself or a clot which has formed in another part of the body and travelled up to the brain, thereby interrupting the brain’s blood flow. Additionally, there are some systemic disorders which speed up blood vessel deterioration in the brain, such as diabetes, high blood pressure, smoking.

Hemorrhagic strokes occur as a result of the patient’s high blood pressure alongside high blood lipid levels, which result in blood vessels losing their flexibility and making them prone to breakage. Such a breakage results in an immediate interruption of blood flow to the brain, which is the reason why this form of stroke is so dangerous, having the potential to cause a fatality extremely quickly.

Risk factors

Strokes can occur as a result of numerous factors, including factors that can and factors that cannot be regulated and changed, while age, gender and genetics all play a part.

Preventable risk factors

  • High blood pressure. This is the highest risky cause of both ischemic and hemorrhagic strokes, with patients suffering from high blood pressure up to eight times more likely to experience a stroke than those who do not.
  • High blood lipid levels. When fat builds up and stuck on blood vessel walls, the extent that blood flow is restricted and the vessels lose their flexibility, it can result in a high risk of ischemic and hemorrhagic strokes. Patients suffering from high blood lipid levels are up to 2-3 times more likely to experience a stroke than those who do not.
  • Diabetics are 1.8-6 times more likely to suffer a stroke than non-diabetics due to diabetes causing blood vessel stiffness and brittleness.
  • Some forms of heart condition. These can cause clots that have the potential to travel up into smaller arteries in the brain and cause stroke.
  • Carotid artery stenosis. Patients with this condition are two times more likely to suffer a stroke than people without the condition due to reduced blood to the brain and clots traveling up to smaller arteries in the brain.
  • Nicotine and carbon monoxide found in cigarette smoke reduce the amount of oxygen reaching the brain while also damaging blood vessel walls, meaning that smokers are 2-3 time more likely to suffer a stroke than non-smokers.
  • Obesity and excess weight. These are major causes of other health disorders which can lead to abnormalities in the brain’s blood vessel system. Obese or overweight patients are 1.3 times more likely to suffer a stroke.

Non modifiable risk factors

  • People over the age of 55 years have a stroke risk that increases by 50% every 10 years. This is because blood vessels deteriorate with age, become thicker and less flexible while fat and calcium increase in volume on the blood vessel walls.
  • Men are more at risk of suffering a stroke than women.
  • Patients with a family history of strokes have an increased risk of suffering a stroke.
  • People who have already suffered a stroke are at higher risk of suffering another, subsequent stroke.

Risk factors which can be prevented and modified

  • Manage any chronic health disorders, such as diabetes, high blood pressure and high blood lipid levels.
  • Exercise regularly for moderate intensity, at least 30 minutes per session, five days per week.
  • Give up smoking (if applicable).
  • Attend annual health checkups and undergo stroke screening.
  • If you are found to be a person with a high stroke risk, ensure that you undergo treatment and act according to the advice of your doctor, including seeking immediate medical attention even though initial symptoms of a suspected stroke might have completely disappeared, such as weakness, numbness down one side of the body, blurred vision, dizziness / vertigo, unsteadiness and a severe headache.

Stroke symptoms

Due to a stroke resulting in reduced brain function, the symptoms displayed vary greatly in terms of severity. That being said, the following symptoms commonly affect stroke victims:

  • A sudden onset of weakness in the arms, legs, facial muscles or another part of the body.
  • Problems with communication, including struggling to speak, speaking very slowly, a drooping mouth and being unable to understand what is being said.
  • A sudden and severe headache which comes without any prior warning or apparent cause.
  • A sudden onset of blurred or fractured vision.
  • Difficulties walking or balancing, vertigo
  • Suddenly decreased the consciousness.

In some cases, however, symptoms may affect the patient only temporarily before disappearing. Alternatively, symptoms could occur repeatedly before the brain is permanently starved of its blood supply. Hence, if any abnormal symptoms present themselves, immediate medical attention should be sought.

Screening for stroke risk factors

Currently, the stroke screening process is able to effectively identify the exact location of any blood vessel abnormalities, meaning that a stroke risk can be found before any symptoms present themselves. Stroke screening assesses the following:

  • Blood viscosity and complete blood count
  • Blood sugar levels, blood pressure and blood lipid levels
  • Screening rates of blood vessel inflammation
  • Electrocardiogram to assess whether or not the patient suffers from arrhythmia
  • Carotid duplex ultrasound examination
  • Transcranial Doppler ultrasound examination
  • MRI scan to check the state of the brain’s blood vessels or analyze the severity of a stroke

Stroke treatment

Stroke treatments depend entirely on whether the stroke is an ischemic stroke or a hemorrhagic stroke. In cases of an ischemic stroke, the patient will be given antithrombotic medication to clear the blood vessels and allow for improved circulation. For best results, any treatment should be carried out within 4.5 hours of the stroke’s onset. This time frame may be stretched to 24 hour if the patient is at a hospital capable of catheter-based interventions for the removal of the blood clot.

With regard to hemorrhagic stroke cases, regulate the patient’s blood pressure and prevent brain damage. Some patients may be required to undergo emergency surgery in cases of severe bleeding in order to stem the bleeding and reduce pressure in the skull.

Post-treatment care

Many patients who undergo timely treatment for their stroke have a higher chance to be able to make a full recovery and return to their former lifestyle, while some patients may require an extended period to do so. All of the patients require multidisciplinary standard medical care for the recovery of their moving, eating, swallowing and communication capabilities. This is achieved by physical rehabilitation, occupational therapy, a proper nutrition plan designed by a dietician and psychological support from the medical provider and the patient’s family.

Nevertheless, the most crucial part of post-treatment care is to strictly follow the advice of doctors, take medication as prescribed and be sure to attend every doctor’s appointment thereafter. This is important because inconsistent post-treatment care has the potential to affect a patient’s recovery and result in another stroke, with potentially life-threatening consequences.

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M.D., MSc. Jitlada Samajarn, M.D. Summary: Internal Medicine Neurology