Stroke

What is a TIA?

DEAR DOCTOR K: My mother went to the hospital for what we all thought was a stroke, but the doctor said it was a TIA. What is a TIA? What does this mean for my mother's health?

DEAR READER: First, let me tell you about a patient. She was a woman in her 70s who was in good health. One day she was on a bus to the grocery store, a trip she had taken hundreds of times. Suddenly, she felt disconnected from the world. When she felt connected again, she realized she hadn't gotten off at the right stop. I'll come back to what happened to her later.

What are the warning signs of a stroke?

DEAR DOCTOR K: What are the warning signs of stroke? Why is it important to be able to recognize them?

DEAR READER: Nothing makes me sadder than to see someone suffer a stroke that could have been avoided. Not all strokes can be avoided, but many produce warning symptoms that can trigger preventive actions -- if they are recognized.

Do women need to take special precautions to prevent a stroke?

DEAR DOCTOR K: Do women need to take special precautions to prevent a stroke?

DEAR READER: Yes, they do -- and a new set of guidelines published earlier this year helps us to understand what those steps should be. The guidelines discuss stroke risk factors that women should consider from adolescence to old age. The first thing that may be surprising about the guidelines is that they include stroke prevention advice for young women.

Are there risks of taking a daily aspirin to reduce the risk of a heart attack or stroke?

DEAR DOCTOR K: What are the risks of taking a daily aspirin to reduce the risk of a heart attack or stroke?

DEAR READER: I didn't have to do much homework on this one, because I take a daily aspirin and already know the answer. It was front-page news in 1988 when colleagues of mine at Harvard Medical School reported the results of a randomized trial that found that a daily aspirin protected against heart disease. A simple, cheap, over-the-counter pill could protect against the No. 1 cause of premature death: heart disease (specifically, atherosclerosis of the arteries of the heart)? It seemed too good to be true.

Is there a connection between music and health?

DEAR DOCTOR K: I believe music helped my mother recover after her stroke. Is there a connection between music and health?

DEAR READER: The ancient Greeks certainly thought so: They put one god, Apollo, in charge of both healing and music. Recent medical studies seem to confirm what the Greeks thought. Music seems to slow heart rate, lower blood pressure and reduce levels of stress hormones. It can also provide some relief to heart attack and stroke victims and patients undergoing surgery.

Can you explain how high cholesterol causes a heart attack or stroke?

DEAR DOCTOR K: Can you explain how high cholesterol causes a heart attack or stroke?

DEAR READER: Cholesterol is a type of fat that travels in the bloodstream. Our bodies need some cholesterol to survive. But high levels of cholesterol in the blood -- particularly low-density lipoprotein (LDL) cholesterol, or "bad" cholesterol -- increase your risk of cardiovascular disease.

My mother’s stroke severely impacted her ability to speak — What are ways she can regain her speech?

DEAR DOCTOR K: My mother recently had a stroke, and it's severely impacted her ability to speak. What can be done to help her regain her speech?

DEAR READER: Losing the ability to speak, or to understand speech, takes away an important part of ourselves -- the ability to communicate easily with others. I would rather be blind or deaf than unable to speak or to understand others. But there is hope that your mother can improve.

Can you explain how tPA works to treat a stroke?

DEAR DOCTOR K: My father recently had an ischemic stroke. He was treated with tPA and has now fully recovered. What is tPA? And how does it work?

DEAR READER: The most common kind of stroke is called an ischemic (is-KEY-mic) stroke: an artery supplying the brain becomes blocked by a blood clot. The part of the brain supplied by the artery needs the nutrition provided by a constant supply of blood. When that supply is interrupted, brain cells can die, taking with them the ability to move, speak, feel or think.

My father had a lacunar stroke — what does this mean?

DEAR DOCTOR K: My father just had a lacunar stroke. I've never even heard of this. What can you tell me about it?

DEAR READER: The most common kind of strokes, called ischemic (iss-KEE-mick) strokes, occur when an artery supplying oxygen-rich blood to a part of the brain is blocked. Many strokes are caused by blockages of the largest arteries in the brain. A lacunar stroke involves smaller arteries deep in the brain that branch off the large arteries.