Stroke

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.

What is a hemorrhagic stroke?

DEAR DOCTOR K: My grandfather just had a hemorrhagic stroke and is in pretty bad shape. What is it, and how is it treated?

DEAR READER: I'm sorry to hear this, but there's a chance he'll make a good recovery. There are two major kinds of strokes. In the most common type, a blockage in one of the brain's arteries shuts off the blood supply to a part of the brain. That's called an ischemic (is-KEE-mic) stroke. A hemorrhagic stroke occurs when one of the brain's arteries bursts and spills blood into the surrounding tissue.

How does atrial fibrillation increase stroke risk?

DEAR DOCTOR K: I have atrial fibrillation. It doesn't bother me, but I still have to take medications because the condition apparently increases my risk of stroke. How does it do that?

DEAR READER: Atrial fibrillation is a heart rhythm disorder that causes a rapid and irregular heartbeat. The atria are the upper two chambers of the heart; they receive blood from the rest of the body. The atria pump blood into the lower two chambers of the heart (the ventricles). Then the ventricles pump blood to the rest of the body. During atrial fibrillation, the atria do not beat normally. Instead, they quiver or "fibrillate."

Can a stroke cause depression?

DEAR DOCTOR K: My father had a stroke and has become depressed during his long recovery. Will antidepressants help? I'm asking because of the damage the stroke has done to his brain.

DEAR READER: I remember a patient like your father. Before his stroke, he was outgoing, active in his church and community, and always cracking jokes. Then he was hit with a stroke that paralyzed his left arm and leg. Fortunately, his speech and thinking were not affected, but his personality changed completely. He sat in bed saying very little to anyone who came in the room, including his family, friends and doctor. When physical therapists tried to get him to do exercises to build back the strength on his left side, he was mostly uncooperative.