Stroke

My wife had a mini-stroke. Can she have an angioplasty to open the narrowed brain artery?

DEAR DOCTOR K: My wife had a mini-stroke. The doctor said she has a narrowed artery in her brain. Can't the doctor open it up with angioplasty, as he would if she had a narrowed heart artery?

DEAR READER: "Mini-stroke" is another name for a transient ischemic attack, or TIA. A TIA causes stroke symptoms -- such as sudden weakness on one side of the body, blurred vision or difficulty speaking -- that last 10 minutes or more, but less than 24 hours. A TIA is a warning sign of an impending stroke. Four to 10 percent of people who have a TIA will go on to have a full-blown 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.