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Background on Stroke
The incidence of stroke, a neurological disease with significant morbidity and mortality, increases with age. Industry sources estimate that 30,000 patients are diagnosed with ruptured cerebral aneurysms each year in the United States. Embolic coiling is currently being used to treat approximately 30% of patients diagnosed with cerebral aneurysms in the United States. Industry sources also indicate that a significant percentage of patients diagnosed with cerebral aneurysms in European countries are treated using embolic coiling procedures and we believe that embolic coiling procedures can be used to treat a similar percentage of patients with cerebral aneurysms in the United States as awareness grows among patients and physicians of the advantages of embolic coiling.”
This section has been
broken into five topics
for your review. Please
select a topic of interest
from the menu.
COMMON RISK FACTORS FOR STROKE (return
to menu)
Hypertension
Heart disease
Diabetes
Previous stroke
Family history of stroke
Smoking
Obesity
Oral contraceptives
(return to menu)
TYPES OF STROKES (return to menu)
The term stroke relates
to sudden onset of neurological impairment. While most people recognize the
term stroke it is important to note that there are two broad categories of
stroke. These two categories include an ischemic event or a hemorrhagic stroke.
In an ischemic event an area of the brain has insufficient blood flow resulting
in inadequate tissue oxygenation. This is due to:
Thrombus - The formation of a blood clot that adheres to the vessel
wall and remains in place.
Embolus - A clot that moves from one area of the body to another.
Stenosis - A narrowing of the blood vessel.
In a hemorrhagic stroke there is bleeding within the cranial vault
typically without an associated traumatic event. The categories you may hear
physicians talk about include the following:
Subarachnoid hemorrhage - Bleeding into the
space between the membranes covering the brain and the brain itself. Such
bleeding occurs when an aneurysm ruptures.
Intracerebral hemorrhage - Bleeding into the
brain tissue resulting form a malformed vascular structure, hypertension,
or bleeding.
Symptoms of stroke typically correspond to the function of a specific area
of the brain where the stroke occurs.
The symptoms include but are not limited to the following:
•Numbness or weakness of the face, arm, or leg, especially if it is
on just one side of the body.
•Confusion - inability to speak or understand speech
•Sudden dizziness and/or loss of balance
•Sudden visual disturbance in one or both eyes
•Drooping eyelid
•Difficulty swallowing
•Nausea and/or vomiting
•Loss of bladder or bowel control
•Sudden and severe headache typically described as "the worst headache
of my life"
•Change of consciousness i.e. sleepy, stupor, or comatose
If someone is experiencing any of these symptoms they may be having a stroke.
A stroke is a true medical emergency. You should go to an emergency room immediately
or call 911 for the paramedics.
The best treatment success rate is achieved within the first few hours of
onset of symptoms.
(return to menu)
DIAGNOSING STROKE (return to menu)
Lumbar puncture
Special x-ray imaging studies:
•Computerized Axial Tomography (CAT) Scan of the head
•Magnetic Resonance Imaging (MRI) Scan of the head
•Angiogram to identify detailed vascular anatomy
Checking for signs of increased intracranial pressure (ICP)
(return to menu)
WHAT IS AN ANEURYSM (return
to menu)
An aneurysm is an
abnormal, balloon-like bulging of an arterial wall. Aneurysms can occur in
any part of the body, but only those in the arteries supplying blood to the
brain can cause a stroke. Aneurysms in the brain are present in about one
to six percent of the general population. They pose a significant health risk
because of their potential to bleed into the brain.
Almost all aneurysms within the brain occur around what is known as the Circle
of Willis, at arterial branch points where one vessel splits into two. When
an aneurysm ruptures it causes bleeding into the space between a membrane
covering the brain and the brain itself. This can result in a number of dangerous
complications from the increased pressure within the skull.
Complications of Hemorrhagic
Stroke
Elevated intracranial
pressure (ICP)
Reduced oxygen to brain tissue secondary to the narrowing of a blood vessel
Rebleeding
Permanent loss of brain function in the affected area
(return to menu)
ANEURYSM
TREATMENT(return
to menu)
Until the mid 1990s
treatment measures centered around surgical intervention. This involves opening
the skull, with dissection through the tissue and removal of an abnormal vascular
structure or clipping of an aneurysm. However, more recently treatments are
moving toward a less invasive and less traumatic interventional approaches.
The goal of treatment is to control the symptoms, prevent any further bleeding
of the aneurysm, and isolate the lesion from the cerebral circulation while
maintaining blood flow through the parent vessel.
Prevention of stroke
It is suggested that
one should make every attempt to reduce risk factors that are within ones
control. However, there is no known way to prevent an aneurysm.
(return to menu)
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