Measures to prevent recurrence

fter a first stroke, a number of precautions to reduce the risk of recurrence.The occurrence of stroke reflects the presence of predisposing factors, it is important to correct to improve the prognosis. In the absence of preventive measures, the risk of recurrence is high.

Hypertension, first target
Hypertension is the major risk factor for stroke. Taking into account to reduce the risk of recidivism. If the beneficial effects of antihypertensive treatment concern above all brain hemorrhages, they also extend to the ischemic (lack of oxygenation of the brain) and may even apply to people with normal blood pressure.

Measures to prevent recurrence

The first results of a large international study presented by Marie Germaine Bousser at the 17th World Congress of Neurology June 22, 2001, in London. More than 6,000 patients who had a stroke have participated in the study, whether or not they are hypertensive. Diuretic and antihypertensive (by converting enzyme inhibitor) treatment resulted in a decrease in recurrence of 40%, compared to placebo. He has also decreased the risk of death and slowed the decline of brain function often associated to the lack of cerebral oxygenation.

The antihypertensive treatment should be in place in the days following the stroke. Further studies are necessary to clarify its place in individuals with normal blood pressure.

Avoid thrombosis
Ischemic, four times more frequent than cerebral bleeding, accidents are due to the obstruction of the arteries of the brain by a blood clot (thrombosis). They typically occur on arteries already narrowed by atherosclerotic plaques. These yellow plates consist of fat deposits on the inner surface of the artery.

Antiplatelet agents, such as aspirin at low doses, prevent the formation of these thrombosis and are prescribed after a first accident to avoid recurrences. Treatments that lower cholesterol levels in the blood, like Statins, appear to be equally effective.

On the other hand, total discontinuation of tobacco and alcohol is essential and oral contraception is definitely contraindicated.

Two special cases
Some cases involve special preventive measures. A stroke can be of to a rhythm disorderembolism which will obstruct brain vessels, heart. Sometimes, it is possible to restore a normal heart rhythm and thus eliminate the risk of embolism. In the contrary case, anticoagulant treatment is necessary to prevent the formation of blood clots that can migrate to the brain.

Stenosis of the carotid artery, i.e. narrowing of its diameter, may be at the origin of ischemic. As long as these narrowings result no symptoms and are not too important, no operation is performed. On the other hand, the intervention is proposed if the strictures have already caused an ischemic.