Surgery Is Not the Answer for Preventing All Strokes
WebMD News Archive
Among the strokes counted in the study, a third had causes other than
blockages in the carotid arteries. Smaller blood vessels were the cause in 20%,
while 10% came from blood clots that originated in the heart and then became
lodged in the brain. Among the patients who previously had surgery, the
researchers found that up to 45% of their strokes did not occur in areas where
the vessels had been clogged. Among the strokes related to the heart, many were
caused by an irregular heart rhythm, called atrial fibrillation, which is
easily treatable with medication.
"We hope that people will pay attention to their patients and make sure
they are not the sort of patient who needs treatment of the heart and things
that will cause small vessel disease -- hypertension, diabetes, and high
cholesterol," Barnett says. "If they have never had any symptoms at
all, by all means just don't think about the arteries in the neck."
In an editorial accompanying the study, Louis R. Caplan, MD, argues that its
findings underscore the need for thorough evaluations of patients who are at
risk for stroke. "The main message of this article is that many patients
have more than one potential cause of stroke. Doctors should try to identify
all potential causes and treat those that can be treated," Caplan tells
WebMD. "Don't necessarily stop the investigation when one suspect is
found." Caplan is a neurologist at Beth Israel Deaconess Medical Center in
Boston and professor of neurology at Harvard Medical School.
This research was supported by the National Institute of Neurological
Disorders and Stroke, part of the National Institutes of Health.
- Surgeons can clean out clogged blood vessels in the neck to prevent a
stroke, but a third of strokes are unrelated to these arteries.
- Some experts are worried about ultrasounds that are advertised to examine
these particular vessels, even though there are many other important factors in
determining stroke risk.
- Physicians should try to identify all potential causes of stroke and treat
those that can be treated.