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| STROKE
Stroke occurs when a clot blocks an artery of the brain, and prevents the blood from supplying oxygen and glucose to that region of the brain. The symptoms of stroke usually come on suddenly, and can consist of paralysis, loss of sensation or vision, difficulty speaking or understanding, double vision, dizziness, imbalance, severe difficulty swallowing, or any combination of these. Major risk factors for stroke include hypertension, diabetes, elevated cholesterol, obesity, tobacco use, coronary artery disease, and cardiac rhythm disturbances such as atrial fibrillation. Hypertension, diabetes, elevated cholesterol, and tobacco use may cause atherosclerotic plaques in the arteries going from the heart to the brain. If these plaques rupture, clots may form and travel to occlude arteries in the brain. Coronary artery disease and atrial fibrillation predispose to forming clots in the heart that can also dislodge and occlude arteries in the brain. Three main therapeutic approaches in addressing strokes exist. These include prevention of a stroke before it occurs, preventing a second stroke after one has occurred, and the acute treatment of a stroke as it is occurring. Preventing a first stroke entails controlling the risk factors for stroke by diet and exercise; medications for hypertension, diabetes, or cholesterol; discontinuing smoking; and treating any coexisting cardiac disease. Preventing the recurrence of a stroke involves using medications that inhibit clot formation, such as aspirin and other available agents, in addition to controlling risk factors. In some cases, surgical removal of plaque from the arteries of the neck is performed to prevent a first or second stroke. The acute treatment of a stroke includes the administration of clot-dissolving medications within the first 3 hours of the onset of symptoms, and sometimes within the first 6 hours. Using such potent medication is not without risk, however, in that dissolving a clot may lead to hemorrhage. Nevertheless, clinical studies have proven an overall benefit of this form of therapy. 
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