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How can I prevent recurrent stroke?

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Oncologist
Practicing since : 2002
Answered : 1753 Questions
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Just came back from visiting 92 year old grandmother (diff state). It appears she has had a stroke. She is drooling and having severe difficulty talking. She was already pretty deaf (you had to yell). She will not go to the doctor. My mom just told me her blood pressure is 203 over 103. We are concerned if we call 911 and force her, she may have another stroke...
Posted Fri, 4 May 2012 in Stroke
 
 
Answered by Dr. Robert Galamaga 6 minutes later
Hello and thanks for the query.

Your question is a good one and I will try to provide you with some good information and recommendations regarding what is going on.

In a case of stroke the body will naturally increase the blood pressure to try to force blood into areas of the brain where the stroke is happening. This can cause blood pressure to shoot up to very high numbers as you are seeing in her case.

Stroke can of course cause difficulty with speech, drooling, muscle weakness and trouble swallowing. This is a problem as patients can then have difficulty with inhaling secretions into the lungs which can cause a subsequent pneumonia.

I am afraid that she needs urgent medical evaluation and I encourage you to have emergency medical technicians transport her for an evaluation. She is elderly yes; but in this setting a thorough examination is warranted. I don't think stress of having 911 come to the house will cause further strokes.

Again I thank you for the query and hope my answer has provided you with the support you need to make your decision. If you have any additional concerns I would be happy to address them.

Sincerely,

Dr. Galamaga

Above answer was peer-reviewed by
 
Follow-up: How can I prevent recurrent stroke? 4 hours later
Thanks. I guess the blood pressure scared her enough that they got to her to agree to see a doctor. Her blood pressure had dropped some by the time they got there. They did confirm the stroke and said they think there is a clot somewhere "chipping away". They did a CT and are scheduling her for an ultra sound for her arteries in her neck. They did allow her to go back home, which was her condition for going.

Last question, can you explain the "chipping away" part to me? Is that like chipping away and then it will be gone? or is that chipping away what's causing the stroke(s)? My mother seems to think she may have had another episode yesterday afternoon. Thanks, we do feel better now that you explained the increase in blood pressure.
 
 
Answered by Dr. Robert Galamaga 6 hours later
Hello and thanks for the followup.

As for the chipping away - I am not exactly sure what they were referring to. I can speculate that they may have been referring to the fact that as a blood clot matures in the setting of stroke it can cause some symptoms to be permanent such as speech deficits, muscle strength deficits or possibly trouble swallowing. every patient is unique in how this will affect them.

I am glad she saw a physician and I hope they will be able to assure her a maintenance of a good quality of life with the additional testing. She will need to be on some mild blood thinners in order to protect against another stroke. I am afraid, however, that she will be at high risk for additional strokes in the future just by the very fact that she had one already. Protecting her as best we can against additional strokes is the goal of her physician.

I thank you again for submitting your query and hope my answer has served to be both helpful and informative. should you have additional concerns I would be happy to address them.

Regards,

Dr. Galamaga
Above answer was peer-reviewed by
 
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