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In the journals

People who suffer from migraines have increased risks of stroke and hospital readmission within 30 days after having surgery, according to research published online Jan. 10, 2017, by BMJ.

The study included 124,558 patients (45% of whom were men), who had a history of migraines, either with or without aura (a period of symptoms, such as flashes of light or facial tingling, that precedes the migraine). The researchers monitored the condition of all the patients after either inpatient or outpatient surgery. They then looked at how many had strokes and how many were readmitted to the hospital over the following 30 days.

Early treatment of the most common type of stroke, ischemic stroke, can limit brain damage and vastly improve outcomes. Ischemic stroke is the kind caused by atherosclerosis, which causes blood clots that block the blood supply to a part of the brain. Yet too few ischemic stroke patients receive important clot-busting drugs, which are most effective when given within three hours after symptoms start. Patients often arrive at the hospital after that window of opportunity has closed. They delay getting treatment because stroke symptoms may not be that pronounced or they are mistaken as coming from other, less serious problems.

As a result, doctors are looking for ways to make it easier for the layperson to identify a stroke. The Cincinnati Prehospital Stroke Scale is one such attempt. Some experts say it leaves out too many symptoms. Others say it will cause false alarms because it's not specific enough..

Most people with atrial fibrillation take anti-clotting drugs to prevent strokes. For those who cannot take these drugs because of a high risk of bleeding, a tiny, basket-like device implanted in the part of the heart that traps clots may be an alternative. 

Lacunar strokes, which account for about one-fifth of all strokes, occur in small arteries deep within the brain. Although these strokes may not cause symptoms, those that do may cause weakness in the face, arm, or leg on one side of the body. 

An abnormal heart rhythm � when your heartbeat is too slow, too fast, or irregular � may be a fleeting, harmless event. But it may also be a symptom of a more serious heart condition. One of these common abnormal heart rhythms, known medically as arrhythmias, is atrial fibrillation.

Atrial fibrillation

In atrial fibrillation (afib, for short), the heart's upper chambers, or atria, quiver instead of beating normally. The result is a fast, irregular heartbeat, which may lead to dizziness and fatigue but is often symptomless. A related condition is called atrial flutter.

In an observational study of 1.3 million women, excess weight was linked to an increased risk of strokes caused by blood clots but a lower risk of strokes caused by bleeding. 

The FDA has approved use of a clot-retrieving device along with a clot-busting drug on stroke patients, as long it’s within six hours of the onset of stroke symptoms.

Strokes seem to come out of the blue. But most of them happen due to decades-long damage to blood vessels and growth of artery-clogging plaque. That raises the question: Is there an early warning test for stroke?

Yes and no. A test called the carotid ultrasound can detect the buildup of cholesterol-filled plaque in the carotid arteries in the neck. These arteries deliver blood to the brain. The test, which uses sound waves, is quick, safe, and without any immediate potential for harm. It makes perfect sense for someone experiencing lightheadedness, memory loss, or the warning signs of a stroke or mini-stroke.

Here's what heart attack survivors need to know to lower their chance of a future stroke.

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First, the good news: The rate of first-time heart attacks has dropped by nearly half in the past 25 years. And heart attack survival rates have surged, thanks to improved treatments. The bad news? Compared to people without such a history, heart attack survivors not only face a higher risk of a second heart attack, they're also more likely to have a stroke.

The risk of stroke is higher in the first year following a heart attack, especially during the first month. After a year, however, only the risk of ischemic stroke remains elevated, according to study in the July 2016 Stroke that tracked more than a quarter-million heart attack survivors over a 30-year period. (See "Types of stroke: Blockage vs. bleeding" for a primer on the different types.)

Transient ischemic attacks, or TIAs, can signal an impending stroke, but prompt care can minimize damage.

Image: FlairImages/Thinkstock

Have you ever experienced a brief episode when your body seemed to be a little off—your vision was blurry, your speech slightly slurred, or one side of your body felt weaker than the other? If so, you may have experienced a transient ischemic attack (TIA), says Dr. Natalia Rost, a neurologist at Harvard-affiliated Massachusetts General Hospital. She notes that many women may assume they have suffered a migraine and get back to life as usual once the episode has passed. In fact, a TIA is a serious medical issue and warrants getting immediate treatment.

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