Stroke
The resources listed in this guide are compiled by the Consumer Health Information Service, 3rd floor, Toronto Reference Library. Complementary materials may also be found at the North York Central Library and local branches of the Toronto Public Library.
Definitions :Source for the following definitions unless otherwise specified: www.stroke.org, accessed Mar. 13, 03.
Aneurysm: A permanent abnormal balloon-like bulging of an artery's wall. The bursting of an aneurysm in a brain artery or blood vessel causes a hemorrhagic stroke.
Anti-coagulants: Drugs used in stroke prevention therapy to prevent blood clots from forming or growing. Anticoagulants interfere with the production of certain blood components necessary for clot formation.
Atherosclerosis: Narrowing of arteries caused by deposits of cholesterol (a fatty substance) in their walls. [Source: What You Really Need to Know about Caring for Someone after a Stroke. By Robert Buckman with J. Sutcliffe. Toronto: Macmillan Canada, 2000, p 76.]
Atrial Fibrillation: A type of irregular heartbeat. In this condition, some blood tends to stay in the heart instead of being pumped through the body. As a result, it can become more sticky and likely to clot. Any clots that form may eventually pass through the body and become lodged in the small arteries of the brain, causing a stroke. [Source: What You Really Need to Know about Caring for Someone after a Stroke. By Robert Buckman with J. Sutcliffe. Toronto: Macmillan Canada, 2000, p 29.]
Brain attack: A term that more accurately describes the effect and action of stroke on the brain.
Carotid endarterectomy: The surgical removal of atherosclerotic plaque blocking or reducing blood flow in a carotid artery. It is performed when the artery is moderately to significantly diseased or blocked (more than 50 percent blockage).
Embolus: An obstruction in the bloodstream-usually a small clot of blood that has broken away from a thrombus, but possibly a globule of fat or a bubble of air. Emboli usually form in the heart and in the arteries that take blood to the brain. [Source: What You Really Need to Know about Caring for Someone after a Stroke. By Robert Buckman with J. Sutcliffe. Toronto: Macmillan Canada, 2000, p 12.]
Stroke: A stroke (also called a cerebrovascular accident, CVA, or brain attack) is the death of brain tissue (cerebral infarction) resulting from lack of blood flow and insufficient oxygen to the brain. A stroke can be either ischemic or hemorrhagic. In an ischemic stroke, the blood supply to part of the brain is cut off because either atherosclerosis or a blood clot has blocked a blood vessel. In a hemorrhagic stroke, a blood vessel bursts, preventing normal flow and allowing blood to leak into an area of the brain and destroy it. [Source: The Merck Manual of Medical Information Home Edition. Editor-in-Chief, Robert Berkow. Whitehouse Station, NJ: Merck Research Laboratories, 1997, p 352.]
Thrombus: A clot of blood that usually forms in an artery already narrowed by a build-up of fatty matter (atherosclerosis), which has a reduced blood flow. [Source: What You Really Need to Know about Caring for Someone after a Stroke. By Robert Buckman with J.Sutcliffe. Toronto: Macmillan Canada, 2000, p 12.]
Thromboembolism: An embolus that originates in, and breaks away from, a clot in one vessel to become lodged in another vessel.
Transient Ischemic Attack (TIA): Temporary interruptions of the blood supply to an area of the brain, typically caused by carotid stenosis. During a TIA, a person experiences a sudden onset of stroke symptoms. By definition, a TIA can last up to 24 hours, but most last only a few minutes and cause no permanent damage or disability. Sometimes called "mini-strokes," TIAs must be taken seriously because they are usually a precursor to full strokes.
For further information:Heart and Stroke Foundation
1920 Yonge St., 4th Floor
Toronto, ON M4S 3E2
Heart and Stroke Healthline: 1-888-473-4636
Internet address: http://www.heartandstroke.ca
Provides professional and public education, community presentations, and patient resources on heart and stroke--such as fact sheets, mini books/pamphlets, the Strokeline Newsletter, wallet cards, cookbooks, and nutrition guides.Stroke Recovery Association of Ontario
80 Bradford Street, Unit 239A
Barrie, ON L4N 6S7
Tel: (416) 425-4209 (Toronto) or 1-888-540-6666
E-mail: srao@mcw.net
Internet address: http://members.aol.com/matherbw/SRAWeb/Home.html
Offers "hands-on help" for families affected by stroke; provides educational materials on stroke; publishes the Phoenix, Ontario’s Stroke Community Newsletter; and provides the names and locations of the various Ontario SRA Chapters.
Books:The Cardiovascular cure: How to strengthen your self defense against heart attack and stroke. By Judith Zimmer and John. P. Cooke. New York, NY: Broadway Books, 2002. 310 p. Hardcover. $38.00 Cdn.
Call no. and location: 616.105 C58 CHIS Open Shelf 3rd floor
Dr. Cook, head of Stanford Medical School’s vascular unit, offers a groundbreaking approach to preventing heart attack and stroke without bypass surgery or angioplasty. He provides information about a diet and exercise program that will reduce cholesterol, blood pressure, and the risks associated with diabetes or other risk factors associated with cardiovascular disease. Included is detailed information on supplemental nutrients and vitamins useful in strengthening the cardiovascular system, as well as recipes for a wide range of foods.Living with stroke: A guide for families. 3rd edition. By Richard C. Senelick and Karla Dougherty. San Antonio, TX: HealthSouth Corp., 2001. 272 p. Paperback. $14.95 U.S.
Call no. and location: 616.81 S25 CHIS Open Shelf 3rd floor
This easy-to-read sourcebook discusses what stroke is--causes, types, symptoms; risk factors for stroke; treatment/rehabilitation; and the family’s role.Managing stroke: A guide to living well after stroke. Edited By Paul R. Rao, Mark N. Ozer, John E. Toerge. Arlington, VA: ABI Professional Publications, 2000. 299 p. Hardcover. $27.00 U.S.
Call no. and location: 616.81 M12 CHIS Open Shelf 3rd floor
An instructional guide for stroke patients and their families. With information on physical therapy, occupational therapy, and daily living skills, this is primarily a guide to rehabilitation rather than a quick reference book or a guide to prevention.The Prevention of stroke. Edited by Philip B. Gorelick and Milton Atler. Boca Raton, FL: CRC Press, 2002. 280 p. Hardcover. $161.95 Cdn.
Call no. and location: 616.81 P67 CHIS Open Shelf 3rd floor
An outstanding resource for clinicians and policymakers, the text consists of three sections covering epidemiology and pathophysiology, approaches to prevention, and management of risk factors. A strength of this book is its reliance of well-founded, scientifically derived evidence interpreted by clinically experienced stroke experts. A difficult read for the average patron.Rehabilitation of stroke. By Paul E. Kaplan, et. al. St. Louis, MO: Butterworth-Heinemann, 2003. 180 p. Paperback. $83.95 Cdn.
Call no. and location: 616.8103 K12 CHIS Open Shelf 3rd floor
Written by a team of rehabilitation medicine academics, the text examines the various components of the evaluation and treatment of patrons who have had hemorrhagic strokes. It covers clinical presentation, deficits of function, medical complications, regional pain syndrome, psychological treatment, and patients with hidden disabilities.Stroke: A Comprehensive guide to "brain attacks". By Vladimir Hachinski and Larissa Hachinski. Toronto: Key Porter Books, 2003. 144 p. Paperback. $19.95 Cdn.
Call no. and location: 616.81 H11 CHIS Open Shelf 3rd floor
Endorsed by the Canadian Medical Association, this title is a new addition to the Your Personal Health Series. Dr. V. Hachinski is a world-renowned stroke expert and is the editor-in-chief of Stroke, the leading publication in the field. The authors provide "an informative, well-written book covering the complex subject of stroke - cause, treatment, and outlook - both comprehensively and in detail." [front cover]Stroke: Your questions answered. By Graeme J. Hankey.St. Louis, MO: Harcourt Health Sciences Group, 2002. 360 p. Paperback. $29.95 U.S.
Call no. and location: ON ORDER CHIS Open Shelf 3rd floor
"Part of the Your Questions Answered series, this text, written in a question-and-answer format, presents succinct information about strokes. It includes both frequently asked and unusual questions regarding pathogenesis, diagnostics, new research, prevention, special populations, and a listing of support services." [adapted from the Amazon.com website, accessed March 12, 2003]Stroke-free for life: The complete guide to stroke prevention and treatment. By David Wiebers. New York: Cliff Street Books, 2001. 340 p. Hardcover. $37.95 Cdn. (Paperback edition released July 2001, $14.95 U.S.)
Call no. and location: 616.81 W37 CHIS Open Shelf 3rd floor
Dr. Wiebers, Chair of Cerebrovascular Diseases at Mayo Clinic, describes "what you need to know to help protect your family from stroke and its aftermath." Includes a risk-assessment questionnaire, a prevention program, and a stroke emergency checklist. [adapted from front cover]The Stroke recovery book: A guide for patients and families. By Kip Burkman. Omaha, NE: Addicus Books, 1998. 152 p. Paperback. $14.95 U.S.
Call no. and location: 616.81 B79 CHIS Open Shelf 3rd floor
This quick reference guide covers such topics as "how strokes occur; major types of strokes and their effects; cognitive changes; speech and language impairments; weakness in limbs; swallowing problems; recovery and rehabilitation, and stroke prevention." [adapted from back cover] Although this is an older text, it is still of significant value to families dealing with the issues related to stroke-related problems.Stroke rehabilitation: A collaborative approach. Edited by Robert Fawcus. Malden, MA: Blackwell Science Inc., 2000. 214 p. 2000. Paperback. $53.95 U.S.
Call no. and location: 616.81 S763 CHIS Open Shelf 3rd floor
This collaborative effort includes contributions from a doctor, nurse, physiotherapist, occupational therapist, speech and language therapist, and a neuropsychologist. Written in an informative and accessible style, this book will help professionals involved in the management of stroke to understand the role of other members of the rehabilitation team. The book covers both the theoretical and the practical issues in preventing stroke and rehabilitating the stroke patient. [adapted from back cover]What you really need to know about caring for someone after a stroke. By Robert Buckman with Jenny Sutcliffe. Toronto: Macmillan Canada, 2000. 80 p.
Call no. and location: 362.19681 B77 CHIS Open Shelf 3rd floor
Part of the "What You Really Need to Know" series, this text "lists the warning signs that signal an increased risk of stroke. Explains what might happen in the hospital and describes what each member of the care team does. Gives positive advice on the practicalities of caring, from helping with physical therapy to taking time off for yourself." [adapted from back cover] Also includes a section, "Useful addresses" which provides Canadian sources for further information.
Articles:Articles from scientific and popular journals, newspaper clippings, lists of related organizations, and pamphlets, when available, are included in the subject file collection. (This collection is available only during CHIS hours of operation)
Location of subject files: CHIS Desk 3rd floor CEREBROVASCULAR DISORDERS Subject Files"9 Preventive Strikes Against Stroke." Harvard Heart Letter, February 2003, p.1-2.
Explains the basics about strokes- what it is and the warning signs, in addition to providing 9 steps that may help in preventing a stroke."Prevention and management issues in stroke." By Gregory W. Albers. Consultant, February 2003, pp.243-7.
Written in a question-and-answer format, this article is directed to family physicians and discusses: which patients stand to benefit from carotid endarterectomy, the benefits and pitfalls of thrombolysis, a workup for patients with suspected TIA’s, and a discussion of optimal blood pressure control in the elderly. Of interest to patrons who are looking for in-depth information about treatment issues."Poor outcome after first-ever stroke: Predictors for death, dependency, and recurrent stroke within the first year." By Peter Appelros, Ingegerd Nydevik, and Matti Viitanen. Stroke, January 2003, pp. 122-126.
Directed to physicians, this discusses a study that was done to demonstrate the impact of prestroke risk factors on the outcome of patients who survived the acute phase of a stroke. The study confirms that age and stroke severity are risk factors for mortality and dependency within the first year after a first-ever stroke. Prestroke heart disease and dementia also influence long-term survival."Duration, frequency, recency, and type of migraine and the risk of ischaemic stroke in women of childbearing age." By M. Donaghy, et. al. Journal of Neurology, Neurosurgery, and Psychiatry, December 2002, pp. 747-50.
Presents the findings of a study evaluating the relationship between migraines and strokes. The data suggests that the risk of ischemic stroke is influence by the frequency, type (with or without aura), and pattern of migraine. The study authors found that those who reported that their initial migraine type was with aura, were approximately three times as likely to develop a subsequent ischemic stroke. Although quite technical in nature, the article will be of interest to those who suffer with migraines."Transient ischemic attack." By S. Claiborne Johnston. New England Journal of Medicine [NEJM], November 21, 2002, pp. 1687-92.
Written for the health professional, this article provides an overview of this condition and discusses various treatment strategies. A review of formal clinical guidelines is also provided, as is a presentation of the author’s clinical recommendations. The article is of value to persons who want to know what their doctor may "do" for a patient who has suffered with a transient ischemic attack [TIA]."Prospective assessment of risk factors for recurrent stroke during childhood: a 5-year follow-up study." By Ronald Strater, et. al, The Lancet, November 16, 2002, pp. 1540-45.
"Risk factors for arterial stroke in children include congenital heart malformations, vasculopathies, infectious diseases, collagen tissue diseases, and metabolic disorders. The authors of this study investigate the relevance of underlying stroke subtypes, organic and metabolic disease, and prothrombotic risk factors to a second stroke in children." [Adapted from Introduction] Their data shows that" recurrent ischemic stroke in childhood is a rare but serious event which arises soon after the first event and has a high fatality rate. Therefore, identification of children at increased risk because of raised lipoprotein (a), protein C deficiency, or stroke of vascular cause will help to improve preventive measures."Sex and acute stroke presentation." By L.A. Labiche, et. al., Annals of Emergency Medicine, November 2002, pp. 453-60.
The results of a study are presented in regards to whether a sex difference exists in the reporting of acute stroke symptoms. The study found that women with validated strokes present more frequently with non-traditional stroke symptoms than men. It is possible that the increased mortality rate for women with stroke may be due to slower triage, diagnosis, and treatment of stroke in women because of this presentation of different stroke symptoms. Recognition of this difference might yield faster evaluation and management of female patients in the future."Homocysteine and the risk of ischemic heart disease and stroke: a meta-analysis." By The Homocysteine Studies Collaboration. JAMA, October 23/30, 2002, pp. 2015-22.
Amongst medical people, the thinking had been that increased homocysteine levels were associated with an increased risk of stroke. This study suggests that homocysteine levels are less strongly related to ischemic heart disease and stroke that had been previously thought. (Quite technical.)"Brain attack: save yourself from a stroke with our six-step plan." By Sari Harrar. Prevention, October 2002, pp. 116-21, 190-91.
Recognizing the information gap that exists between "stroke experts" and the general population, the author asked three experts to recommend simple steps to prevent or survive a stroke. Included is an anti-stroke shopping guide."Low dose Aspirin for everyone?" [Johns Hopkins] Health After 50, October 2002, pp. 4-5.
A discussion of the risks and benefits of aspirin therapy used to decrease the risk of ischemic stroke."Hormone replacement therapy and associated risks in postmenopausal women." Archives of Internal Medicine. September 23, 2002. pp. 1954-60.
Presents the results of a study which indicates that " the risk of both types of stroke appeared to be transiently increased after the initial of HRT. Compared with current HRT use of longer duration, there was a 2-fold increase in risk of first ischemic/hemorrhagic stroke during the first 6 months after initiating HRT use. In addition, the association between current HRT and ischemic stroke differed depending on the dose of estrogen used. Until better evidence is available to guide such decisions, these findings suggest that the lowest possible dose of estrogen would be used when women receive HRT for symptoms of menopause." [within text of article]"New evidence for stroke prevention: scientific review." By S.E. Straus, S.R. Majumdar, and F.A. McAlister. JAMA, September 18, 2002, pp. 1388-95.
Written for the family physician or for the layperson seeking (semi-technical) information about the latest studies relating to the treatment and prevention of stroke, the authors provide an overview of recent developments relating to drugs and strategies. The variability of study findings is also discussed."Botox dramatically reduces stroke patients’ spasticity." By Kylie Taggart. Medical Post. August 27, 2002. p. 4.
Presents the results of a new study which shows that intramuscular injections of Botox for spasticity in stroke dramatically improves the patient’s functional outcomes and quality of life."Stroke: risks, recognition, and return to work." By Julie J. Zerwic, Kathy Ennen, and Holli A. DeVon, AAOHN Journal [American Association of Occupational Health Nurses], August 2002, pp. 354-59.
Although the article is directed at occupational health nurses, the language is clear and thoroughly understandable. An excellent article which provides an overview about the pathophysiology, risk factors, symptoms, treatment, and prevention of stroke. A discussion about returning to employment following a stroke is included .The section which discusses federal legislation and regulations as it relates to employment is U.S.A.-based."What blacks need to know about stroke." By Nicole Walker. Jet, July 22, 2002, pp. 22-4, 26.
African-Americans, ages 35-54, are four times more likely to die of a stroke that white people in the same age group. Information about strokes - the risk factors, symptoms, preventative measures, etc. is presented and a discussion of the increased mortality rate for blacks is included within this material."Exercise programming for post-rehabilitation stroke clients - Part 1." By Maribeth Salge. American Fitness, March/April 2002. pp. 47-50.
"Exercise programming for post-rehabilitation stroke clients - Part 2." By Maribeth Salge. American Fitness, May/June 2002. pp. 56-59.
These articles are "intended to be an educational tool for personal trainers interested in developing programs for post-rehabilitation stroke clients (i.e., those who have completed physical and/or occupational therapy)." Part 1 focuses on definitions, demographics and challenges related to stroke sufferers; Part 2 focuses on the development and implementation of an exercise program. [taken from within the text of the articles]"Stroke: Using recent advances in diagnosis and treatment." By Dorothy L. Pennachio. Patient Care, May 2002. pp. 25-26,28,31-34,39.
Recent surveys indicate that as many as 15% of people with symptoms of a stroke call their doctor instead of going to the emergency department. Studies conclude that both diagnostic studies necessary for the selection of appropriate therapy in patients with TIA or stoke and anticoagulation therapy are underused in primary care settings. The article points out the various diagnostic aids and range of therapies available to the physician and presents an in-depth discussion of the use of intravenous thrombolytic agents. Secondary preventative measures are also discussed and the American Heart Association’s Guidelines for Stroke Therapy is also included. Written for the health professional."Brain health - TIA’s: Heed these warning signs of a stroke." Harvard Health Letter. April 2002. Pp. 1-2.
Discusses the importance of TIA’s: what the symptoms are and what they mean. Includes information about treatment during a TIA, and about post-TIA stroke prevention."Preventing atherosclerotic events with aspirin." By John G.F. Cleland. BMJ [British Medical Journal]. January 12, 2002. pp. 103-5.
In response to a series of meta-analyses regarding the use of aspirin to prevent atherosclerotic events, Professor Cleland argues that evidence supporting aspirin’s use in preventing atherosclerotic events is inconclusive. One adverse effect in the belief in its effectiveness is the neglect of more effective drugs for preventing heart disease and stroke
Periodicals:Phoenix, Ontario’s Stroke Community Newsletter
Published quarterly by the Stroke Recovery Association of Ontario, 10 Overlea Boulevard, Toronto, ON M4H 1A4. Tel: (416) 425-4209 or 1-888-540-6666 (Ontario).
Provides general information on stroke, articles by stroke survivors and caregivers, plus news and events of interest to stroke patients and their families.Strokeline Newsletter
Published quarterly by the Heart and Stroke Foundation, 1920 Yonge St., 4th Floor, Toronto, ON M4S 3E2. Tel: 1-888-HSF-INFO (1-888-473-4636)
This newsletter is for stroke survivors and their families to help them live better after stroke. Includes helpful hints on day-to-day living after stroke; Strokesmart recipes; updates on stroke research; and inspiring stories from other stroke survivors. This free newsletter is available in English and French. Register for Strokeline on the Heart and Stroke Foundation’s web site at www.heartandstroke.ca or call 1-888-473-4636.
Internet Resouces:
- Heart and Stroke Foundation of Canada/Fondation des Maladies du Coeur du Canada
http://www.heartandstroke.ca
This site covers a variety of topics relating to heart and stroke, as well as Canada’s Food Guide. The Resource Library’s section on stroke includes such topics as risks for stroke, types of stroke, symptoms, treatment, and caregiver issues. Site also has links to provincial heart and stroke foundations.
- Stroke Recovery Association of Ontario (SRAO)
http://members.aol.com/matherbw/SRAWeb/Home.html
The SRAO site provides general information on stroke for stroke patients and their families. Includes sections on the impact of stroke on the family, aphasia, help for caregivers, emotional and behavioural changes after stroke, and links to other stroke-related web sites.
- American Stroke Association, A Division of the American Heart Association
http://www.StrokeAssociation.org
Professional and consumer information on stroke: risks, symptoms, treatment, and more. Site also includes links to other stroke-related web sites.
- National Institute of Neurological Disorders and Stroke, National Institutes of Health [USA]
http://www.ninds.nih.gov/
Published by the National Institute of Neurological Disorders and Stroke (NINDS), this site contains information about many neurological disorders such as stroke, epilepsy, and Parkinson disease. Site also includes an "NINDS stroke information page", with links to related organizations and publications; news releases and research.
- National Stroke Association [USA]
http://www.stroke.org
Published by the National Stroke Association, this site provides information on types of stroke, risk factors, effects of stroke, recovery and rehabilitation, treatment, and research. Also includes stroke prevention guidelines and a stroke glossary.
This brief guide is intended to provide health information. It is a representative, rather that a comprehensive, list of publications, organizations and resources on stroke. This guide does not imply recommendation of any treatment and should not be substituted for the advice of a health care provider.