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Introduction

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What is Stroke?
A stroke occurs when an artery carrying blood to the brain becomes blocked or ruptures, causing damage to the surrounding brain cells (Stroke Center, 2019). Strokes are the second leading cause of death and the third leading cause of disability worldwide (Johnson et al., 2016). 

Pathophysiology
The two main causes of stroke are ischemic  or hemorrhagic (Figures 1 & 2). Ischemic strokes occur wehn an artery that supplies blood to the brain becomes blocked. Ischemic strokes can be thrombotic (blood clot forms in an artery supplying blood to the brain) or embolic (blood clot travels through the bloodstream to an artery in the brain) (Mergenthaler et al., 2004). Hemorrhagic strokes occur when an artery bleeds in the brain (intracerebral) or in the meninges (subarachnoid) (Mergenthaler et al., 2004). Hemorrhagic strokes are considered far more dangerous than ischemic strokes because bleeding in the brain causes increased pressure in the skull, further constricting blood flow (Mergenthaler et al., 2004).

Risk Factors
Strokes are associated with modifiable and non-modifiable risk factors. Non-modifiable risk factors include age, sex, and ethnicity. Age is the strongest predictor of stroke incidence, with the risk of stroke doubling every decade above the age of 55 (Truelsen et al., 2006). In terms of sex and ethnicity, men, African Americans and Hispanic Americans are at a greater risk than women and White Americans (Stern et al., 2003). Furthermore, a recent stroke study found that ten risk factors are responsible for 90% of all strokes (Donkor, 2018). These preventable, modifiable risk factors include hypertension, hyperlipidemia, current smoking, a diet high in saturated fats and low in fiber, alcohol consumption, diabetes mellitus, stress, obesity, heart disease and physical inactivity (Donkor, 2018). Lifestyle and behavioural changes can help prevent a stroke.

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