Stroke: Causes, Warning Signs, Therapy

Brief overview

Causes and risk factors: Reduced blood flow in the brain, e.g. due to a blood clot or cerebral hemorrhage, more rarely vascular inflammation, embolisms, congenital bleeding and clotting disorders; risk increased by unhealthy lifestyle, cardiovascular and metabolic diseases, age, genetic predisposition, hormone therapies, etc.
Examination and diagnosis: Stroke test (FAST test), neurological examination, magnetic resonance and/or computer tomography (MRI/CT), ultrasound, X-ray, electrocardiography (ECG), blood test
Symptoms: feelings of paralysis and numbness in one half of the body, sudden visual and speech disorders, acute and severe headaches, acute dizziness, speech disorders, etc.
Treatment: First aid (call an ambulance: Tel: 112), stabilization and monitoring of vital functions, lysis therapy and/or thrombectomy (dissolving/removing the blood clot), medication, surgery for major cerebral haemorrhage, treatment of complications (epileptic seizures, increased intracranial pressure, etc.), rehabilitation
Prevention: Healthy lifestyle with a balanced diet, regular exercise, moderate alcohol consumption, no smoking

What is a stroke?

A stroke is a disease of the brain in which a sudden loss of blood flow to certain regions of the brain occurs. Doctors also speak of apoplexy or apoplexy, stroke, brain insult, apoplectic insult or cerebral insult.

The acute circulatory disorder in the brain results in the brain cells receiving too little oxygen and nutrients. As a result, they die. Loss of brain function is usually the result and causes, for example, numbness, paralysis, speech or visual disturbances. With prompt treatment, they sometimes disappear again; in other cases they remain permanent. A severe stroke is often fatal.

Frequency

According to a study by the Robert Koch Institute (RKI), around 1.6% of adults in Germany suffered a stroke or had chronic symptoms as a result of a stroke in 2014/2015. An apoplexy is the second most common cause of death and one of the most significant causes of disability in adults.

People who have already had a stroke are at an increased risk of having another one. Around 40 out of 100 people who have already had a stroke will have another one within ten years. The risk of other cardiovascular diseases (such as heart attacks) is also increased in stroke patients.

Stroke in young adults

The risk of a stroke increases with age, but the number of people affected increases year on year, even among people well before senior age. The reason for this is presumably that the risk factors are also shifting to earlier and earlier stages of life: obesity, elevated blood lipid levels, high blood pressure, diabetes, lack of exercise. Only a large proportion of younger people have turned away from smoking compared to the past.

This means that typical stroke symptoms should be taken seriously, even at a young age. Always call an emergency doctor if you suspect a stroke.

Stroke in children

Children also occasionally suffer a stroke – even unborn children in the womb. Possible causes include clotting disorders, heart and vascular diseases. Sometimes an infectious disease also triggers a stroke in children.

There is no clear number of children and adolescents who have been diagnosed with apoplexy. Experts are convinced that it is much higher than stated because the diagnosis of “stroke” is more difficult to make in children. The reason for this is that the brain has not yet fully matured and a stroke in children therefore often only becomes apparent months or years later. For example, hemiplegia in newborns only becomes apparent after around six months.

How does a stroke develop?

Stroke cause no. 1: Reduced blood flow

Acute reduced or insufficient blood flow (ischemia) in certain regions of the brain is the most common cause of all strokes. It is responsible for around 80 percent of all cases. Doctors refer to this as an ischemic stroke or cerebral infarction.

There are various reasons why there is a lack of blood flow to certain regions of the brain. The most important are

Blood clot: A blood clot blocks a cerebral vessel and thus cuts off the blood and oxygen supply to a region of the brain. The clot has often formed in the heart (e.g. in atrial fibrillation) or in a “calcified” carotid artery and is then swept into the brain with the blood flow.
“Vascular calcification” (arteriosclerosis): Brain vessels or vessels supplying the brain in the neck (such as the carotid artery) are “calcified”: deposits on the inner wall constrict a vessel more and more or even close it off completely. The area of the brain to be supplied with blood then receives too little blood and oxygen.

Stroke cause no. 2: cerebral hemorrhage

Around 20 percent of all strokes are caused by bleeding in the head. A stroke caused by such a cerebral hemorrhage is also called a hemorrhagic stroke. The bleeding occurs in different places:

Bleeding in the brain: In this case, a vessel suddenly bursts directly in the brain and blood leaks into the surrounding brain tissue. The trigger for this so-called intracerebral hemorrhage is usually high blood pressure. Other illnesses, drug abuse and the rupture of a congenital vascular malformation (such as an aneurysm) in the brain may also cause bleeding in the brain. Sometimes the cause remains unexplained.

Bleeding between the meninges: In this case, the stroke is caused by bleeding in the so-called subarachnoid space: this is the gap-shaped space filled with cerebrospinal fluid between the middle meninges (arachnoid) and the inner meninges (pia mater), which together with the outer hard meninges (dura mater) surround the brain. The cause of such a subarachnoid hemorrhage is usually a spontaneously burst aneurysm (congenital vascular malformation with bulging of the vessel wall).

There are other causes for a stroke, especially in younger people, other than reduced blood flow or cerebral haemorrhage. In some patients, for example, the stroke is caused by inflammation of the blood vessel walls (vasculitis). Such vascular inflammation occurs in the context of autoimmune diseases such as giant cell arteritis, Takayasu arteritis, Behcet’s disease and systemic lupus erythematosus.

Other rare causes of stroke include fat and air embolisms: in these cases, droplets of fat or air clog a cerebral vessel, resulting in a cerebral infarction. A fat embolism occurs, for example, in the case of severe bone fractures when fat-rich bone marrow washes into the blood. An air embolism occurs, for example, as a very rare complication of open heart, chest or neck surgery.

Congenital coagulation disorders and the formation of blood clots in the veins are also among the rare causes of stroke.

Risk factors for stroke

However, there are also many risk factors that can be reduced. These include, for example, high blood pressure (hypertension): It leads to “vascular calcification” (arteriosclerosis), which in turn increasingly narrows the vessels. This favors a stroke. The more severe the high blood pressure, the more likely a stroke is.

Smoking is also an avoidable risk factor for a stroke: The more cigarettes someone smokes per day and the more years their smoking “career” has lasted, the higher their risk of stroke. There are several reasons for this:

Among other things, smoking promotes vascular calcification (arteriosclerosis) and lipid metabolism disorders – both of which are further risk factors for a stroke. Smoking also causes the blood vessels to constrict. The resulting increase in blood pressure favors a stroke.

Last but not least, smoking increases the blood’s ability to clot – mainly because the blood platelets become stickier. This makes it easier for blood clots to form, which in turn block a blood vessel. If this happens in the brain, the result is an ischemic stroke.

It is therefore worth giving up smoking. Just five years after quitting smoking, you have the same risk of stroke as people who have never smoked.

Other important risk factors for a stroke are:

Alcohol: High alcohol consumption – whether regular or infrequent – increases the risk of a stroke. In particular, the risk of a cerebral hemorrhage increases. Regular alcohol consumption also harbors other health risks (such as addiction potential, increased risk of cancer).
Overweight: Being overweight increases the risk of many different diseases. In addition to diabetes and high blood pressure, this also includes strokes.
Lack of exercise: Possible consequences are obesity and high blood pressure. Both favor a stroke.
Diabetes: In diabetes mellitus, the permanently high blood sugar level damages the blood vessel walls, causing them to thicken. This impairs blood flow. Diabetes also exacerbates existing arteriosclerosis. Overall, diabetics have a two to three times higher risk of stroke than people who are not diabetic.
Atrial fibrillation: This heart rhythm disorder increases the risk because blood clots easily form in the heart. Carried along by the blood flow, these clots block a vessel in the brain (ischemic stroke). This risk is even greater if you also have other heart conditions such as coronary heart disease (CHD) or heart failure.
Other cardiovascular diseases: Other cardiovascular diseases such as “smoker’s leg” (PAOD) and “impotence” (erectile dysfunction) also increase the risk of stroke.
Aura migraine: A stroke due to reduced blood flow often occurs in people who suffer from a migraine with aura. The headache is preceded by neurological symptoms such as visual or sensory disturbances. The exact connection between aura migraine and stroke is not yet known. Women are particularly affected.
Hormone preparations for women: Taking the contraceptive pill increases the risk of stroke. This is particularly true for women with other risk factors such as high blood pressure, smoking, obesity or aura migraine. Taking hormone preparations during the menopause (hormone replacement therapy, HRT) also increases the risk of a stroke.

Stroke in children: causes

Strokes in children are rare, but do occur. While lifestyle factors and diseases of civilization (smoking, arteriosclerosis, etc.) are considered the main causes of stroke in adults, children have other causes of stroke.

How is a stroke diagnosed?

Whether a stroke is severe or mild – every stroke is an emergency! If you even suspect a stroke, you should call the emergency doctor immediately (112)!

The FAST test is a quick and easy way to check for a stroke. The stroke test works as follows:

F for “face”: Ask the patient to smile. If the face is contorted on one side, this indicates hemiplegia as a result of a stroke.
A for “arms”: Ask the patient to simultaneously stretch their arms forward while turning their palms upwards. If he has problems doing this, there is probably incomplete paralysis of one side of his body as a result of a stroke.
S for “speech”: Ask the patient to repeat a simple sentence. If he is unable to do this or his voice sounds slurred, there is probably a speech disorder as a result of a stroke.
T for “time”: Call an ambulance immediately!

After admission to hospital, a neurologist is the specialist responsible if a stroke is suspected. He or she will carry out a neurological examination. This includes checking the patient’s coordination, speech, vision, sense of touch and reflexes.

As a rule, the doctor will also immediately order a computer tomography scan of the head (cranial computer tomography, cCT). The CT scan is often supplemented by vascular imaging (CT angiography) or a blood flow measurement (CT perfusion). The images of the inside of the skull show whether a vascular occlusion or a cerebral hemorrhage is responsible for the stroke. Its location and extent can also be determined.

Sometimes the doctor uses magnetic resonance imaging (MRI, also known as magnetic resonance imaging) instead of computer tomography. It can also be combined with vascular imaging or blood flow measurement.

In some patients, the doctor performs a separate X-ray examination of the vessels (angiography). Vascular imaging is important, for example, to detect vascular malformations (such as aneurysms) or vascular leaks.

An ultrasound examination of the heart cavities (echo sonography) reveals heart diseases that promote the formation of blood clots, for example deposits on the heart valves. Sometimes doctors discover blood clots in the heart cavities. They increase the risk and may be the cause of another stroke. Patients are therefore given blood-thinning medication to dissolve the blood clots.

Another important cardiac examination after a stroke is electrocardiography (ECG). This is the measurement of the heart’s electrical currents. Sometimes it is also carried out as a long-term measurement (24-hour ECG or long-term ECG). The doctor uses the ECG to detect any heart rhythm disturbances. These are also an important risk factor for an ischemic insult.

Blood tests are also important in the diagnosis of a stroke. For example, the doctor determines the blood count, blood coagulation, blood sugar, electrolytes and kidney values.

What are the typical symptoms of a stroke?

The symptoms of a stroke depend on which region of the brain is affected and how severe the stroke is. Very often there are symptoms of numbness and paralysis on one side of the body, for example one side of the face.

This can usually be recognized by the fact that the corner of the mouth and the eyelid on one side droop and/or an arm can no longer be moved. The left side of the body is affected if the stroke occurs in the right side of the brain, and vice versa. If the patient is completely paralyzed, this indicates a stroke in the brain stem.

Sudden visual disturbances are also common stroke symptoms: Those affected report, for example, that they only have blurred vision or perceive double vision. A sudden, temporary loss of vision in one eye, for example, also indicates a stroke. Due to the acute visual disturbances, those affected run the risk of falling or – while driving, for example – causing an accident.

Other possible signs of a stroke are sudden dizziness and very severe headaches.

You can read more about the signs and symptoms of a stroke in the article Stroke: symptoms.

Transient ischemic attack (TIA) – the “mini stroke”

The term “transient ischemic attack” (TIA for short) refers to a temporary circulatory disorder in the brain. It is an early warning sign of a stroke and is sometimes also called a “mini-stroke”. The symptoms are generally not as pronounced, which is why this form is often referred to as a mild or minor stroke.

TIAs are usually caused by tiny blood clots that briefly impair the blood flow in a cerebral vessel. The person affected notices this, for example, through temporary speech or visual disturbances. Sometimes weakness, paralysis or a feeling of numbness in one half of the body may also occur for a short time. Temporary confusion or a disturbance of consciousness may also occur.

You can read everything you need to know about the “mini stroke” in the article Transient ischemic attack.

How to treat a stroke?

Every minute counts when treating a stroke, because the principle of “time is brain” applies. Brain cells that – depending on the type of stroke – are not sufficiently supplied with blood or are squeezed by increased intracranial pressure die quickly. Stroke patients should therefore receive medical help as quickly as possible!

First aid in the event of a stroke

If you suspect a stroke, you should call the emergency doctor immediately (emergency number 112)! You should keep the patient calm until the doctor arrives. Raise the patient’s upper body slightly and open any constricting clothing (such as a collar or tie). This will make breathing easier. Do not give him anything to eat or drink!

If the patient is unconscious but breathing, you should place them in the recovery position (on the paralyzed side). Check his breathing and pulse regularly.

Acute medical treatment for every stroke includes monitoring vital functions and other important parameters and stabilizing them if necessary. These include breathing, blood pressure, heart rate, blood sugar, body temperature, brain and kidney function as well as water and electrolyte balance. Further measures depend on the type of stroke and any complications.

Treatment for ischemic stroke

Most cerebral infarctions (ischemic strokes) are caused by a blood clot that blocks a cerebral vessel. This needs to be removed as quickly as possible in order to restore blood flow in the affected area of the brain and save nerve cells from destruction. The blood clot can either be dissolved with a drug (lysis therapy) or removed mechanically (thrombectomy). Both methods can also be combined with each other.

Lysis therapy

If more than about 4.5 hours have already passed, the clot can hardly be dissolved with medication. In certain cases, systemic lysis can still help up to 6 hours after the onset of stroke symptoms – as an individual attempt at healing.

However, lysis therapy must not be carried out in the event of a stroke caused by a cerebral hemorrhage. This usually worsens the bleeding. Lysis therapy is also not recommended in certain other situations, for example in the case of uncontrollable high blood pressure.

In addition to systemic lysis therapy, there is also local lysis (intra-arterial thrombolysis). This is carried out using a catheter, which the doctor advances via an artery to the site of the vascular occlusion in the brain, where he directly injects a clot-dissolving drug. However, local lysis therapy is only suitable in very specific cases (such as brain stem infarction).

Thrombectomy

Combination of thrombolysis and thrombectomy

It is also possible to combine both procedures – dissolving the blood clot in the brain with a drug (thrombolysis) and mechanically removing the clot using a catheter (thrombectomy).

Treatment for hemorrhagic stroke

If a minor cerebral hemorrhage is the cause of a stroke, conservative stroke treatment is usually sufficient. In this case, absolute bed rest must be observed and all activities that increase the pressure in the head must be avoided. This includes, for example, pushing hard during bowel movements. Patients are therefore usually given a laxative.

It is also very important to monitor blood pressure and treat it if necessary. If the pressure is too high, it increases the bleeding, while if it is too low, it can lead to a lack of blood flow to the brain tissue.

Treatment of complications

Depending on requirements, stroke treatment may include further measures, especially if complications occur.

Increased intracranial pressure

In the case of a very large cerebral infarction, the brain often swells (cerebral edema). However, because the space in the bony skull is limited, the intracranial pressure increases as a result. This in turn squeezes nerve tissue and damages it irreversibly.

Even in the event of a major cerebral hemorrhage, the pressure in the skull sometimes rises due to the escaping blood. If blood enters the ventricles, which are filled with cerebrospinal fluid, the cerebrospinal fluid also builds up – a “hydrocephalus” develops. This also causes the intracranial pressure to rise dangerously.

Whatever the reason for increased intracranial pressure, it requires immediate treatment and lowering of the intracranial pressure. It helps, for example, to elevate the patient’s head and upper body. The administration of dehydrating infusions or the drainage of cerebrospinal fluid via a shunt (e.g. into the abdominal cavity) is also useful.

Vascular spasms (vaso-spasms)

In the event of a stroke caused by bleeding between the meninges (subarachnoid hemorrhage), there is a risk that the vessels will constrict in a spasmodic manner. As a result of these vasospasms, the brain tissue is no longer supplied with sufficient blood. An ischemic stroke then also occurs. Vascular spasms must therefore be treated with medication.

Epileptic seizures and epilepsy

A stroke is very often the reason for the onset of epilepsy in older patients. An epileptic seizure sometimes occurs within the first few hours after the stroke, but can also occur days or weeks later. Epileptic seizures can be treated with medication (anti-epileptic drugs).

Lung inflammation

One of the most common complications after a stroke is bacterial lung inflammation. The risk is particularly high in patients who suffer from swallowing disorders (dysphagia) as a result of the stroke: When swallowed, food particles get into the lungs and cause pneumonia (aspiration pneumonia).

Urinary tract infections

In the acute phase after a stroke, patients often have problems urinating (urinary retention or urinary retention). In such cases, a bladder catheter, which the patient wears regularly or permanently, helps. Both urinary retention and permanent catheters promote a urinary tract infection after a stroke. These are treated with antibiotics.

Rehabilitation after a stroke

Medical rehabilitation after a stroke aims to help a patient return to their old social and possibly professional environment. To this end, medical specialists use suitable training methods, for example, to try to reduce functional limitations such as paralysis, speech and language disorders or visual impairments.

Rehabilitation after a stroke is also intended to enable patients to cope with everyday life as independently as possible. This includes, for example, washing, dressing or preparing a meal on their own.

Inpatient or outpatient

Neurological rehabilitation takes place on an inpatient basis, for example in a rehabilitation clinic, particularly in the initial period after a stroke. The patient receives an individualized treatment concept while being cared for by an interdisciplinary team (doctors, nursing staff, occupational and physiotherapists, etc.).

In semi-inpatient rehabilitation, the stroke patient comes to the rehabilitation ward for their therapy sessions during the day on weekdays. However, they live at home.

If interdisciplinary care is no longer necessary, but the patient still has physical functional limitations in certain areas, outpatient rehabilitation can help. The respective therapist (e.g. occupational therapist, speech therapist) regularly visits the stroke patient at home to practice with them. The rehabilitation facilities or practices where outpatient rehabilitation takes place are generally located as close to the patient’s home as possible.

Motor rehabilitation

Physicians often use the Bobath concept for the rehabilitation of hemiplegia: The aim is to persistently encourage and stimulate the paralyzed part of the body. For example, the specialist staff do not feed the patient, but guide the spoon to the mouth together with the impaired arm.

The Bobath concept must also be applied to every other activity in everyday life – with the help of doctors, nursing staff, relatives and all other caregivers. Over time, the brain reorganizes itself so that healthy parts of the brain gradually take over the tasks of the damaged areas of the brain.

Another approach is Vojta therapy. It is based on the observation that many human movements are reflex-like, such as the reflex-like grasping, crawling and rolling over in babies. This so-called reflex locomotion is still present in adults, but is normally suppressed by conscious movement control.

Proprioceptive neuromuscular facilitation (PNF) aims to promote the interaction between nerve and muscle via external (exteroceptive) and internal (proprioceptive) stimuli. First, the therapist asks the patient detailed questions and examines them. In doing so, the therapist precisely analyzes the patient’s movement behavior as well as any restrictions and disorders in this regard. On this basis, the therapist draws up an individual treatment plan, which is repeatedly reviewed and, if necessary, adapted during the course of therapy.

PNF treatment is based on certain defined movement patterns in the shoulder and hip joint area, which are geared towards everyday functions. The exercises are repeated continuously so that the movements become increasingly effective and coordinated. Patients are also encouraged to practise regularly at home.

Initially, the therapist guides the patient’s hand or foot to avoid incorrect patterns. Later, the patient performs the movements themselves, but is still supported or corrected by the therapist. Eventually, the stroke patient learns to perform more difficult movements on their own and to control disturbances via the brain.

Forced-use therapy is also known as “constrained induced movement”. Therapists usually use it to train a partially paralyzed arm and the corresponding hand, sometimes also the lower limbs.

In some patients, the damaged area of the brain regenerates over time to such an extent that the affected part of the body gradually regains its functionality. The problem is that the affected person has now completely forgotten how to move the diseased limbs and therefore hardly uses them, if at all.

Forced-use therapy is more promising than conventional physiotherapy in the treatment of motor deficits following a stroke.

Rehabilitation for swallowing disorders

Swallowing disorders (dysphagia) are another common consequence of a stroke. With the right therapy, the person affected regains the ability to eat and drink. At the same time, this reduces the risk of choking. To achieve this, there are three different therapy methods, which can also be combined with each other:

Restorative (restorative) procedures: Stimulation, movement and swallowing exercises eliminate the swallowing disorder. This is achieved, for example, by other areas of the brain taking over the task of the damaged brain area in whole or in part.
Compensatory procedures: Changes in posture and swallowing protection techniques reduce the risk of the patient choking. If food or liquids end up in the lungs, this can lead to coughing attacks, choking or lung inflammation (aspiration pneumonia).

Cognitive rehabilitation

Cognitive rehabilitation after a stroke attempts to improve impaired cognitive functions such as language, attention or memory. As with the treatment of swallowing disorders, rehabilitation is also aimed at restitution, compensation or adaptation. Very different therapy methods are used.

For example, computer-assisted training methods are helpful for attention, memory and visual disorders. In the case of memory disorders, learning strategies improve memory performance and aids such as a diary offer a way of compensating for this. In certain cases, medication can also be used.

Prevention of another stroke

For every patient, doctors try to eliminate or at least reduce existing causes and risk factors for the stroke. This helps to prevent another stroke (secondary prophylaxis). For this purpose, it is often necessary for those affected to take medication for the rest of their lives. Non-drug measures are also important for secondary prophylaxis.

In this case, lifelong use is usually indicated. The same applies to anticoagulants – stroke patients with atrial fibrillation often receive anticoagulant medication in tablet form (oral anticoagulants). These drugs block the complicated process of blood clotting and thus the formation of clots.

Incidentally, ASA sometimes causes stomach or duodenal ulcers as a side effect. Affected patients are therefore often given a so-called proton pump inhibitor (“stomach protection”) in addition to ASA.

Cholesterol-lowering drugs: One of the main causes of stroke is vascular calcification (arteriosclerosis). Cholesterol is a component of the calcium deposits on the inner wall of blood vessels. After a stroke caused by reduced blood flow, patients are therefore usually given cholesterol-lowering medication from the group of statins (CSE inhibitors). These prevent existing arteriosclerosis from progressing further.

In the case of a stroke caused by cerebral haemorrhage, doctors only prescribe cholesterol-lowering drugs if necessary and after carefully weighing up the risks and benefits.

Incidentally, ASA sometimes causes stomach or duodenal ulcers as a side effect. Affected patients are therefore often given a so-called proton pump inhibitor (“stomach protection”) in addition to ASA.

In the case of a stroke caused by cerebral haemorrhage, doctors only prescribe cholesterol-lowering drugs if necessary and after carefully weighing up the risks and benefits.

Prognosis for stroke

In general, the larger the affected blood vessel that is blocked and/or bursts, the more serious the brain damage caused by a stroke. However, in particularly sensitive regions of the brain, such as the brain stem, even minor damage has a devastating effect and reduces life expectancy accordingly.

Around a fifth (20 percent) of all stroke patients die within the first four weeks. Over the course of the first year, more than 37 percent of those affected die. Overall, stroke is therefore one of the most common causes of death alongside heart attacks and cancer.

Of those stroke patients who are still alive after a year, around half suffer permanent damage and are permanently dependent on outside help.

Strokes in children have a very good chance of recovery. There are good treatment options for the young patients, so that most of them can lead a normal life again after a while. Only in around ten percent of all children affected does the stroke leave a major impairment.

What are the consequences of a stroke?

The possible consequences of a stroke also include speech and language disorders: With a speech disorder, those affected have problems formulating their thoughts (verbally or in writing) and/or understanding what others are saying to them. Speech disorders, on the other hand, affect the motor articulation of words.

Other common consequences of a stroke include attention and memory disorders as well as visual and swallowing disorders. You can read more about this in the article Stroke – consequences.

Living with a stroke

After a stroke, often nothing is as it was before. Consequential damage such as visual and speech disorders and hemiplegia can affect your entire everyday life. For example, after a stroke, the ability to drive is so severely impaired that patients are better off not getting behind the wheel.

But even people who appear to be fit are advised by doctors to inform the driving license authority about the stroke and submit a medical certificate. The authorities may require additional driving lessons or a conversion of the vehicle.

Life after a stroke also poses challenges for relatives. The aim is to support the patient as much as possible in everyday life, but not to do everything for them.

You can read more about the challenges of everyday life after a stroke in the article Living with a stroke.

Preventing a stroke

Various risk factors contribute to the development of a stroke. Many of these can be specifically reduced or even completely eliminated. This effectively prevents a stroke.

For example, a balanced diet with plenty of fruit and vegetables is important. On the other hand, it is advisable to consume fat and sugar only in moderation. This healthy diet can prevent vascular calcification (arteriosclerosis), which is one of the main causes of stroke.

Regular exercise and sport also keep the blood vessels healthy and thus reduce the risk of a stroke. If you are overweight, it is advisable to lose weight. Excess kilos increase the risk of high blood pressure and arteriosclerosis. Both of these increase the risk of a stroke.

You can read more about how you can reduce the risk of stroke in the article Stroke prevention.