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Johns Hopkins Health - Staving Off Strokes

Spring 2012
Issue No. 16

Staving Off Strokes

Date: April 25, 2012

Staving Off Strokes

Get help and prevent a second “brain attack”

Although we can’t change our age, family history, race, gender or personal history of stroke, we can alter other risk factors—weight, smoking, blood pressure and cholesterol levels, diabetes and activity—through medications and lifestyle changes.

“We believe that patients who’ve had a stroke need to be managed in an active way to help them control these risk factors,” says Victor Urrutia, M.D., director of The Johns Hopkins Hospital Stroke Center. A startling 20 to 40 percent of people who have a first-time stroke will have another one within five years, and research shows that the first three months are critical for recovery and prevention of future strokes.

People who have suffered a stroke or transient ischemic attack (a TIA is a “warning stroke”) must be steadfast in their follow-up treatment. They should receive a medical checkup, detailed assessment of their risk factors, and strategies to reduce those risks.

Traditionally, a doctor will go over all of this information with a patient just after a stroke. Rafael Llinas, M.D., director of cerebrovascular neurology at Johns Hopkins Bayview Medical Center, says more comprehensive follow-up is essential.

“A week or two after you’ve had a stroke, you come back and go over all this information again,” Llinas says, citing his preference and practice, “and it sticks much better than when you first heard it in the hospital.”

Afterward, Johns Hopkins patients receive follow-up calls and appointments to monitor their progress on action items such as smoking cessation and weight loss.

“By tracking those parameters over time, we help people stay on target,” Urrutia says.

It is straightforward, but not easy, even though the goal for everyone is the same—to defuse the ticking time bomb that is this “brain attack” by empowering first-time stroke patients to better manage their risks.

9 Stroke Symptoms
Call 911 and get immediate treatment if you or someone you know suddenly experiences any of the following:

  1. Weakness or numbness in the face, arms or legs, especially on one side of the body
  2. Confusion
  3. Difficulty speaking or understanding speech
  4. Blurred vision, or partial or complete loss of vision in one or both eyes
  5. Dizziness
  6. Trouble walking, or loss of balance
  7. Sudden severe headache
  8. Nausea or vomiting with no known cause
  9. Fainting, convulsions or brief loss of consciousness

Signs That You Need Follow-Up Care
You are advised to seek assistance if you:

  • Had a stroke or transient ischemic attack (also called a “warning stroke”)
  • Have a family history of stroke or heart attack at age 55 or younger
  • Have risk factors for stroke, such as diabetes, hypertension and obesity

Free Online Seminar
Updates in Stroke Risk and Prevention

Tuesday, May 22, 7–8 p.m.

Join Johns Hopkins neurologist Victor Urrutia, M.D., as he discusses the latest research in stroke risks and shares advice on how to lessen your risk, especially if you have had a stroke or have a family history of stroke. To register, visit

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