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7: Protecting Your Brain in .NET framework
7: Protecting Your Brain
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Illegal drugs: Using illegal drugs such as amphetamine, ecstasy, and cocaine increases blood pressure and your chances of a brain attack Lack of exercise: A sedentary lifestyle predisposes you to a brain attack, but exercise can drastically decrease your chances of having a brain attack Tobacco: Smoking cigarettes or cigars or chewing tobacco reduces oxygen in the blood and damages the walls of the blood vessels Conversely, kicking your tobacco habit oxygenates the blood and decreases the likelihood of damaged blood vessels Transient ischemic attack (TIA): This is a milder form of brain attack, and TIA symptoms are always temporary (See the Moving Fast When You See Symptoms of a Brain Attack section later in this chapter) Drugs can reduce the incidence of these attacks If you keep these risk factors under control, you re sure to decrease the likelihood of a disabling brain attack
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Funduscopic examination minus the fun
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When a doctor looks into your eyes with an ophthalmoscope (called a funduscopic exam), he s observing the one area of the brain that can be seen directly High blood pressure causes changes in the blood vessels of your eyes that are similar to the changes it causes in small blood vessels in the brain The earliest change that the doctor sees with the ophthalmoscope is a narrowing of the arteries: The artery walls thicken, and although blood may still flow, the column of blood is not visible and the artery looks like a silver wire As the arteries thicken, nearby veins are also compressed, and arteriovenous (AV) nicking (a compression of a vein where the artery crosses it) appears Your physician may see other changes in your eyes due to high blood pressure with his ophthalmoscope: The eye s major central retinal vein, which carries blood away from the retina (the tissue that acts as a screen for sight), can close Then vision is lost in that eye, and the back of the eye appears to be bleeding As blood flow fails, areas of the retina die, leaving a white, patchy appearance (called cotton wool spots) Appearing as sacs attached to arteries, aneurysms can form in the arteries of the eyes just as elsewhere in the brain due to the high blood pressure They rarely cause hemorrhage within the eye, but if they do, it may be necessary to clot them with laser treatment Hemorrhaging from the retina s arteries produces a flame-shaped area in the retina a sign of malignant or accelerated (out-ofcontrol) high blood pressure ( 6 discusses this condition)
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Part II: Considering the Medical Consequences
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Working some miracles with preventive drugs
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If you re at high risk to have a stroke because you previously had one or had a TIA or because you have atrial fibrillation or narrowing of the carotid arteries (the main arteries arising from the aorta that provide blood to the brain), a number of drugs can lower the risk The most valuable are as follows: Aspirin, a drug that prevents platelets in the blood from forming a clot: If you have a TIA, aspirin may reduce your risk of a stroke by 30 percent You should use no more than a baby aspirin (81 milligrams) daily, but check with your doctor Clopidogrel (Plavix), an antiplatelet drug: It doesn t cause the gastrointestinal bleeding of aspirin, but its reduction of stroke risk is similar to aspirin s Dipyridamole plus Aspirin (Aggrenox): This drug helps prevent a second stroke for people who have already had one but causes gastrointestinal bleeding more often than aspirin Anticoagulants such as warfarin (Coumadin): These drugs prevent formation of clots but run the risk of excessive bleeding They must be monitored with blood tests, which are inconvenient Interestingly, a study in the January 2007 Archives of Internal Medicine indicates that combining aspirin and oral anticoagulants like warfarin provides no better protection than aspirin alone and runs the risk of much increased major bleeding
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