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Stroke

Stroke / stress

09/06/2005

Question:

I am a 60 year old male. Six years ago I experience a TIA that affected my memory. It lasted only a few hours. About 6 months ago I experienced what radiology reports now describe as "an elliptical area of low density change in the right peripheral occipital lobe" Symtoms were primarily vision limitation in the lower right quadrant of my vision field. This was been confirmed by a vision field test. In addition to the vision issues I am experiencing heavy head type pressure (sort of like a headache but different) after periods of perhaps an hour or two intense mental concentration. Is there a connection to the stroke? A day rarely goes by without this symptom. I am the CEO of a large health care facility and experience lots of stress and work pressure. Does high stress and work pressure contribute to increased risk of another stroke and if so, to what degree? I look forward to hearing from you. Gerald Neufeld

Answer:

First, if you are not sure about what these pressure sensations represent, you probably should ask your physician about them (if you haven't already).  I cannot provide anything except general advice since I have not seen you, taken a full history, and done a full physical exam.

I will tell you that symptoms such as those you report are very common.  Many patients tell us that they feel fatigued after a stroke and that many tasks are more difficult.  For example, concentration at your work likely involves reading.  During reading tasks, your brain is subconsciously dealing with the field cut from the stroke, and this (in a simple way) can be thought to consume "mental energy" and thus leaving you fatigued.  Perhaps this is related to your pressure sensation(?).

Do stress and work pressure directly increase your risk of stroke?  Not to my knowledge, and I am not aware of any research showing a direct link.  And yet, stress may have very important effects on such things as your blood pressure, your ability to exercise, your nutrition, etc. that could have direct effects on future stroke risk.  Recall that high blood pressure is the single largest risk factor for stroke!  The best thing that you can do right now to prevent another stroke is to work with your physician to modify your risk factors.

I hope I have answered your question, and good luck.

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Response by:

Brett   Kissela, MD Brett Kissela, MD
Assistant Professor of Neurology
Director, Neurology Residency Program
College of Medicine
University of Cincinnati