Inflammation Directly Responsible for Most Common Form of Stroke

It is well-known that strokes are deemed by many as the silent killer (Web MD) because they happen often with very little warning sign; sometimes symptoms do not appear until just minutes before a stroke event.  That being said, the symptoms are very well-documented in the wonderful introduction post by Negeen.  Most startling is the fact that a person suffers of a stroke every 53 seconds in the United States alone; approximately half a million people are afflicted each year.  Of those, Ischemic strokes account for about 75% of all events while hemorrhagic strokes account for the other quarter...  So why is it that Ischemic events are so much more common?

Now we all know that the University of Arizona is an awesome place so I'd like to point out an extremely well-written article by one of our own, Dr. Bruce M. Coull, in which he embarks on the answer to that question above.  Here is a link to his published text:  http://stroke.ahajournals.org/content/38/2/631.full.pdf  

From Negeen's intro, we know that the main event associated with this type of stroke is the formation of a thrombus, which either directly blocks blood flow to the brain, or breaks off from somewhere else in the body (embolus) so as to travel to the brain and disrupt its blood and oxygen supply.  Dr. Coull adds that "a panalopy of acute and chronic infections as well as many exogenous and intrinsic sources of inflammation is associated with an increased risk for ischemic stroke".  He also points out that "atherosclerosis producing focal carotid stenosis localized to the carotid bulb and proximal internal carotid artery is a principal cause of atheroembolic ischemic stroke in North America."  Atherosclerotic lesions can form over time and are mostly "characterized by chronic inflammation within the vessel wall in a response to the deposition of oxidized LDL cholesterol components."  This information is extremely critical to understanding the slow development of these conditions that eventually lead to an ischemic stroke event.

What's most interesting is that we can bring it back to everything recently applied by our obesity specialists.  The bottom line is that usually people who are obese have extremely high cholesterol, which is quite essential to setting the table for stroke conditions in the brain.  Diabesity, along with high cholesterol, are very correlative to chronic inflammation in the body, which is hypothesized as one of the main precursors to Ischemic strokes.  I wonder just how many strokes we could eliminate in the USA if we took a long term stand against the absolute biggest health issues facing our country today- diabesity, hypertension, and chronic inflammation.  These are the conditions that make Ischemic strokes much more prevalent than Hemorrhagic strokes. 

Work Referenced:

-Negeen's intro:  http://www.medicalnewstoday.com/articles/7624.php

-Web MD:  http://www.webmd.com/healthy-aging/features/stroke-silent-killer

-Dr. Bruce M. Coull's "Inflammation and Stroke":  http://stroke.ahajournals.org/content/38/2/631.full.pdf