Birth control pills increase risk of ischemic stroke

image credit: npr.org

"Oral contraceptives increase the risk of ischemic stroke, but this risk is very small among women who do not have other stroke risk factors, according to a Jan. 3, 2018 paper in the journal MedLink Neurology by Loyola Medicine stroke specialists.

Birth control pills do not increase the risk of hemorrhagic strokes, wrote neurologists Sarkis Morales-Vidal, MD, and José Biller, MD. Ischemic strokes, which account for about 85 percent of all strokes, are caused by blood clots.

Hemorrhagic strokes are caused by bleeding in the brain.

Several mechanisms have been proposed to explain why oral contraceptives increase stroke risk, including by raising blood pressure and by making blood hypercoagulable (more likely to clot).

When prescribing hormonal contraceptives, physicians should consider the type and dose of estrogen or progestin and route of administration (such as pill or patch). "The ideal drug is one with the lowest estrogen and progestin doses that will be effective in preventing pregnancy while minimizing adverse effects," Drs. Morales and Biller wrote.

For healthy young women without any stroke risk factors, the stroke risk associated with oral contraceptives is very small.

"However, in women with other stroke risk factors, the risk seems higher and, in most cases, oral contraceptive use should be discouraged," Drs. Morales and Biller wrote. These risk factors include high blood pressure, cigarette smoking and migraine headaches, especially migraines with sensory disturbances called aura (such as flashes of light and tingling in the hands or face).

However, women may not always be adequately screened. One previous study found that, among women with one or more stroke risk factors, only 15 percent recalled being advised not to start oral contraceptives and only 36 percent remembered being told to stop. Fifteen percent of women were still taking oral contraceptives despite being told to discontinue. These findings highlight the need to improve physician counseling and patient compliance, Drs. Morales and Biller wrote.

The report is titled "Hormonal Contraception and Stroke." It is an update of a report originally published in Medlink Neurology in 2003."

Source: https://medicalxpress.com/news/2018-03-birth-pills-ischemic.html

Newborn babies who suffered stroke regain language function in opposite side of brain

image credit: annahusrtphotography.com

"It's not rare that a baby experiences a stroke around the time it is born. Birth is hard on the brain, as is the change in blood circulation from the mother to the neonate. At least 1 in 4,000 babies are affected shortly before, during, or after birth.

But a stroke in a baby—even a big one—does not have the same lasting impact as a stroke in an adult. A study led by Georgetown University Medical Center investigators found that a decade or two after a "perinatal" stroke damaged the left "language" side of the brain, affected teenagers and young adults used the right sides of their brain for language.

The findings, to be reported Feb. 17 in a symposium at the American Association for the Advancement of Science (AAAS) Annual Meeting in Austin, Tex., demonstrates how "plastic" brain function is in infants, says cognitive neuroscientist Elissa L. Newport, PhD, professor of neurology at Georgetown University School of Medicine, and director of the Center for Brain Plasticity and Recovery at Georgetown University and MedStar National Rehabilitation Network.

Her study found that the 12 individuals studied, aged 12 to 25, who had a left-brain perinatal stroke all used the right side of their brains for language. "Their language is good—normal," she says.

The only telltale signs of prior damage to their brain are that some study individuals limp a bit and many have learned to make their left hands dominant because the stroke left right hand function impaired. They also have some executive function impairments—slightly slower neural processing, for example—that are common in individuals with brain injuries. But basic cognitive functions, like language comprehension and production, are excellent, Newport says..."

Learn more:

https://medicalxpress.com/news/2018-02-newborn-babies-regain-language-function.html