StrokeThe questions below were raised by visitors to the STOMP (Straits Times Online Mobile Print) website in the AskST section of the website. eMenders doctors provided the answers to the questions raised as a public health education project. The information provided below is of a general nature and should not be treated as a replacement for medical advice. You should seek consultation from a medical or healthcare professional about your specific medical condition.
Question:
My father has a serious stroke which left him half paralysed. The cause of the stroke was due to a blood clot in the right brain. Currently, he is on warfarin, which only helps to thin the blood. Is there a type of medicine that can prevent another stroke? My father has a history of diabetes, hypertension and atrial fibrillation. This is his third stroke.
Answer:
Warfarin reduces stroke risk from atrial fibrillation by about 85%, and is probably the most effective stroke prevention treatment for your father. However, having hypertension and diabetes, he could still have a stroke from other mechanisms such as the blockage of a blood vessel in the neck/brain from the formation of a blood clot in the vessel wall (atherothrombosis).
If there is indication of significant stroke risk from atherothrombosis, then an addition of an anti-platelet drug such as clopidogrel may be useful. However, combining warfarin with clopidogrel may increase the risk of brain haemorrhage, so a lower dose of warfarin may well be safer. As such, it is imperative that your father controls his hypertension and diabetes to prevent further strokes.
We recommend that you consult a neurologist for more specific advice concerning your father's condition.
DR. NEI I-PING is a Consultant Neurologist at the Mount Elizabeth Medical Centre. He was previously the Head and Senior Consultant (Department of Neurology) at Tan Tock Seng Hospital.