~Thrombotic Stroke

Alternatives to Anti-Platelet Agents

The majority of strokes occur when a blood clot blocks the flow of oxygenated blood to a portion of the brain. This type of stroke, caused by a blood clot blocking, or "plugging," a blood vessel, is called ischemic stroke. An ischemic stroke can be caused by a blood clot that forms inside the artery of the brain (thrombotic stroke), or by a clot that forms somewhere else in the body and travels to the brain (embolic stroke).

In healthy individuals, blood clotting is beneficial. When you are bleeding from a wound, blood clots work to stop the bleeding. In the case of ischemic stroke, abnormal blood clotting blocks large as well as small arteries in the brain, cutting off blood flow, resulting in a clinical diagnosis of ischemic, thrombotic, or embolic stroke.

Ischemic strokes account for 83% of all strokes, and occur as either an embolic or thrombotic stroke. Thrombotic strokes represent 52% of all ischemic strokes. Thrombotic stroke is caused by unhealthy blood vessels becoming clogged with a buildup of fatty deposits, calcium, and blood clotting factors such as fibrinogen and cholesterol. We generally refer to this as atherosclerotic disease.

Simplistically, what happens with a thrombotic stroke is that our bodies regard these "buildups" as multiple, infinitesimal, repeated injuries to the blood vessel wall. Our own bodies react to these injuries, and just as they would if we were bleeding from a small wound, respond by forming blood clots. Unfortunately, in the case of thrombotic strokes, these blood clots get caught on the plaque on the vessel walls and reduce or stop blood flow to the brain. That's when we suffer a brain attack.

An analysis of 18 trials documented a 23% reduction in stroke risk with anti-platelet agents. The drug ticlopidine was found to be the most effective anti-platelet agent, but its adverse side effects frequently restrict its long-term use. A more benign approach such as use of aspirin or nutrients like ginkgo biloba, melatonin, fish oil, and garlic, as well as green tea extract, may be as effective and are free of side effects.

Consideration should now be given to the use of melatonin as part of an integrated treatment for thrombotic stroke according to a 1998 report which says, "Melatonin is one of the most powerful scavengers of free radicals. Because it easily penetrates the blood-brain barrier, this antioxidant may, in the future, be used for the treatment of Alzheimer's and Parkinson's diseases, stroke, nitric oxide, neurotoxicity and hyperbaric oxygen exposure."

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