Low Blood Pressure & Stroke

[Misty P]

Evening ABers
I wonder if any medical minded people could help with this query.
A relative was admitted to hospital with a suspected stroke. They felt weak & pins & needles on one side. In the ambulance & during their 4 day stay in hospital they continually had low blood pressure.
CT scan & Cartoid Doppler tests showed no signs of a stroke, but they were still treated as such.
Surely, Low BP can't accompany a stroke- it is because of a high BP that a stroke manifests?

Thanks in advance

[DTCwordfan]

It's called an ischemic stroke, Misty, caused by low blood pressure.......

http://www.webmd.com/stroke/guide/stroke-cause

[Misty P]

But the Cartoid Doppler test showed that there were no blood clots..?

[RATTER15]

Possibly a TIA Transient ischemic Attack. Transient being the operative word here, the clot had passed through and gone hence a quick recovery, usually with no lasting effect.

[RATTER15]

//Surely, Low BP can't accompany a stroke- it is because of a high BP that a stroke manifests?//

That depends on the type of stroke. http://www.stroke.org.uk/about/types-stroke

[Sqad]

Misty, I agree this is an unusual situation where a low BP causes problems.

To be clear, a stroke means that brain cells die.....permanently...no way back and this almost invariably happens with a high BP.

Low BP may give symptoms by "irritating" the brain cells but not badly enough to cause death to theses cells and hence cannot be called a stroke.

So your relative has not had a stroke, but the low BP will have to be investigated to find a cause.

[Misty P]

I have learned that it was classed as a Lacunar Infarction.
Some internet research suggest that, as Sqad says, this is more likely caused by a high BP so it is likely, is it not, that my relative did not ACTUALLY have this event?

[Misty P]

thanks everyone for taking the time to answer.

[slaney]

If there is a lacunar infarction then your relative did have an ischaemic stroke due to the blockage of an artery by atheroma or an embolism.

While high blood pressure is a major risk factor for ischaemic strokes, about 38% of people on presentation have normal blood pressure, so you don't need high blood pressure to have a stroke.

You don't say what the BP figure was and how low it was - occasionally a fall in BP can precipitate a stroke.
In a recent paper it was suggested that the optimum BP to aim for in someone who had had a lacunar stroke was a systolic reading of about 130mm Hg.

[Sqad]

slaney

\\Surely, Low BP can't accompany a stroke- it is because of a high BP that a stroke manifests?\\\

Yes, high BP and normal BP readings are associated with "strokes" but the question her was that of a LOW BP.

Yes., I agree that lacunar infarcts are due to either atheroma or emboli, but i have never seen any work that shows that they have been associated with low BP, as was queried by the OP.

It is difficult on a forum to know at what level to aim your answers, to someone who has a medical degree or perhaps posy medical degree OR indeed to an person of the general public who would like it answered in relatively simple terms.

[slaney]

I stand open to correction here sqad, but...
"Surely, Low BP can't accompany a stroke- it is because of a high BP that a stroke manifests?"
.. suggested to me that Misty P was under the impression that the event could not have been a stroke because the blood pressure was not raised which is not correct.

And as it says in DCT's link above "Low blood pressure may also cause an ischemic stroke", although I agree is it relatively uncommon.

Or to ask a more relevant question
"Is it possible to have low blood pressure and still get a stroke?" To which the answer is "Yes"

I was concerned that you wrote..."your relative has not had a stroke". Surely the clinicians who examined the patient would be in much better position to make a diagnosis, and they would not have mentioned lacunar infarction without good cause.

[Sqad]

slaney....my answer was given before the diagnosis of a lacunar infarction was mentioned......i.e i wasn't aware of the diagnosis.
Even if i had been in possession of that information, i doubt that my answer would have been any different.

Misty P is an intelligent woman and like the majority of people think of a stroke as a facial paralysis with weakness of limbs down the opposite side associated with lifestyle, high BP, diabetes and a high cholesterol, because that is the way that the medical profession and the media have introduced it...why? because that's the way it usually is. I have always tried to word my answers in the simplistic way in order that they are understood.

We can argue as to the pathogenesis of lacunar infarcts until the "cows come home" but that will be of little value to the points raised by Misty.

Yes, you have every right to state your opinion as you did and it was correct, but i chose not to go down that road in an effort to answer the queries posed by Misty.

[Sqad]

.\\\\\ Im 67 this year and very fit for my age, still in full time employment with a physical job and not on any medication.\\\

That surely answers your query.