Causes and Risk of Stroke: the Rotterdam Study

It is not easy to imagine that the essence of our being is enclosed in a single organ: the brain. In addition to its miraculous function, also the immensely delicate anatomical and chemical structure of the brain is astounding. In order to maintain its structure and function, the brain needs a constant supply of blood. If the blood flow is interrupted by the occlusion of an artery, the affected part of the brain immediately stops functioning. The brain tissue becomes irreversibly damaged within seconds and the area of irreversible brain damage expands in the course of several hours, resulting in what is called an ischemic stroke (figure 1). A hemorrhagic stroke occurs when blood leaks from an artery into the brain, which has the same detrimental effect on brain tissue as ischemia. Strokes usually take patients completely by surprise. In the normal brain, the input from all of our senses is collected, thoughts and emotions arise, and all voluntary body actions are initiated and coordinated, therefore all these functions can be affected by a stroke. For example, a patient who has a stroke may become unable to utter or understand language, become paralyzed on one side of the body, experience half-sided blindness or difficulties with swallowing, and his or her personality may change dramatically.

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