I was curious if varicose veins can lead to a stroke, and if so, what
the mechanism is.  I've found some herbal remedy sites that link the
two, but no more traditional sites.  My level is a little low, as I'm
still getting up to speed on the different ways stroke can originate
in arteries.  I guess part of the reason I'm asking to find out if
varicose veins' running in our family helps explain why stroke would
run through the family.

Thank you in advance.

Hello Cwd,

   What a great question!  There are several kinds of strokes, and
more than several causes of stroke.


   Varicose veins that have become enlarged and tortuous ? known as
phlebitis, or DVT, can lead to clots, but clots that travel to the
brain, causing some strokes usually generate in the heart.
Occasionally a blood clot from severe varicose veins (DVT, or deep
vein thrombosis) can travel to the brain and cause a stroke.

?Deep venous thrombosis (DVT) affects mainly the veins in the lower
leg and the thigh. It involves the formation of a clot (thrombus) in
the larger veins of the area. This thrombus may interfere with
circulation of the area, and it may break off and travel through the
blood stream (embolize). The embolus thus created can lodge in the
brain, lungs, heart, or other area, causing severe damage to that
organ.?
http://health.allrefer.com/health/deep-venous-thrombosis-info.html


Learn more about varicose veins and phlebitis here:
http://ww2.heartandstroke.ca/Page.asp?PageID=33&ArticleID=573&Src=heart&From=SubCategory#varicose%20veins


Risk factors for stroke include:
================================
Hardening of the arteries (atheroslerosis)
Obesity
Heart disease
Smoking
High blood pressure (hypertension)
Diabetes
Increased age
Use of estrogens
Gender (men have a higher risk)
High cholesterol (hyperlipidemia)
Polycythemia (high red blood cell count)
Race (African-Americans have a higher risk)

http://www.diseases-explained.com/Stroke/whatcausesastroke.html


   ?Another type of stroke occurs when a blood clot or a piece of
atherosclerotic plaque (cholesterol and calcium deposits on the wall
of the inside of the heart or artery) breaks loose, travels through
open arteries, and lodges in an artery of the brain. When this
happens, the flow of oxygen-rich blood to the brain is blocked and a
stroke occurs. This type of stroke is referred to as an embolic
stroke. For example, a blood clot might originally form in the heart
chamber as a result of an irregular heart rhythm, such as occurs in
atrial fibrillation. Usually, these clots remain attached to the inner
lining of the heart, but occasionally they can break off, travel
through the blood stream, form a plug (embolism) in a brain artery,
and cause a stroke. An embolism can also originate in a large artery
(for example, the carotid artery, a major artery in the neck that
supplies blood to the brain) and then travel downstream to clog a
small artery within the brain.?
http://www.medicinenet.com/stroke/article.htm


?Each side of the neck has an artery called the common carotid. Each
common carotid splits into two branches -- the internal branch, which
brings oxygen-rich blood to the brain, and the external branch, which
brings blood to the face.
Blockage of the internal carotid artery can reduce blood supply to the
brain, causing a stroke. When the internal carotid arteries become
blocked by fat and cholesterol build-up of atherosclerosis (also
called plaque) can result.
Over time, the plaque slowly begins to block the flow of blood. The
plaque itself may block the artery enough to cause a stroke. In
addition, the plaque often causes the blood to flow abnormally, which
leads to a blood clot. A clot can stay at the site of narrowing and
prevent blood flow to all of the smaller arteries it supplies. This
type of clot, which doesn't travel, is called a thrombus. In other
cases, the clot can travel and wedge into a smaller vessel. A clot
that travels is called an embolism.?
http://www.nlm.nih.gov/medlineplus/ency/article/002951.htm

   ?The plaque may cause the blood to flow abnormally, which may lead
to blood clots. A clot may remain at the site of narrowing and prevent
blood flow to all of the smaller arteries it supplies. Alternatively,
a clot can travel and wedge into smaller vessels. This is called an
embolism. If a clot or plaque blocks the blood flow to your brain, it
can lead to an ischemic stroke, which may cause brain damage or death.
If a clot or plaque blocks a tiny artery in the brain, it may cause a
transient ischemic attack (TIA), also known as a mini-stroke.?
http://www.neurosurgerytoday.org/what/patient_e/carotid.asp

This page illustrates plaque buildup
http://www.heartsite.com/html/cad.html


?What is a cerebral embolism?
A wandering clot (an embolus) or some other particle that forms away
from the brain, usually in the heart, may also cause an ischemic
stroke. This is called cerebral embolism. The clot is carried by the
bloodstream until it lodges in an artery leading to or in the brain,
blocking the flow of blood.
The most common cause of these emboli is blood clots that form during
atrial fibrillation (AF). AF is a disorder found in about 2.2 million
Americans. It's responsible for 15?20 percent of all strokes. In AF,
the heart's two small upper chambers (the atria) quiver instead of
beating effectively. Some blood isn't pumped completely out of them
when the heart beats, so it pools and clots. When a blood clot enters
the circulation and lodges in a narrowed artery of the brain, a stroke
occurs.?
http://www.americanheart.org/presenter.jhtml?identifier=4755



?Q: Are strokes hereditary? 

A: There is a slightly increased chance of having a stroke if members
of your immediate family have had strokes. This is particularly true
if your relatives were young when they had their strokes. Some of the
reasons why strokes run in families are understood and relate to high
cholesterol and high blood pressure being in part inherited problems.
We also tend to take on certain behavioural characteristics from our
families. For example, eating patterns are learnt from our parents,
and high alcohol consumption and smoking may be copied from one
generation to the next. Social class depends to a large extent on our
parents, although obviously it can be changed.?
http://www.stroke.org.uk/information/all_about_stroke/why_has_it_happened/genetics_.html

More stroke information:
http://www.stroke.org.uk/information/what_is_a_stroke/index.html

Are varicose veins hereditary?
?No one is sure what causes the initial malformation, but vulnerable
veins may be partially hereditary. Hormones also seem to contribute to
the problem, which may account for the fact that women are nearly
twice as likely as men to develop varicose veins. An injury, or added
pressure due to pregnancy or obesity can also make a good vein turn
ugly.?
http://health.discovery.com/centers/plasticsurgery/articles/varicose.html

?So it's as we suspected. Women are more likely to get varicose veins
than men are. How much more likely? "Two to four times," says Albert
M. Kligman, M.D., Ph.D., professor of dermatology at the University of
Pennsylvania School of Medicine in Philadelphia. He adds that some
estimates make women ten times more likely to develop this painful
problem.
 
Why are women at special risk? Female hormones are the major culprits,
say phlebologists, doctors who specialize in vein disease, and
dermatologists, who treat skin conditions, including swollen veins
that appear near the surface of the skin. One reason doctors connect
the problem to hormones is that some girls begin to show varicose
veins at puberty, confirming theories that the condition is related to
changes in the body's estrogen and progesterone levels.?
http://www.mothernature.com/Library/Bookshelf/Books/62/95.cfm

Additional Useful Information:
------------------------------
http://www.enh.org/aboutus/press/article.asp?id=3595

http://www.strokecenter.org/pat/ais.htm



I hope this information has explained stroke and varicose veins to
you. While there is a link between varicose veins and stroke, it is
but one cause.

If any part of my answer is unclear, please request an Answer
Clarification. I will be happy to assist you further, before you rate
this answer.

Sincerely, Crabcakes

Search Terms
============
Brain attack + causes
Heredity + stroke
Heredity + varicose veins

Thanks very much for the feedback.  The search list, website, and
probabilities helped a lot.

I would add a quick comment, just to reiterate and clarify some of the
information that the researcher has already gathered.  In general,
varicose veins are NOT considered a risk factor for stroke.  There are
a couple of important reasons:
1. Varicose veins represent inflammation and occlusion/clotting of the
small, superficial veins of the body (usually lower extremities). 
These are not associated with a risk for embolizing (breaking off and
causing blockages 'downstream').  Deep vein thrombosis (DVTs) are the
result of clotting in the large, deep veins -you can't see them from
the surface- of the leg (popliteal, femoral veins) or arms (subclavian
vein).  These are associated with possible embolization.  But...
2. Clots that do break loose (from a DVT, not from varicose veins)
usually go to the lungs first.  The lungs function as a sort of
'filter' to keep these clots out of the arterial circulation. 
However, if the clot is large enough, it can cause a pulmonary embolus
(PE), which can cause acute chest pain, shortness of breath, and
death.  While this is an all-too-common cause of death, it's not the
subject of the question.  Which brings us to...
3. For a clot to get from the peripheral veins to the brain, it would
need to bypass the lungs.  This can, and does, happen in some people
who have a small hole between the atria (small upper chambers) of
their heart.  This hole is called a PFO (patent foramen ovale) and is
present in a significant portion of the population (10-27%) and
usually causes no problems.  However, if a clot does bypass the lungs,
it can enter the arterial circulation and, potentially, go to the
brain and cause a stroke.
4. As crabcakes pointed out, you are more likely to get an embolic
stroke from a plaque rupturing in your carotid artery or from a clot
that forms in the left side of your heart (atrial fibrillation
[a.fib], damaged or prosthetic heart valve, poor contractility of the
left ventricle, etc).
In addition to the above information, I'd also point you to
emedicine.com for clinical (though a bit technical) information.  You
should be able to find articles on most of the topics I mentioned
(DVTs, PFO, stroke) and the site is generally pretty well written.

Hope this helps ease your concerns
jshaw

Thank you for the tip!