DEAR DR. DONOHUE: I have read about heart problems in your column many times. You seem to avoid any commentary pertaining to strokes. Why ignore this medical issue? I am particularly interested in brainstem strokes. Are aftermaths of such a stroke constant headaches and difficulty riding in a car? – D.G.

ANSWER: I’d better not ignore stroke. It is the second leading cause of death in Canada and the United States. Strokes come in two varieties. The more common kind – representing 80 percent of all strokes – comes from a block in blood flow to part of the brain. That’s called an ischemic stroke. The block is a clot in an artery feeding the brain. It’s similar to what happens in a heart attack, when one of the heart arteries becomes plugged and blood cannot get to the heart muscle. The less common kind of stroke is due to bleeding from a brain blood vessel.

The brainstem is a narrow part of the brain that consists of three different sections — the midbrain, pons and medulla. Through those structures, located at the back and underside of the brain, run bundles of cables connecting brain centers to the spinal cord. The brainstem has its own important centers, two of which regulate blood pressure and breathing. A brainstem stroke is often fatal. Surviving such a stroke makes you very lucky.

Constant headaches and difficulty riding in a car are not things commonly ascribed to a previous brainstem stroke.

Prevention of strokes, regardless of where they strike the brain, is similar to the prevention of heart attacks – lower cholesterol, maintain normal blood pressure, exercise, don’t smoke, control blood sugar if diabetic and lose weight if need be.

People who have had a clot-induced stroke should talk to their doctors about going on anticoagulant prevention by taking aspirin or a similar medicine.

The stroke booklet provides details on this important topic and its treatment. Readers can obtain a copy writing: Dr. Donohue – No. 902, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: This past summer, after a colonoscopy, my wife went into atrial fibrillation. This past month, a friend had colon surgery for cancer. Shortly after, he too had atrial fibrillation. Is there some relationship here? – A.I.

ANSWER: Perhaps the stress of both procedures brought on the atrial fibrillation. Stress – both physical and mental – can do it. This is the only relationship I can see.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com

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