August 12th, 2010
11:09 AM ET

What is the best dosage of aspirin after a stroke?

As a feature of CNNhealth.com, our team of expert doctors will answer readers' questions. Here's a question for Dr. Gupta.

From Vercie Pruitt-Jenkins, Arlington, Texas

My 16-year-old son recently had a stroke.  He was previously healthy and a three-sport athlete.  No cause was ever determined for his stroke.  He has been prescribed 325 mg aspirin.  Do you believe the dosage is too strong?"


It is difficult to answer your question, Vercie, without more information about the condition that led to your son's stroke.  Stroke at such a young age is exceedingly rare.  It could be caused by a range of things, from a traumatic tear in an artery to an abnormal blood clotting disorder.

The cause of the stroke is one of the considerations for your doctor when he or she is considering what dosage of aspirin to prescribe.

"What we do know is that 50 milligrams of aspirin is just as good at preventing a stroke as 325 milligrams of aspirin," said Olajide Williams, associate professor of clinical neurology at Columbia University. "In fact lots of patients are on a baby aspirin for stroke prevention, which is 81 milligrams."

The American Heart Association/American Stroke Association guidelines recommend 50mg to 325mg per day be taken, depending on the patient's circumstances.

Aspirin has anti-platelet properties.  Platelets are cells that cause the blood to clot; they have "sticky" properties, meaning they cause things to stick together in blood vessels.  When platelets cause abnormal clotting, that can stifle blood flow to the brain and cause a stroke.  Doctors rely on aspirin after a stroke or heart attack because it can reduce that "stickiness."

Bottom line: The dosage your son should take is really at his doctor's discretion.  What is most important for a 16-year-old who just had a stroke is to get a thorough examination for potentially treatable causes of the stroke, such as a heart problem or genetics.

Filed under: Expert Q&A

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