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 New evidence recently found that many ER doctors fail to recognize signs and symptoms of a stroke, which can leave patients at a higher risk for a potentially life-threatening "brain attack." Although patients should still rely on their physician for a complete cognitive and cardiovascular checkup, they should also be wary of their own warning signs. A study published in the American Heart Association’s journal Stroke has revealed a patient’s ability to stand on one leg can determine their risk for a stroke. 
 
 "One-leg standing time is a simple measure of postural instability and might be a consequence of the presence of brain abnormalities," Dr. Yasuharu Tabara, associate professor at the Center for Genomic Medicine at Kyoto University Graduate School of Medicine in Kyoto, Japan, said in a statement. 
 
 Tabara and his colleagues recruited 841 women and 546 men at an average age of 67. Participants were asked to stand on one leg with their eyes open for a maximum of 60 seconds. This examination was performed twice and researchers used the better of the two times for their research. The research team used brain magnetic resonance imaging to evaluate cerebral small vessel disease. 
 
 Ability to stand on one leg can predict stroke risk. Photo courtesy of Shutterstock 
 
 Participants who were unable to balance on one leg for more than 20 seconds were at a higher risk for cerebral small vessel disease, most notably small infarctions — a type of ischemic stroke that occurs when blood supply to the brain is blocked or leaks outside vessel walls. These small infarctions did not show any symptoms, such as lacunar infarction and microbleeds. The presence of both lacunar infarction and microbleeds is usually associated with cognitive decline. 
 
 Findings revealed that 34.5 percent of participants with more than two lacunar infarction legions had trouble balancing on one leg, while 16 percent of those with one lacunar infarction lesions also struggled with balancing. Thirty percent of participants with more than one microbleed lesion had trouble balancing on one leg and 15.3 percent of those with one microbleed lesion had trouble balancing. On average, patients with cerebral disease were older and those who were unable to stand on one leg for over 20 seconds recorded lower cognitive scores. 
 
 "Our study found that the ability to balance on one leg is an important test for brain health," Tabara added. "Individuals showing poor balance on one leg should receive increased attention, as this may indicate an increased risk for brain disease and cognitive decline." 
 
 According to the American Stroke Association, small vessel disease is a condition in which already small arteries in the heart become even narrower. It is often a common occurrence of aging; however, factors such as high blood pressure and diabetes can worsen this condition. Patients with small vessel disease are at a higher risk for lacunar infarction and intracerebral hemorrhage. 
 
 Source: Okada Y, Ohara M, Tabara Y, et al. Stroke. 2014. 

 Your Balance on One Leg & Your Stroke Risk Linked 
 
 Inability to stand on one foot for 20-plus seconds could suggest brain vessel damage, study contends 
 
 
 
 WebMD News from HealthDay 
 
 WebMD News Archive 
 
 By Steven Reinberg 
 
 HealthDay Reporter 
 
 THURSDAY, Dec. 18, 2014 (HealthDay News) -- If you can't balance on one leg for at least 20 seconds you may be at risk of a stroke, Japanese researchers suggest. 
 
 Difficulty standing on one leg may indicate that small strokes or tiny bleeds have already occurred, which means the risk for more serious strokes is high, the investigators reported online Dec. 18 in the journal Stroke. 
 
 "Individuals showing instability while standing on one leg, as well as problems walking, should receive increased attention, as this physical frailty may signal potential brain abnormalities and mental decline," said lead author Yasuharu Tabara, an associate professor in the Center for Genomic Medicine at the Kyoto University Graduate School of Medicine. 
 
 Stroke, a leading cause of disability and death, occurs when blood flow to a part of the brain is interrupted because of a clot or bleeding. 
 
 For the study, Tabara's team had nearly 1,400 men and women, average age 67, try to balance on one leg for a minute. The researchers also took MRI scans to assess disease in the small blood vessels of participants' brains, in the form of "silent" strokes -- or microbleeds. 
 
 The researchers found that the inability to balance on one leg for more than 20 seconds was linked to having had tiny strokes or small bleeds in the brain. Balance problems were also associated with reduced thinking and memory skills. 
 
 Dr. Richard Libman, chief of vascular neurology at North Shore-LIJ Health System in Manhasset, N.Y., said that "narrowing or blockages of tiny blood vessels deep within the brain can give rise to small strokes or tiny amounts of bleeding." 
 
 These small strokes, which are a major contributor to mental decline and dementia, have also been associated with walking and balance difficulty and falling, he explained. 
 
 "The authors of this study have devised a simple test of balance, which seems to be able to reflect 'small vessel disease' of the brain," Libman said. 
 
 "This test may be an inexpensive, low-tech method to screen people for small vessel disease who are most likely at risk for further strokes and brain damage," Libman added.
– Think you're at risk of a stroke? Then try standing on one one leg for at least 20 seconds, a new study says. Japanese researchers had nearly 1,400 women and men, with an average age of 67, try the balancing act for at least a minute—and found that those who lasted less than 20 seconds were more likely to have already suffered a small stroke, WebMD reports. Such strokes are considered a serious contributor to dementia and mental decline. People who can't go 20 seconds "should receive increased attention, as this physical frailty may signal potential brain abnormalities and mental decline," says chief study author Yasuharu Tabara. Those who failed the test were at greater risk of small vessel disease like "infarctions"—ischemic strokes caused by a block or leak in the brain's blood supply, Medical Daily reports. Worse, such strokes show no symptoms. So the one-leg test "may be an inexpensive, low-tech method to screen people for small vessel disease who are most likely at risk for further strokes and brain damage," says a vascular neurologist. Published in the journal Stroke, the study recalls a finding earlier this year that 53-year-old men and women who could rapidly stand and sit in a chair for a minute, and stand on one leg for more than 10 seconds, were at less risk of an early death, the Telegraph reports. (Another study shows that half of Dr. Oz's advice is all wrong.)