MAY 1, 2016
Minutes count. If there is one thing to know about strokes, it’s that every minute counts. That’s the message Texas Health Care doctors want you to remember this May as we observe Stroke Awareness Month.
“A stroke is one of those extreme medical emergencies in which minutes can literally make the difference between life and death,” warns Dr. Jiangping Liu, a Neurologist. “The longer someone experiencing a stroke goes without medical attention, the less chance they have to survive. That’s why every minute is so important – if you think you or someone else may be experiencing a stroke, call 911 immediately.”
Stroke – the disruption of blood flow to the brain – is the fifth leading cause of death in the United States and one of the leading causes of disability. Fortunately, the death rate due to stroke is declining, as treatments and prevention strategies have improved.
There are two main types of stroke: an ischemic stroke, in which a blood clot either forms in the brain or travels to the brain from the heart. About 87 percent of all strokes fall into this category. The other 13 percent are hemorrhagic strokes, which occur when a blood vessel ruptures and causes bleeding into the brain. In either event, the result is that the brain is deprived of oxygen-rich blood and nutrients.
When blood flow to the brain is interrupted, the cells in the affected part of the brain begin to die. The longer someone goes without treatment, the more permanent damage the stroke is likely to cause.
Recognizing the Signs of Stroke
There are several telltale signs of a stroke. It is important to remember that just one of these symptoms is reason enough to call 911 and seek emergency medical treatment, even if the symptom seems to go away:
- Difficulty speaking and/or understanding: If you suddenly have difficulty talking or comprehending what someone else is saying, you’re experiencing one of the top signs of a stroke.
- Numbness in the face, arm or leg: The sudden onset of numbness or paralysis in any part of your body can be a warning sign of a stroke. This often occurs only on one side of the body.
- Vision troubles: If you have sudden difficulty seeing out of one or both eyes, this could indicate a stroke.
- Severe headache: A sudden and severe headache, brought on by no apparent reason and sometimes accompanied by vomiting, could indicate a stroke.
- Difficulty walking: If you suddenly have difficulty walking or maintaining balance, this is also a stroke warning sign.
The U.S. Centers for Disease Control and Prevention advises people learn to “act F.A.S.T.” so they can help someone who is having a stroke:
“F—Face: Ask the person to smile. Does one side of the face droop?
A—Arms: Ask the person to raise both arms. Does one arm drift downward?
S—Speech: Ask the person to repeat a simple phrase. Is their speech slurred or strange?
T—Time: If you observe any of these signs, call 9-1-1 immediately.”
“If you think you may be having a stroke, under no circumstances should you attempt to drive yourself to the hospital. Call 911 and tell them you need an ambulance,” says Dr. Luis Martinez, a critical care physician and Hospitalist. “The emergency medical personnel can begin potential life-saving care in the ambulance on the way to the hospital. Also, do your best to note the time that symptoms began – giving that information to the emergency room physicians will help guide our treatment approach.”
Treating a Stroke
The reason time is so precious when it comes to responding to a stroke is that the sooner treatment begins, the greater the odds for recovery. If treatment begins within three hours of the onset of symptoms of an ischemic stroke, the emergency room physician can administer a “clot-busting” drug known as a thrombolytic. This can dissolve the blood clot and reduce the amount of damage it can cause, but it can only work if you get to the hospital quickly.
The hospital will also perform either an MRI or CT Scan to get an image of the brain and assess the extent of damage caused by the stroke. In the event of a hemorrhagic stroke, an endovascular procedure may be used, in which a long tube is guided up an artery in the leg or arm and used to place a small device in the brain to stop the bleeding. Alternatively, surgery may be necessary to repair the damaged area.
Recovering from Stroke
As stroke damages the brain, it also disrupts a person’s ability to complete routine tasks. This could include talking, walking, reading, writing, using a hand to lift or hold something and numerous other tasks we take for granted. A stroke that occurs on the right side of the brain will affect the left side of the body, whereas a stroke on the left side of the brain affects the right side of the body, as well as speech function.
As soon as a stroke patient has left the hospital, rehabilitation services begin. This could include the following:
- Speech therapy: to help with speech and language issues;
- Physical therapy: to help relearn walking and balance; and
- Occupational therapy: to help with daily activities, such as eating, drinking, and bathing.
Your physician will typically assign you to the most challenging rehab programs that you can handle, based upon the severity of the stroke, your age and overall health. Additionally, it is common for a doctor to place a stroke patient on blood thinner medication, in order to reduce the chances of future clotting and a second stroke.
“Stroke recovery is not limited to physical and medical needs – emotional and psychological recovery is just as important and sometimes more difficult. The loss of ability to easily do things you could once do – cook a meal or read a book – can be depressing and frustrating,” says Dr. Melissa McFadden, a primary care physician. “The support of family and friends for a person recovering from stroke is essential, as is making sure the patient gets out of the house and resumes as much activity as doctors and therapists will allow.”
Stroke Risk Factors & Prevention
There are several known risk factors which increase the chances of having a stroke, as well as a number of steps a person can take to reduce the odds of a stroke. Risk factors include high blood pressure, diabetes, high cholesterol, obesity and heart disease. Eating a healthy diet and getting enough exercise are two keys to reducing blood pressure and cholesterol, as well as managing diabetes. If your physician prescribes medication for any of these conditions, it is important to take it regularly as directed – doing so helps lower your chance of heart disease and stroke.
If you smoke, quit. Among numerous other bad things it does to your body, smoking narrows blood vessels and increases the chances of developing clots.
According to Dr. Triwanna Fisher-Wikoff, a primary care physician, “Most of the things we can do to reduce our chances of stroke – keep blood pressure and cholesterol down, manage diabetes, keep extra weight off through a good diet and regular exercise – are the same things we must do to reduce our chance of heart disease, so we’re getting double the benefit!” These steps are described in detail in our February article, “8 Keys to a Healthier Heart.”
Sleep apnea, a condition that causes the interruption of air flow to the body while sleeping, is also a known risk factor for stroke. If you think you might have sleep apnea, you should visit with your physician.
Biological risk factors include having had a stroke before, a family history of stroke and being older than 55. Men are at greater risk for stroke than women, and African-Americans have a higher risk than the population as a whole.
The “Mini-Stroke”
Some people experience what is known as a “mini-stroke” – a transient ischemic attack (TIA). A TIA is caused by a temporary reduction in blood flow to the brain, resulting in brief symptoms similar to those of a full-blown stroke. The symptoms of a TIA generally last between a few minutes and up to 24 hours.
It can be tempting to ignore the symptoms of a TIA and pass them off as something inconsequential – that would be a huge mistake. TIAs are often precursors to a full-blown stroke, much like a small tremor can forewarn of a powerful earthquake. Anyone experiencing the symptoms of a TIA should seek immediate medical attention. The symptoms could well mean that a blood vessel is partially blocked, necessitating emergency medical treatment.
Remember, Act F.A.S.T.
Stroke is a serious condition, one which causes one out of every 20 deaths in the Unites States each year. The good news is that number is declining and through smart prevention strategies, such as managing chronic conditions, not smoking and maintaining a good diet while getting enough exercise, we can reduce it even further. Remember, act F.A.S.T. if you or someone you are with is experiencing any of the signs of a stroke. Don’t wait and don’t think about it – call 911 immediately. It could save your life.
This article contains information sourced from:
The U.S. Centers for Disease Control and Prevention
National Institute of Neurological Disorders and Stroke, National Institutes of Health
