What is a stroke?
Stroke is a leading cause of disability in adults and the fourth leading
cause of death. Eighty percent of strokes are preventable by managing
risk factors. When a stroke occurs, quick recognition and treatment can
give you or a loved one the best chance of a full recovery.
Also known as a cerebrovascular accident (CVA), stroke occurs when a blood
clot blocks an artery that supplies blood flow to the brain or when a
blood vessel breaks interrupting the flow of blood to an area of the brain.
Strokes are classified as ischemic, the most common, or hemorrhagic.
Ischemic stroke
About 87 percent of strokes are ischemic strokes. They are caused by blockage
of an artery that impairs blood flow to part of the brain causing cells
and tissues to die from lack of oxygen. The blockage can come from a blood
clot in the blood vessels inside the brain (thrombotic stroke) or from
a blood clot or plaque debris that develops elsewhere in the body and
travels to one of the blood vessels in the brain (embolic stroke).
Hemorrhagic stroke
About 13 percent of strokes are caused when a blood vessel that supplies
the brain ruptures and bleeds. This hemorrhagic stroke builds up pressure
in surrounding tissues causing irritation and swelling.
When the bleeding is from blood vessels within the brain it is called an
intracerebral hemorrhage. This is usually caused by high blood pressure
and the bleeding occurs suddenly and often results in coma or death. When
the bleeding is in the space between the brain and the membranes that
cover the brain it is called a subarachnoid hemorrhage. This type of hemorrhage
often results from bleeding due to an aneurysm or an arteriovenous malformation
(AVM) (a disorder present at birth).
Stroke Symptoms and What to Do
You can save a loved one from death or disability by learning to recognize
the symptoms of stroke."BEFAST” and call 9-1-1 immediately at any sign of a stroke.
Balance - see if the person is not walking straight or walking wobbly
Eyes - ask if the person has blurry vision or is experiencing double vision.
Face - ask the person to smile. Does one side of the face droop?
Arms - ask the person to raise both arms. Does one arm drift downward?
Speech - ask the person to repeat a simple phrase. Is their speech slurred
or strange?
Time - if you observe any of these signs, call 9-1-1 immediately!
Note the time that symptoms first appear. If given within three hours of
the first symptoms, an FDA-approved clot-busting drug may reduce long-term
disability for the most common form of stroke.
Common symptoms of stroke in men and women
- SUDDEN numbness or weakness of face, arm or leg-especially on one side
of the body
- SUDDEN confusion, trouble speaking or understanding
- SUDDEN trouble seeing in one or both eyes
- SUDDEN trouble walking, dizziness, loss of balance or coordination
- SUDDEN severe headache with no known cause
If you experience any of these symptoms call 9-1-1 immediately. Note the
time, it may be important in determining treatment.
Stroke treatment
A stroke requires emergency medical treatment! The specific treatment for
stroke depends on the type of stroke and the duration of your symptoms.
Your age, overall medical status and tolerance for various treatments
is also considered. Your caregiver will rapidly assess you and begin appropriate
treatment. A combination of medications and surgical treatments may be
used. The goals of treatment include:
- Eliminate clotting
- Reduce or eliminate swelling in the brain
- Protect the brain from damage and lack of oxygen
Medications that may be used include:
Thrombolytics-Thrombolytic (fibrinolytic) drugs dissolve clots to restore blood flow
to the brain. For greatest effectiveness, this treatment must be given
as quickly as possible.
tPA-tPA is an enzyme that occurs naturally in the body. It converts or activates
plasminogen into another enzyme to dissolve a blood clot. Your doctor
might put it in an IV to speed up dissolving the clot. This treatment
is typically only used within three hours of a stroke’s onset.
MERCI Retrieval System-This treatment is FDA approved for patients who are not eligible for IV-tPA
or fail to respond to it. The system can be used for patients who present
after the three-hour time window for IV-tPA. The innovative Merci Retriever,
a tiny corkscrew device that wraps around the clot to trap it so it can
be retrieved from the body, is proven to restore blood flow in the larger
vessels of the brain by removing blood clots.
Penumbra System-This is another treatment option for patients up to eight hours after
the onset of symptoms. The Penumbra Systems allows for safe revascularization
of occluded (blocked) vessels after an ischemic stroke. It helps restore
brain blood flow by using suction to “grab” blood clots in
the brain.
Surgical treatment
In some cases, surgical treatment may be used to remove plaque and clots
from the arteries to prevent stroke. A stent may also be placed in the
carotid artery (in the neck). A craniotomy (brain surgery) may be performed
to remove clots and repair bleeding in the brain. Other surgeries include
repair of aneurysms and artery defects that could impact blood flow to
the brain.
Preventing Stroke
Many people believe that stroke only occurs in the elderly and cannot be
prevented. Both are myths! Stroke can occur at any age, and there are
risk factors that you can control such as:
-
Control your blood pressure - Levels higher than 120/80 can put you at risk.
-
Maintain healthy cholesterol levels - An LDL of 100 or less is optimal and a total cholesterol of less than
200 is desirable.
-
Cease tobacco use - If you smoke, stop. Smoking nearly doubles your risk for stroke.
-
Maintain a healthy weight/diet - Choose a low salt, low fat diet with a balance of fruits, vegetables, whole
grains, and proteins (lean meat, fish, eggs, beans, nuts, and low-fat milk).
-
Exercise-Aim for 30 minutes a day at least five days a week. Always check with
your doctor before starting an exercise program.
-
Manage your diabetes - Manage diabetes closely to avoid complications that could result in a stroke.
-
Limit alcohol consumption - Excessive alcohol consumption can increase blood pressure so no more
than two drinks per day!
-
Get treatment for atrial fibrillation - Tell your doctor if you experience heart palpitations. An irregular heartbeat,
called atrial fibrillation (Afib), can lead to blood clot formation and
increase your risk for stroke by nearly 500%!
-
Get treatment for TIA (Transient Ischemic Attacks) - TIA symptoms, “mini strokes” are just like a stroke but may
come and go. Having a TIA can be a sign that something is wrong. Call
your doctor immediately!
Source: National Stroke Association
Link to additional materials from the
National Stroke Assocation.
Did you know?
- Stroke is the third leading cause of death and a leading cause of disability
in America.
- About 795,000 Americans will suffer a stroke this year, yet most Americans
cannot identify stroke symptoms or risk factors. Many strokes can be prevented
through risk factor management.
- Someone has a stroke every 40 seconds, on average.
- Women are twice as likely to die from stroke than breast cancer annually.
- There are many manageable risk factors for stroke, including: high blood
pressure, weight control, alcohol consumption, smoking, diabetes, atrial
fibrillation and transient ischemic attack (TIA).
- It’s important to understand stroke symptoms and response. Time is
a very urgent factor when it comes to stroke. Emergency treatment is available
if a stroke is recognized fast and 9-1-1 is called. The faster a person
having a stroke is taken to the hospital, the better chance of them receiving
emergency treatment that can reduce or even reverse the symptoms of stroke.
- Stroke will cost the United States an estimated $73.7 billion in 2010.
- Stroke incidence rate in African Americans is almost double that of Caucasians.
-
Link to additional materials from the
National Stroke Association.