May is Stroke Awareness Month and Privia Medical Group North Texas wants to help its patients understand how to recognize the signs of a stroke and what to do if one occurs. With nearly 800,000 strokes each year in the United States, they are a leading cause of disability and the fifth-leading cause of death. Fortunately, the death rate due to stroke is declining as awareness, treatments and prevention strategies continue to improve.
A stroke occurs when blood flow to the brain is disrupted – this is a medical emergency and a life-threatening event. “Every minute counts when someone suffers a stroke,” says Dr. Jiangping Liu, a neurologist. “Immediate, emergency medical care is critical to increasing the odds of survival and recovery. If you ever believe you or someone else is experiencing the symptoms of a stroke, do not hesitate – call 911 immediately.”
What is a Stroke?
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.”
“Calling 911 right away in the event of a suspected stroke is one of the most important things someone can do to improve the odds of survival,” explains Dr. Adib Asrabadi, an internal medicine physician. “Because every minute counts, paramedics will begin life-saving care in the ambulance on the way to the hospital. Obviously, no one experiencing stroke symptoms – or any other serious medical event – should ever attempt to drive themselves.”
The earlier treatment for stroke 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 this only works if the patient gets 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. Alternately, surgery may be necessary to repair the damaged area.
When a stroke occurs, it damages the brain and hinders the patient’s ability to complete routine tasks. Tasks and activities that we take for granted, such as talking, walking, reading, writing and using a hand to lift or hold something can all be negatively affected by a stroke. 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 one or more of 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.
“Emotional and psychological recovery from a stroke is just as important and sometimes more difficult than the physical rehabilitation. The loss of ability to do simple things you could once do can be depressing and frustrating,” says Dr. Charles Cook, a family medicine physician. “The support of family and friends is essential to recovery. Family members ensuring the patient gets out of the house and resumes as much activity as doctors and therapists will allow is very important.”
Risk Factors & Prevention
There are several known risk factors that 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, you need to stop. Among the numerous harmful effects smoking has on the body, it narrows blood vessels and increases the likelihood of developing blood clots, which are the culprit behind the vast majority of strokes.
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.
“Just as with heart disease, we can reduce our risk of stroke by adopting and maintaining healthy lifestyle habits: exercise at least 30 minutes per day, don't use tobacco products, drink no more than one alcoholic beverage per day (if you choose to drink), and stick with a low-sodium, heart-healthy diet," says Dr. Kira Haydon, a family practice physician.
TIA – 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.
Some people are inclined to ignore the symptoms of a TIA and pass them off as something inconsequential – that is 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 that 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 be the difference between life and death.
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