Stroke - What You Need to Know
Stroke is the third leading cause of death in the US and it is the leading cause of severe, long-term disability. Despite this, the public awareness of stroke symptoms and the need for immediate treatment evaluation is poor. Strokes occur two ways. The most common is an embolic stroke where one of the arteries leading to the brain is blocked by a small piece of plaque that has broken off. A second type of stroke is a hemorrhagic stroke where the vessel leading to the brain bleeds.
The five most common warning signs of stroke are:
(a) sudden numbness or weakness of the face, arm or leg, especially on one side of the body;
(b) sudden confusion, trouble speaking, or understanding speech;
(c) sudden difficulty seeing in one or both eyes;
(d) sudden difficulty walking, dizziness, or loss of balance or coordination;
(e) sudden severe headache with no known cause.
Notice the word "sudden". Strokes occur suddenly. That headache that you get every monday morning is not a warning sign of a stroke, nor is that numbness in your fingers when you wake up or the twitch in your eye.
When I started medical training there wasn't much you could do for a patient who was having a stroke. We admitted them to the hospital and did frequent neuro checks but if a stroke was going to happen, it just happened. Times have changed. We now have intravenous thrombolytic therapy called tPA (tissue plasminogen activator) that can reduce the resulting disability, yet few patients arrive in time to be eligible for tPA. The window for treatment is just 3 hours from the first sign until drug infusion so early recognition and getting to a hospital fast is critical. A number of hospitals are becoming Stroke Centers of Excellence, which means they have special protocols in place for rapid evaluation and treatment.
Now that you know the warning signs of a stroke, what can you do to prevent it from occurring at all? The risk factors for ischemic (not enough blood getting through the vessel) vascular strokes are the same as the risk factors for heart attack. That is why some neurologists are using the term "Brain attack", so people will make the connection. The risk factors are:
1. Hypertension (even slightly elevated blood pressure increases risk)
3. High Cholesterol (hyperlipidemia)
Every single one of these risk factors is treatable and within our control. Virtually all stroke victims have hypertension.
Since I have a morbid fear of a stroke, I am going to re-commit to eating 5-6 fruits and vegetables a day. If any of you want to join me with this intent, email me and I will check back with you in a week to see how you are doing.
For more information about stroke click here, American Stroke Association