Get Smart About Stroke

National Stroke Awareness Month is the perfect time to learn about stroke and stroke prevention. The most important thing you need to remember is that stroke is a time-sensitive emergency. Why? These statistics paint an alarming picture:

• Stroke is the fifth most common cause of death in the United States, cutting short the lives of 137,000 Americans each year
• Stroke is the leading cause of long-term disability
• In the United States, one person has a stroke every 40 seconds — roughly 795,000 people a year
• Every 4 minutes, stroke kills another American
• There are more than 7 million stroke survivors living in the United States and two-thirds of them are currently disabled
• Approximately 25% of people who recover from their first stroke will have another within 5 years

When it comes to stroke, time is brain. The sooner a stroke patient can get medical attention, the greater the chance that doctors can limit the damage.

What Is a Stroke?

A stroke occurs when blood flow to the brain is suddenly interrupted, depriving the brain of oxygen. Nerve cells can’t function and die within minutes. This can cause temporary or permanent brain damage, disability, and even death. There are several different types of stroke:

• Ischemic stroke is caused by a blockage in an artery. This can be the result of plaque buildup or a blood clot traveling up to the brain. The vast majority of all strokes — about 87% — are ischemic.
• Hemorrhagic stroke, also called an intracerebral hemorrhage, is when an artery bursts inside the brain due to a weakness in the blood vessel wall (aneurysm) or to an arteriovenous malformation, a tangle of abnormal blood vessels connecting arteries and veins in the brain. Damage from a hemorrhagic stroke is due to pooling blood putting pressure on brain tissue.
• Subarachnoid hemorrhage is a hemorrhagic stroke in which the bleeding occurs between the brain and the skull.
• Transient Ischemic Attack (TIA), sometimes called a mini stroke, is a temporary blockage of blood flow to your brain. Symptoms may last for just a few minutes. However, about 15% of strokes are preceded by one or more TIAs. Even if symptoms appear to subside, a person experiencing a TIA needs to go to the Emergency Department.

Treating Stroke

The first step of stroke treatment is literally in your hands: CALL 911 IMMEDIATELY. If you are the person experiencing symptoms, do not drive yourself to the hospital! If you are driving someone else, consider how close the nearest hospital is. An ambulance may be able to get there faster. Calling 911 triggers a “Stroke Code,” setting off the following preparations:

• The stroke team gets ready to assess the patient as soon as they arrive
• The CT scanner is prepped for the incoming stroke patient
• The on-call neurologist is notified
• The hospital pharmacy is notified and preparations of medication such as tPA begin

Stroke treatment is based on the type of stroke and the patient’s overall health. The Emergency Department team will immediately evaluate stroke patients when they arrive. Testing may include any and all of the following:

• Computerized tomography, or CAT scan
• CT angiogram (CTA) which provides a detailed view of the affected blood vessels in the brain
• Magnetic resonance imaging (MRI)
• Magnetic resonance angiography (MRA) of the head and neck

If certain criteria are met, the Emergency Department will give the patient intravenous tPA, a medication that dissolves the blood clots. However, this treatment is usually only given within 3 hours of the stroke onset. When conventional tPA stroke treatment is not an option, intra-arterial tPA may be applied directly to the blood clot. Using guided imagery, an interventional radiologist inserts a thin, flexible catheter into the body through an artery in the groin and guides the catheter directly to the clot, where it releases the medication.

Depending on the type and degree of brain damage, a person may benefit from physical, speech, and/or occupational therapy in the weeks and months following a stroke.

Know Your Risk Factors

Although a stroke can happen to anyone at any age, strokes are more common in people 60 years of age or older. Women have a slightly greater stroke risk, accounting for 55,000 more stroke cases each year compared to men. African Americans have almost twice the risk of first-ever stroke compared to Caucasians. Significant medical and lifestyle-related risk factors include:

• Family history of stroke
• Previous stroke or previous episode of TIA
• Diabetes
• High cholesterol
• High blood pressure
• Cardiovascular disease, including atrial fibrillation and carotid artery disease
• Smoking
• Excess weight
• Drinking too much alcohol (more than one drink a day for women and two a day for men)
• Bleeding disorders
• Existing arteriovenous malformation (AVM) or aneurysm

Learn more about your stroke risk by taking our free StrokeAware Risk Assessment.

Reducing Your Stroke Risk

No matter what your risk factors are, there are several steps you can take to help protect yourself against stroke:

• Know your blood pressure and work with your doctor to get it under control
• Stop smoking
• Drink moderately
• Know your cholesterol number and work to with your doctor to keep it low
• If you are diabetic, follow your doctor’s recommendations carefully to control your blood sugar
• Exercise regularly — as little as 30 minutes of daily exercise helps reduce your stroke risk
• Cut down on the sodium (salt) and fat in your diet

Know the Signs of Stroke

If you recognize the signs of stroke in yourself or someone else, BE FAST in getting them help!

B is for balance

Does the person have a sudden loss of balance or coordination?

E is for eyes

Is the person experiencing dramatic vision changes, such as full or partial loss of vision in one or both eyes?

F is for face

Does the person's face look uneven? Ask them to smile. Look for facial droop or a lopsided grin.

A is for arm

Is one arm hanging down? Have the person close his/her eyes and hold both arms out with palms facing up. Look to see if one arm drifts down. Ask if the person is experiencing numbness, weakness, or tingling, or if they are unable to move an arm or leg.

S is for speech

Is the person's speech slurred? Are they having trouble understanding you? Check to see if the person has trouble speaking, seems confused, or is not able to talk at all.

T is for time

Remember, time is brain. It is essential that you call 911 and get the stroke victim to the hospital immediately. If possible, note the time the symptoms started, or the last time the person was known to be well. This is important information for the medical team treating the patient. If you are the one having the stroke symptoms do not drive yourself. Call 911 and unlock your door so the paramedics can let themselves in.

If you or a family member is recovering from stroke, the Community Memorial Stroke Support Group is here to help. Learn more about this free group.