May is National Stroke Awareness Month - an opportunity for everyone to learn about stroke prevention, symptom recognition and recovery . Stroke is the third leading cause of death in the United States. One way Baptist Health System is doing its part to help reduce stroke deaths is by educating the public on ways to recognize and respond to the symptoms of stroke. Act F.A.S.T. stands for face, arms, speech and time. Here’s how it works: if a person is having trouble with these basic commands, call 911 immediately:
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 sentence. Are the words slurred? Can the patient repeat the sentence correctly?
Time : Get the affected person to a hospital right away to receive the most effective treatment.
For every minute that brain cells are deprived of oxygen during stroke, the likelihood of brain damage increases. Treatment can be more effective if given early on. Act F.A.S.T.
Facts About Stroke
What is a stroke?
Stroke is a brain injury that occurs when the brain's blood supply is interrupted. Without oxygen and nutrients from blood, brain tissue starts to die rapidly, usually in less than 10 minutes, resulting in a sudden loss of function. This condition is also known "brain attack" or cerebrovascular accident (CVA).
What causes a stroke?
A stroke most often occurs when blood flow to the brain becomes blocked (called ischemic stroke). One of the following may cause this blockage:
- Sudden decreased blood flow—Damage to a blood vessel supplying blood to the brain can occur suddenly from injury or from a clot that forms and breaks off from another location in the body, such as the heart or neck. There are certain conditions which predispose people to form blood clots, such as cancer, pregnancy, atrial fibrillation, and certain autoimmune diseases.
- Local blood clot—A build-up of fatty substances (atherosclerotic plaque along the inner lining of the artery causes it to narrow, reduces its elasticity, causes local inflammation, and decreases the blood flow in the artery. A clot forms in an artery supplying the brain. Inflammation of blood vessels—Inflammatory conditions in the blood vessels (vasculitis) can interrupt blood flow. A stroke may also occur if a blood vessel breaks and bleeds into or around the brain, this is called hemorrhagic stroke.
Hemorrhagic vs. Ischemic Stroke
What are the risk factors for stroke?
The following factors can increase your chance of getting a disease or condition:
Modifiable risk factors :
- High blood pressure is the number one risk factor for stroke.
- Drug abuse (heroin, cocaine, amphetamines)
- Narrowing of arteries supplying the brain due to atherosclerosis
- High cholesterol levels - particularly low-density lipoprotein (LDL) cholesterol
- Smoking * Diabetes * Atrial fibrillation (abnormality of heart rhythm)
- Use of birth control pills if you are over 35 years old and smoke
Nonmodifiable risk factors:
- Prior stroke or pre-existing cardiovascular disease such as heart attack
- Prior transient ischemic attack (TIA): Some patients experience a "warning stroke" or TIA, a temporary interruption of the brain's blood supply, often called a mini-stroke. These are symptoms of a stroke that resolve completely, usually within minutes. Such patients are at a significantly increased risk of having a full-blown stroke sometime in the near future.
- Age: 60 or older
- Family members who have had a stroke
- Gender: males are at greater risk than females
- Race: Black, Asian, Hispanic
- Blood disorders which increase clotting in sickle cell disease and polycythemia
- Valvular heart disease such as mitral stenosis
What are the symptoms of a stroke?
Symptoms occur suddenly and differ depending on the part of the brain affected. Multiple symptoms generally arise simultaneously. Do not delay calling for emergency medical help. Brain tissue dies quickly when deprived of oxygen. Symptoms include:
- Weakness or numbness on one side of the body, including the face
- Seizures
- Confusion
- Nausea and vomiting of sudden onset
- Blurry, dimming, double vision, or no vision
- Difficulty swallowing, talking, or comprehending others
- Dizziness, falling, or loss of balance
- Severe or unusual headache
How is a stroke diagnosed?
Having a stroke is an emergency situation. Diagnosis includes:
Neurological exams Electrocardiogram (ECG, EKG)—a test that records the heart's activity by measuring electrical currents through the heart muscle Brain and blood vessel imaging via CT scan, MRI scan, and/or ultrasonography Blood tests especially homocysteine, prothrombin time, and other coagulation tests Other tests to quickly determine the cause, location, and amount of damage
What is the treatment for stroke?
Immediate treatment is needed to dissolve a clot causing an ischemic stroke, or stop the bleeding during a hemorrhagic stroke. Other treatments aims to reduce the chance of subsequent strokes, improve functioning and overcome disabilities.
Are there medications that help?
Clot-dissolving drugs are given to carefully selected patients within three hours of the onset of symptoms. Tissue plasminogen activator (tPA) is given through a vein after the doctor has confirmed the stroke's cause and there is no evidence of bleeding. Blood-thinning drugs like Heparin are given by vein (along with tPA, if indicated) and an oral medication called Warfarin is sometimes started if long-term treatment with a blood-thinner is anticipated. Antiplatelet drugs are also given. Aspirin is the most common, but clopidogrel (Plavix), dipyridamole (Persantine), and ticlopidine (Ticlid) are also sometimes used. Other drugs are used to control blood pressure, reduce the chance of additional clot formation, reduce brain swelling, and/or correct irregular heart rhythm.
When is surgery necessary?
Surgery may be performed following a stroke or TIA to prevent a recurrence. Surgical techniques include:
- Carotid endarterectomy which removes fatty deposits from a carotid artery, which are the major arteries in the neck that lead to the brain.
- Carotid angioplasty and stenting are less invasive procedures in which the carotid artery is widened, and a metallic mesh tube is inserted into the artery to help keep it open.
- Extracranial/intracranial bypass is surgery that reroutes the blood supply around a blocked artery using a healthy scalp artery.
- Craniotomy is performed in the case of a hemorrhagic stroke, to relieve pressure buildup in the brain caused by swelling.
What can be done to prevent a stroke?
- Exercise regularly.
- Increase intake of fruits and vegetables and limit dietary salt and fat
- Stop smoking.
- If you drink alcohol, drink alcohol only in moderation (1-2 drinks per day)
- Maintain a healthy weight.
- Frequently check blood pressure and follow physician recommendations for keeping it in a safe range.
- Consider taking a low dose of aspirin (75 milligrams per day) if your physician determines it is safe.
- Keep chronic medical conditions under control - such as high cholesterol and diabetes
- Seek medical care if you have symptoms of a stroke, even if symptoms stop
- Stop the use of recreational drugs - cocaine, heroin, marijuana, amphetamines
Baptist Health System is working to provide comprehensive stroke care that incorporates an interdisciplinary approach consisting of physicians and researchers from emergency medicine, neurology, neurosurgery and interventional radiology as well as nursing and rehabilitation services, pharmacy, radiology, food & nutrition and social workers. Watch videos about stroke from the American Heart Association
For more information please call 297-7005 or visit www.baptisthealthsystem.com.
