Stroke

     When we think of  a "Stroke", what do we think about? We think of a disabled family member or friend who has trouble moving and speaking, and needs to be cared for; possibly for the rest of their lives What you may not know is the stroke is the third leading cause of death in America, and it is number one in causing long term disability. Simply put, a stroke is an interruption of the blood supply to any part of the brain. It is sometimes called a "Brain Attack." Strokes occur when a blood vessel in the brain bursts, or more commonly when a blockage occurs. Without immediate treatment the cells in the brain become starved for oxygen and quickly begin to die. The result can be a serious disability or even death. It sounds pretty bad, doesn't it?

The good news is that there are many things to do to prevent strokes and to minimize the damage when one occurs. The key is to take the time to learn how to recognize the onset of a stroke, and what to do. Sometimes the symptoms can be confusing. Sometimes you may be confusing age related problems such as physical infirmities, along with age related memory loss, dementia or Alzheimer's with what may actually be a stroke. The key is to learn all the symptoms, and keep your eyes open for them. Take a look at the picture below. Notice how one side of the face is dropping at the eyes and mouth. It is very important to look for this. Here are more symptoms.

Symptoms of Strokes

Severe headaches.

Change in alertness (including sleepiness, unconsciousness, and coma).

Changes in hearing and taste.
Clumsiness, loss of balance, lack of coordination., and trouble walking.
Confusion or loss of memory
Difficulty swallowing
Difficulty writing or reading
Dizziness or abnormal sensation of movement (vertigo)
Lack of control over the bladder or bowels
Muscle weakness in the face, arm, or leg (usually just on one side)
Numbness or tingling on one side of the body
Personality, mood, or emotional changes
Problems with eyesight, including decreased vision, double vision, or total loss of vision
Sensation changes that affect touch and the ability to feel pain, pressure, different temperatures, or other stimuli.
Trouble speaking or understanding others who are speaking.

     The key to minimizing stroke damage and to possibly save a stroke victims life is to act quickly. The word "FAST" is a medical acronym for what you should do if you suspect a stroke.

F is for Face. Take a look at the persons face. Ask them to smile, and see if one corner of the mouth is drooping slightly.

A is for Arms. ask them to raise both arms over their head. Are they having trouble raising one arm, or after it's raised, does it drift down? Do they have trouble keeping it raised?

S is for Speech. ask the person to repeat a simple sentence and look for slurred speech.

T is for Time. This is the most critical part. Immediately call 911. Many strokes can be minimized if they can be treated quickly. There are blood thinning drugs such as Heparin and Warfarin which can help, but must be administered within three hours.

Recognition of a stroke and prompt medical care are the keys to minimizing damage to the brain and hopefully preventing long term disability.

     Now that we know the symptoms and what to look for, let's take a look at the two types of strokes. 

     The first type of stroke is called an "Ischemic Stroke". It is the most common, with 9 out of 10 strokes being this kind. It is caused by a blood clot that obstructs a blood vessel inside the brain. The clot can develop in the brain or move through blood vessels from another part of the body. Blood clots can also develop in the Carotid Arteries, which run up either side of our necks, and are the main blood supply to the brain.

    A less common type of stroke, but one that is more dangerous and often leads to permanent disability or even death is call a "Hemorrhagic Stroke." This is when a weakened blood vessel in the brain bursts. The bleeding is often hard to stop and surgery is often required to find and repair the broken blood vessel.

It should be noted that some people get "Mini-Strokes", or what are called TIA's which stands for a "Transient Ischemic Attack." These are a warning sign that a major stroke may occur. It may be a temporary blockage of an artery. The key is to be aware of even the smallest symptoms, and seek prompt medical attention.

     What causes a stroke, what are the risk factors, and what can be done to prevent them from occurring? These are all important questions. Most Ischemic strokes are caused by "Atherosclerosis." This is a hardening of the arteries, caused by a build-up of Plaque. Plaque is fat, cholesterol, calcium, and other substances which build up on the walls of arteries and blood vessels. It can reach the point where there is a total blockage of the flow of blood. The main cause of Hemorrhagic strokes is long-term high blood pressure which eventually weakens blood vessels and arteries.

     Lets take a look at some of the risk factors for strokes. These factors include both chronic and behavioral factors.

Chronic Risk Factors

1. High Blood pressure.

2. High Cholesterol levels.

3. Diabetes.

4. Obesity.

Behavioral Risk Factors

1. Smoking.

2. Lack of exercise.

3. Alcohol or drug abuse.

4. Poor diet.

Things You Can't Control

1. Age. As you get older your risks increase.

2. Family history.

3. Gender. Men have a higher risk, but women are more likely to die.

4. Race. African Americans, Native Americans, and Alaskan Natives have a higher risk of strokes.

   What can we do to prevent strokes? There are many ways that we can help to lower the risk of suffering a debilitating stroke.

1. Lifestyle changes. These are all things we can do to improve our overall health, including: dieting to lose excess weight, exercising, avoidance of drugs, and the cutting down of alcohol and salt consumption.

2.Medications. These should be utilized under a Doctor's care by high risk people. These may include: Anti-platelet medications to keep arteries clear, aspirin, anti clotting drugs, and high blood pressure medication.

3. Surgery. I spoke previously of "Mini-Stokes", or TIA's. If they occur Doctor's may perform surgery to remove plaque in the Carotid Arteries..

4. Balloon and Stent. Doctors may perform an "Angioplasty." This is when they temporarily insert a catheter into an artery and inflate a tiny balloon to widen the area that is narrowed by the plaque. They may also permanently insert a metal tube, called a stent to keep the artery open.

     What happens if you do have a stroke? What's next? There is hope for most stroke victims of having a good life. Over 50% of stroke victims regain the ability to take care of themselves. Even those who have disabilities can learn to function independently. Long term damage will depend on the location of the clot in the brain, the severity of the stroke, whether it was a burst blood vessel, and how quickly the victim got treatment. After suffering a stroke you may have numbness in the arms and legs, difficulty walking, vision problems, trouble swallowing, and problems with speech and comprehension. Some of these may be permanent, but for many people they are temporary. They are many options open for the treatment of strokes. There is rehabilitation including speech therapy and physical therapy which helps with muscle weakness and balance. There are many Psychologists and Mental Health Counselors who work not only with stroke victims, but their families as well. It should be noted that victims of stroke are susceptible to bouts of depression. Just remember that the best medicine is prevention, recognition, and then quick medical care