- - Friday, May 1, 2015

I learned what a stroke is when I was in medical school. Although I had heard people allude to the term when they were upset, “I am going to have a stroke,” I had not wrapped my head around what a devastating event this could be. Today, as a practicing physician, hardly a day goes by that I will not interact or care for a patient who has been affected by this devastating occurrence.

Every year, 800,000 Americans suffer from a stroke. And, on average, one American dies from a stroke every four minutes, making it the 5th leading cause of death in our country. However, by recognizing the signs and symptoms of a stroke and getting fast treatment, you, or a loved one, may be able to decrease disability, save someone’s life, or possibly survive.

Dr. Nina’s What You Need To Know About Strokes

What is a stroke? Brain cell death due to insufficient blood flow. The formal medical term is cerebrovascular accident (CVA). Our brain cells, also known as neurons, are responsible for thinking, memory, movement, feeling/sensation, talking, and practically every aspect of our body and life. Because these cells are so active, they require a constant supply of oxygen and nutrients that are provided by our blood vessels. Any interruption of blood flow can create significant disability in how we live our lives and can even result in death.

What are the different types of strokes?
• Ischemic (ih-skee-mik). The artery gets blocked, often by a clot, preventing adequate blood flow.
• Hemorrhagic (hem-ur-ajic). The artery leaks or ruptures and the leaked blood puts pressure on the neurons causing damage. This can result because of weaknesses in the arteries or high blood pressure.

What is a “mini-stroke”? Also known as a transient ischemic attack (TIA), it is a temporary blockage caused by a clot. Unlike a stroke, the symptoms resolve and there is no permanent injury to the brain. A TIA is a warning sign for a future stroke. In fact, greater than 30% of people who have a TIA end up having a major stroke within 1 year if they do not receive treatment.

Recognizing and treating TIAs can reduce the risk of a major stroke. If you have a TIA, your health care team can find the cause and take steps to prevent a major stroke.

What are risk factors for a stroke? Anyone, at any age, can have a stroke. All it takes is an inadequate blood supply to meet the demands of the neurons. However, there are certain known risk factors—genetic, lifestyle, medical illnesses—that increase our risk. While we cannot change our genes, we can make adjustments to lifestyle choices and manage illnesses in order to decrease our risk for a stroke.
• Lifestyle: Physical inactivity, unhealthy eating, obesity, smoking, heavy drinking
• Medical illnesses: High blood pressure, high cholesterol, diabetes, heart disease

What symptoms are seen when there is a stroke in evolution? Any sudden:
• Weakness or numbness in our leg, arm, or face
• Confusion
• Difficulty speaking
• Difficulty with vision
• Dizziness or loss of balance

What do you do if you or someone you know may be having a stroke? Act F.A.S.T. This pneumonic can help to identify symptoms of stroke, fast.
• 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

There is a saying: “With stroke, time lost is brain lost.” Every minute counts and as a result fast treatment can reduce the brain damage.

What are treatments for a stroke? Upon arrival to the hospital, a history and physical exam, as well as a brain scan will be performed. Depending on the type of stroke and time elapsed since symptoms started, treatment will be tailored to the patient. They may include specialized medications to break up a clot, endovascular (non-invasive) treatment, or surgery.

Public awareness and advancements in medical technology have moved stroke from the 3rd leading cause of death amongst Americans down to the fifth. However, there is much more work to do. By knowing our risk factors, we can take proven, effective steps towards minimizing those that we have control over. And by acting F.A.S.T. when a stroke has hit, we can decrease devastating disability and, even, survive as a result. The choices we make, today, can affect the life we live, tomorrow. Let’s work together to help end strokes.

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