What is stroke?
Stroke is a broad term that describes a variety of catastrophic events taking place in the human brain. Strokes fall into one of two categories, ischemic which accounts for up to 87% of all strokes, and hemorrhagic accounting for the rest. An ischemic event refers to a portion of the brain getting deprived of oxygen through reduced or absent blood flow. On the other hand, a hemorrhagic stroke is one of bleeding into one or more compartments of the brain. Today we will focus on ischemic events.
How bad are strokes?
In the united states, stroke is the fifth leading cause of death and the leading cause of long-term disability. As such strokes, carry a huge negative impact on the individual and national level. Stroke victims can permanently lose the ability to work, drive, and even enjoy life at the most basic level. A better way to think about stroke is a “brain attack”, and just like with a heart attack, when it occurs, immediate medical attention is advised. Similarly, just like with a heart attack, modifying risk factors that predispose to stroke is paramount.
Am I at risk for stroke?
Risk factors can be nonmodifiable such as being a male, having a familial predisposition, or aging. However, a larger body of risk factors is modifiable thankfully and includes hypertension, diabetes, high cholesterol, smoking, sedentary lifestyle, kidney disease, sleep apnea, excessive alcohol use, diet, and atrial fibrillation (an irregular heart rhythm). Taking care of these things can substantially reduce your risk of having a stroke, even if you are an older gentleman (the nonmodifiable risks).
What happens during a stroke?
Symptoms of a stroke vary based on the portion of the brain that has been attacked. Common symptoms include slurred speech, trouble swallowing, loss of language comprehension, loss of expressive ability, weakness/numbness in one or more limbs, double vision, vision loss, behavioral changes, facial droop, and vertigo to name a few. An easy way to remember the common symptoms and what to do about them is the word FASTER.
How are strokes treated?
Stroke treatment involves two portions. In the acute setting, all efforts are aimed at saving as much healthy brain tissue as possible. This is done in one of two ways. A blood thinner called Alteplase or tPA is given intravenously to hopefully dissolve the clot and restore blood flow up to 4.5 hours from symptom onset. The earlier this medication is given, the more likely it is to be beneficial and the lower the risk of bleeding. In select patients, an additional therapy may be available where the clot can be mechanically retrieved or dissolved using angiography for up to 24 hours from symptom onset. And since stroke treatment is time sensitive, you want to get to the hospital as soon as your symptoms begin.
In the long run, the treatment of stroke is aimed at diagnosing the underlying cause, preventing another stroke, and rehabbing your brain with therapy (physical, occupational, and speech). The main causes of stroke are blockage in the large arteries of the head and neck, blockage in the small arteries of the brain, and clots emerging from the heart for various reasons including irregular heart rhythm. There are numerous secondary causes of stroke apart from the aforementioned that are more commonly seen in younger patients.
Have you been taking care of your brain health?
We hope this brief overview of this disabling disease has been helpful to you and your loved ones. With routine check ups with your primary care doctor, several if not all stroke risk factors can be mediated to lower your chance of having a stroke. That is the best stroke prevention. Please, should you ever experience any sudden onset symptoms as discussed above, call 911 right way and come see us at the Iberia Medical Center for treatment. Remember, time is brain. The longer you wait, the more brain you lose. And the more brain you lose, the worse your long-term outcome. Do NOT become another statistic.
Source: All citations in this article are obtained from the medical resource Continuum Journal of Neurology published by the American Academy of Neurology (AAN).
Oliver Achi, MD, Neurologist
Iberia Medical Center – Neurology
2312 East Main Street
New Iberia, LA 70560