Strokes are one of the top five killers in the United States, and yet many people do not know about stroke symptoms. However, knowing stroke warning signs, risk factors and how to respond can save a life, perhaps even your own.
Strokes are also a leading cause of serious, long-term disability. If you suspect a loved one is having a stroke, call 911 or take them to the nearest emergency room as soon as possible.
A stroke, or brain attack, happens when part of the brain’s blood supply is blocked by a blood clot or damaged vessel, which stops your brain from getting enough oxygen. Since the brain is the command center of the body, having a stroke can affect your ability to talk, walk, read, write, think and see.
Nationwide, hemorrhagic strokes account for 13 percent of all strokes, yet are responsible for more than 30 percent of all stroke deaths. Hemorrhagic strokes are when a ruptured blood vessel causes bleeding in the brain.
Ischemic strokes, which account for about 87 percent of all cases, happen when the brain does not get enough oxygen-rich blood. Usually this happens due to a blood clot blocking a major artery leading to the brain.
Transient ischemic attacks (TIAs), also called mini-strokes, are smaller, temporary blockages in the brain that can produce milder, stroke-like symptoms but may not leave lasting damage. However, TIAs are an important warning sign, as up to 40 percent of all people who suffer a TIA will go on to experience a full stroke.
Rapid diagnosis and treatment can minimize or even prevent the effects of a stroke. Unfortunately, people experiencing a stroke often do not recognize what is happening and delay medical treatment. That’s why it’s so important to know the signs and act quickly.
Risk Factors for Stroke
First, remember that the best time to treat a stroke is before it occurs. Your doctor can help control or treat risk factors, such as high cholesterol, high blood pressure, smoking, diabetes, physical inactivity, obesity, drug and alcohol abuse and disorders of the heart, arteries and blood. Other risk factors can’t be treated, but it’s helpful to be aware of them:
- Age: The risk of stroke increases with age, almost doubling during each decade of life after age 55.
- Gender and race: Women, African Americans and Hispanic Americans have a higher risk.
- Family history: People with a personal or family history of stroke are also at greater risk.
Stroke Warning Signs
It is important to learn the signs and symptoms of a stroke so you can take immediate action in an emergency. To recognize stroke warning signs, BE FAST.
B stands for balance: With a stroke, a person can experience a sudden loss of balance.
E stands for eyes: Ask the person if they can see out of both eyes. Loss of vision is a stroke symptom.
F stands for face: Ask the person to smile. If the person is experiencing a stroke, one side of the face and mouth may droop.
A stands for arms: Ask the person to raise both arms. Stroke will often cause arm weakness and one arm to drift downward.
S stands for speech: Ask the person to repeat a sentence. Strokes can cause speech difficulty and may cause their words to be slurred.
T stands for time: If you see signs of a possible stroke, it’s time to call 911 or take the person to the emergency room.
Treatments for Stroke
Because “time is brain” when treating a stroke, it is imperative to seek emergency care as soon as possible. Once arriving at the hospital, you will be assesed by a team of specialists who will determine the best course of treatment depending on the type of stroke, how much time has passed and if you have any other medical conditions.
Transient ischemic stroke treatments include:
- Tissue plasminogen activator (tPA): Medicine used to break up blood clots that affect blood flow to the brain
- Blood-thinning medicines, such as aspirin
- Thrombectomy procedure: Removes the clot from the blood vessel
- Carotid endarterectomy procedure: Surgery to remove plaque from the carotid artery
Hemorrhagic strokes are treated in a variety of ways based on the location of the bleed and its severity. Due to the nature of hemorrhagic strokes, patients may be given medicine to lower their blood pressure and be taken off any blood-thinning medications.
Depending on where the bleeding is occurring and how severe, procedures for treating hemorrhagic strokes may include blocking blood flow by clamping or using a coil to seal an aneurysm. Additional surgeries may also be required to remove any pooled blood, remove part of the skull to alleviate pressure due to swelling or remove a tangle of veins called an arteriovenous malformation (AVM).
Levels of Stroke Care
Hospitals can possess four levels of advanced certification for stroke care. As designated by DNV, stroke center certifications are based on standards set forth by the Brain Attack Coalition and the American Stroke Association.
Levels of stroke care include:
- Acute Stroke Ready: These are usually small or rural hospitals that have a stroke-focused medical program with the staff and resources to diagnose, stabilize, treat and transfer most stroke patients.
- Primary Stroke Center: These are medium or large hospitals that have the same capabilities as acute stroke ready centers, but also have the resources for a designated stroke unit with acute therapy capabilities.
- Primary Plus Stroke Center: Also known as thrombectomy capable stroke centers, these are primary stroke centers that can also provide endovascular care.
- Comprehensive Stroke Center: These are typically the largest and best-equipped hospitals in a given geographical area that can treat any kind of stroke or stroke complication.