Stroke

 

About Stroke

Stroke is a medical emergency. Know the signs and symptoms of stroke, and call 9-1-1 right away if you think someone might be having a stroke. Getting fast treatment is important to preventing death and disability from stroke.

You may be able to prevent stroke or reduce your risk through healthy lifestyle changes. In addition, medication can reduce stroke risk for some people.

To understand stroke, it helps to understand something about the brain. The brain controls our movements; stores our memories; and is the source of our thoughts, emotions, and language. The brain also controls many functions of the body, like breathing and digestion.

To work properly, your brain needs oxygen. Although your brain makes up only 2% of your body weight, it uses 20% of the oxygen you breathe. Your arteries deliver oxygen-rich blood to all parts of your brain.

What Happens During a Stroke
If something happens to interrupt the flow of blood, brain cells start to die within minutes because they can’t get oxygen. This is called a stroke. Sudden bleeding in the brain also can cause a stroke if it damages brain cells. A stroke can cause lasting brain damage, long-term disability, or even death.

If brain cells die or are damaged because of a stroke, symptoms of that damage start to show in the parts of the body controlled by those brain cells.

Quick Treatment Is Critical for Stroke
A stroke is a serious medical condition that requires emergency care. Call 9-1-1 immediately if you or someone you are with shows any signs of a stroke.

Types of Stroke

Stroke The illustration to the right showss how a blood vessel can burst within the brain causing a hemorrhagic stroke, and how a blood clot within an artery of the brain can cause an ischemic stroke.

The main types of stroke are

  • Ischemic stroke.
  • Hemorrhagic stroke.
  • Transient ischemic attack (a warning or “mini-stroke”).

Ischemic Stroke
Most strokes (85%) are ischemic strokes. If you have an ischemic stroke, the artery that supplies oxygen-rich blood to the brain becomes blocked.

Blood clots often cause the blockages that lead to ischemic strokes.

Hemorrhagic Stroke
A hemorrhagic stroke occurs when an artery in the brain leaks blood or ruptures (breaks open). The leaked blood puts too much pressure on brain cells, which damages them.

High blood pressure and aneurysms—balloon-like bulges in an artery that can stretch and burst—are examples of conditions that can cause a hemorrhagic stroke.

There are two types of hemorrhagic strokes:

  1. Intracerebral hemorrhage is the most common type of hemorrhagic stroke. It occurs when an artery in the brain bursts, flooding the surrounding tissue with blood.
  2. Subarachnoid hemorrhage is a less common type of hemorrhagic stroke. It refers to bleeding in the area between the brain and the thin tissues that cover it.

Transient Ischemic Attack (TIA)
A transient ischemic attack (TIA) is sometimes called a "mini-stroke." It is different from the major types of stroke because blood flow to the brain is blocked for only a short time—usually no more than 5 minutes.

It is important to know that

  • > A TIA is a warning sign of a future stroke.
  • A TIA is a medical emergency, just like a major stroke.
  • Strokes and TIAs require emergency care. Call 9-1-1 right away if you feel signs of a stroke or see symptoms in someone around you.
  • There is no way to know in the beginning whether symptoms are from a TIA or from a major type of stroke.
  • Like ischemic strokes, blood clots often cause TIAs.
  • More than a third of people who have a TIA end up having a major stroke within 1 year if they don’t receive treatment, and 10%-15% will have a major stroke within 3 months of a TIA.

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.

Stroke Signs and Symptoms

During a stroke, every minute counts! Fast treatment can reduce the brain damage that stroke can cause.

By knowing the signs and symptoms of stroke, you can be prepared to take quick action and perhaps save a life—maybe even your own.

Signs of Stroke in Men and Women
  • Sudden numbness or weakness in the face, arm, or leg, especially on one side of the body.
  • Sudden confusion, trouble speaking, or difficulty understanding speech.
  • Sudden trouble seeing in one or both eyes.
  • Sudden trouble walking, dizziness, loss of balance, or lack of coordination.
  • Sudden severe headache with no known cause.

Call for paramedics immediately if you or someone else has any of these symptoms.

Acting F.A.S.T. Is Key for Stroke
Acting F.A.S.T. can help stroke patients get the treatments they desperately need. The most effective stroke treatments are only available if the stroke is recognized and diagnosed within 3 hours of the first symptoms. Stroke patients may not be eligible for the most effective treatments if they don’t arrive at the hospital in time.

If you think someone may be having a stroke, act F.A.S.T. and do the following simple test:

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.

Note the time when any symptoms first appear. Some treatments for stroke only work if given in the first 3 hours after symptoms appear. Do not drive to the hospital or let someone else drive you. Call an ambulance so that medical personnel can begin life-saving treatment on the way to the emergency room.

Treating a Transient Ischemic Attack
If your symptoms go away after a few minutes, you may have had a transient ischemic attack (TIA). Although brief, a TIA is a sign of a serious condition that will not go away without medical help. Tell your health care team about your symptoms right away.

Unfortunately, because TIAs clear up, many people ignore them. Don’t be one of those people. Paying attention to a TIA can save your life.

Stroke Treatments

If someone you know shows signs of stroke, call for paramedics right away.

If you have a stroke, you may receive emergency care, treatment to prevent another stroke, rehabilitation to treat the side effects of stroke, or all three.

Emergency Treatment
Your emergency treatment starts in the ambulance. The emergency workers may take you to a specialized stroke center to ensure that you receive the quickest possible diagnosis and treatment.

At the hospital, health care providers will ask about your medical history and about the time your symptoms started. Brain scans will show what type of stroke you had. You may also work with a neurologist who treats brain disorders, a neurosurgeon that performs surgery on the brain, or a specialist in another area of medicine.

If you get to the hospital within 3 hours of the first symptoms of an ischemic stroke, a health care provider may give you a type of medicine called a thrombolytic (a "clot-busting" drug) to break up blood clots. Tissue plasminogen activator (tPA) is a thrombolytic.

tPA improves the chances of recovering from a stroke. Studies have shown that patients with ischemic strokes who received tPA are more likely to recover fully or have less disability than patients who do not receive the drug. In addition, patients treated with tPA are less likely to need long-term care in a nursing home. Unfortunately, many stroke victims don’t get to the hospital in time for tPA treatment. This is why it’s so important to identify a stroke immediately.

Medicine, surgery, or other procedures may be needed to stop the bleeding and save brain tissue. For example:

  • Endovascular procedures. Endovascular procedures may be used to treat certain hemorrhagic strokes. These procedures are less invasive and less dangerous for the patient than surgical treatments. The doctor inserts a long tube through a major artery in the leg or arm and then guides the tube to the site of the weak spot or break in a blood vessel. The tube is then used to install a device, such as a coil, to repair the damage or prevent bleeding.
  • Surgical treatment. Hemorrhagic strokes may be treated with surgery. If the bleeding is caused by a ruptured aneurysm, a metal clip may be put in place to stop the blood loss.

Preventing Another Stroke
If you have had a stroke, you are at high risk for another:
  • 1 of 4 stroke survivors has another stroke within 5 years.
  • The risk of stroke within 90 days of a TIA may be as high as 17%, with the greatest risk during the first week.

That's why it's important to treat the underlying causes of stroke, including heart disease, high blood pressure, atrial fibrillation (fast, irregular heartbeat), high cholesterol, and diabetes. Your doctor may give you medications or tell you to change your diet, exercise, or adopt other healthy lifestyle habits. Surgery may also be helpful in some cases.

Stroke Rehabilitation
After a stroke, you may need rehabilitation (rehab) to help you recover. Rehab can include working with speech, physical, and occupational therapists:
  • Speech therapy helps people who have problems producing or understanding speech.
  • Physical therapy uses exercises to help you relearn movement and coordination skills you may have lost because of the stroke.
  • Occupational therapy focuses on improving daily activities, such as eating, drinking, dressing, bathing, reading, and writing.

Therapy and medications may help with depression or other mental health conditions following a stroke. Joining a patient support group may help you adjust to life after a stroke. Talk with your health care team about local support groups, or check with an area medical center.

Support from family and friends can also help relieve fear and anxiety following a stroke. Let your loved ones know how you feel and what they can do to help you.

Recovering From Stroke

Recovery time after a stroke varies—it can take weeks, months, or even years. Some people recover fully, but others have long-term or lifelong disabilities.

If you have had a stroke, you can make great progress in regaining your independence. However, some problems may continue:

  • Paralysis (inability to move some parts of the body), weakness, or both on one side of the body.
  • Trouble with thinking, awareness, attention, learning, judgment, and memory.
  • Problems understanding or forming speech.
  • Trouble controlling or expressing emotions.
  • Numbness or strange sensations.
  • Pain in the hands and feet that worsens with movement and temperature changes.
  • Trouble with chewing and swallowing.
  • Problems with bladder and bowel control.
  • Depression.

Before you are discharged from the hospital, social workers can help you find care services and caregiver support to continue your long-term recovery. It is important to work with your health care team to find out the reasons for your stroke and take steps to prevent another stroke.


Call (847)758-1230 today for an appointment and consultation with our physician.

Adapted from the Centers for Disease Control