May 25, 2010 in Features

Be wary of stroke symptoms

Dr. Alisa Hideg
 

Imagine talking to a friend and suddenly having trouble making the words come out right. Your speech becomes a mixture of sounds, but not the words you mean to say.

Your friend looks confused. You start to get upset. How scary would this be?

Sudden difficulty with speech is one of the many possible symptoms of a stroke or a transient ischemic attack.

Bret Michaels, the rock singer and reality TV star, went to the hospital last month with a severe headache that turned out to be a stroke caused by cerebral bleeding. Then last week he was hospitalized again for numbness that was found to be a TIA caused by a small blood clot from his heart.

If a person has stroke symptoms, 911 should be called immediately to have an ambulance take them to the hospital. The sooner they are treated, the better the chance of surviving a stroke and having less permanent damage to the brain.

This is why some physicians refer to TIAs and strokes as “brain attacks” – to emphasize that they are as serious as a heart attack.

Possible symptoms include:

•Sudden numbness, paralysis or weakness in your face, arm or leg, especially on only one side of your body.

•New problems with walking or balance.

•Sudden vision changes.

•Drooling or slurred speech.

A stroke or TIA happens when a blood vessel in your brain gets blocked or leaks; oxygen cannot get to the part of your brain that the vessel supplies and brain cells start to die.

An ischemic stroke is loss of blood flow caused by blockage of a blood vessel and a hemorrhagic stroke is bleeding in or around the brain. In a TIA the symptoms are similar, but usually go away after 10 to 20 minutes.

It used to be that because the symptoms of a TIA went away on their own, they were not considered to be worrisome. My friend’s grandmother had them relatively often the last few years of her life and the only time her family called 911 about it was when her blood pressure skyrocketed at the same time.

Now we know better. A TIA is often a sign that a person is going to have a more severe stroke. It is just as important to call 911 if you think someone is having a TIA as it is if you think they are having a stroke.

About one out of every three people who have a TIA will have a stroke later, many within a year. With prompt treatment at the time of the TIA and good follow-up treatment afterward, you can improve those odds.

Although about 80 percent of strokes are caused by blood clots, one of the first things to be done during an emergency evaluation of a stroke is determining whether it is being caused by a blood clot or a leaking blood vessel.

Doctors use imaging studies on the brain, like a CAT scan or an MRI. Blood tests are also done to look for other problems.

Our region’s certified stroke program is at Providence Sacred Heart Medical Center. The stroke team evaluates patients within 15 minutes of their arrival to the emergency department.

Treatment can include carotid endarterectomy, catheterization techniques, balloon angioplasty and aneurysm coiling – all done to improve blood flow or to stop bleeding.

After a person has a stroke or a TIA, the goal is to prevent a future stroke. The most common risk factor for a stroke is high blood pressure. Other risk factors include smoking, high cholesterol, irregular heartbeat and diabetes.

Usually if a person has had a stroke or TIA that is caused by a clogged blood vessel they are started on medications to thin the blood and lower cholesterol and blood pressure.

Recommended changes in daily life include reducing salt, sugar and fat in the diet, quitting smoking, cutting back on alcohol and being more active.

If someone has had a stroke and lost some abilities with speech, walking or doing simple tasks, they are referred to a stroke rehabilitation program with physical, speech and occupational therapists.

Starting a rehabilitation program soon after a stroke improves the chances of resuming normal, independent activities.

Dr. Alisa Hideg is a family medicine physician at Group Health’s Riverfront Medical Center in Spokane. Her column appears every other Tuesday in the Today section. Send your questions and comments to drhideg@ghc.org.


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