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House Call: Recognizing and preventing stroke

When blood flow to an area of the brain is stopped and an area of brain tissue dies, we call that a stroke. An artery to your brain can be blocked leading to lack of oxygen and blood flow or you can have a leaking or burst blood vessel. A stroke caused by a blockage is called an ischemic stroke and one by a leaking or burst artery is called a hemorrhagic stroke. Both are reasons to call 911 immediately if you suspect you or someone you are with is having one. We now like to refer to strokes as a “brain attack” to stress the importance of immediate treatment. Time is brain.

Signs and symptoms of a stroke include the following:

Trouble speaking or understanding

Weakness or numbness of the face (one side of the face may droop)

Inability to raise or keep raised an arm or leg

Trouble seeing (one or both eyes)

Difficulty walking

Keep track of when the symptoms started because it helps determine the most appropriate treatment. Don’t wait to see if symptoms stop or go away. Every second counts when it comes to acute stroke treatment.

The majority (about 80 percent) of strokes are caused by blood clots; however, one of the first things done during the emergency evaluation of a stroke is to determine whether it is being caused by blockage, leaking, or a rupture. Imaging studies on the brain – like a CAT scan help doctors figure out what kind of stroke you are having. You may need medication, surgery, other procedures or a combination of these treatments.

After the initial treatment and evaluation, most people need some rehabilitation therapy to help them regain function lost due to the stroke. Rehab may start before you even leave the hospital. Once you leave the hospital, there are options for where to continue rehab, such as in a rehab hospital, a skilled nursing facility, an outpatient unit, or even in your home. Rehab can be hard work, but it is the best way to regain as much function as possible after a stroke. Some stroke patients recover fully and some continue to have problems with the area affected. You generally don’t grow back brain tissue that has died, but your brain can re-wire itself to a degree and recover function.

A patient of mine had a stroke a few years ago affecting an area of the brain that affects his balance and coordination. With exercises to improve his balance and medication to lower his blood pressure and cholesterol, he has improved greatly and is able to do most of the things in his life that he likes to do.

There are steps you can take to prevent having a stroke, even if you have already had one. Your doctor will probably prescribe a cholesterol lowering medicine called a statin. They get undeserved bad press on the internet but they are really good for lowering the risk of a stroke or heart attack. If you have high blood pressure, take your medicine and make sure that it is controlled. If you have diabetes, work with your doctor to get it under control. Eat lots of fruits and vegetables every day and cut back on meat and salt. Stop smoking and drink less alcohol. Exercise for at least 30 minutes pretty much every day. If you have sleep apnea, get it treated. Strokes can be devastating. It is worth doing as much as possible to avoid having one, or if you’ve had one, to avoid having another one.

Bob Riggs is a family medicine physician practicing at Kaiser Permanente’s Riverfront Medical Center. His column appears biweekly in The Spokesman-Review.


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