Most of us know a family member or friend who has suffered the effects of an acute stroke. There are about 800,000 patients a year in the U.S. who experience a stroke. It is a frightening event that can be devastating to daily functioning.
It remains the No. 1 cause of disability in this country. A stroke used to be an event that often had little treatment other than aggressive rehabilitation, but now we have interventions that can minimize or even reverse the effects of a stroke if caught early.
Many of us have heard the saying “time is muscle” when it comes to limiting damage from an acute heart attack. Now, we also need to remember “time is brain.”
It’s simple but potentially lifesaving advice: If you are having signs or symptoms of a stroke, don’t wait to see if they will go away. Call 911 and get to medical care right away. Fast reaction, evaluation and treatment can be the difference between life and death or disability.
I’ve known a number of patients who went to the emergency room quickly when they exhibited severe neurologic deficits (near complete paralysis on one side and unable to move around) who after treatment for a stroke were able to walk out of the hospital functionally normal!
How do you know if someone may be having a stroke? Remember the words BE FAST:
Balance. Does the person have a sudden loss of balance or coordination?
Eyes. Is the person having double vision? Are they unable to see out of one eye?
Face. Ask the person to smile. Does one side of the face droop?
Arms. Raise both arms. Does one arm drift downward? Or is one arm unable to rise?
Speech. Repeat a simple phrase. Is his or her speech slurred or odd?
Time. Time to act! Call 911 immediately!
An acute ischemic stroke occurs when the blood supply to part of the brain is blocked by a clot, preventing brain tissue from getting oxygen. About 85% of all strokes are this type of stroke. With ischemic strokes, the quicker you can get to a hospital, the more options doctors will have to treat you to minimize the damage and lead to the best outcome possible.
The sudden onset of the symptoms above can indicate a stroke, as well as other acute symptoms like changes in alertness or confusion; numbness or weakness of the face, arm or leg; changes in hearing or taste; problems swallowing; or sudden, severe headache with no known cause.
If someone shows these signs, they are emergency symptoms, and this is a true medical emergency.
What is the treatment for an acute stroke?
There are effective treatments that can reduce, reverse or resolve neurological damage right in the emergency room.
First, brain imaging (CAT scan) will be done to see whether it is an ischemic or hemorrhagic (bleeding) type of stroke. A variety of labs will be checked as well as vital signs, most important, blood pressure.
If a person is having an ischemic stroke, they may receive treatments such as thrombolytics (clot-busting drugs) or thrombectomy, a procedure when a physician threads a small device into the blocked artery and retrieves the clot to restore blood flow to the brain. Both of these options are time limited, meaning they should be performed soon after the stroke.
We are fortunate in our area to have hospitals that were at the forefront of developing acute stroke interventions in the early 1990s, which have saved countless patients from severe and devastating injury.
Another point to remember is that sometimes symptoms can initially be transient and resolved within minutes, for example if it is a transient ischemic attack (TIA). Patients may be tempted to ignore the symptoms since they have resolved; however, in many cases, these symptoms may come back and develop into a completed or acute stroke, so urgent evaluation is still warranted.
If you aren’t sure when the symptoms started, or if the symptoms appear and then go away, call 911 anyway. The purpose of getting an emergency or urgent evaluation is to get you in treatment as soon as possible.
This is critical if it is a stroke, but also can be important for other issues that can mimic a stroke, including seizures, infections or low blood sugar in diabetics. Even migraine headaches can resemble a stroke. An evaluation by a medical provider will help determine the cause and treatment options.
What can I do to prevent a stroke?
While more strokes happen to older adults, they can happen at any age. Making healthy changes to manage blood pressure (the highest risk factor for stroke) and other conditions reduces the risk of a stroke. Focus on these treatable risk factors that support health overall to help prevent a stroke:
Blood pressure: This is the No. 1 treatable risk factor for stroke. It is vital to check blood pressure at home and work with your primary care provider to make sure it is in the appropriate range.
Cholesterol: Treat elevated cholesterol with diet and exercise and when necessary work with your provider for recommendations on medication such as statins.
Diabetes: Manage your blood sugar with your provider. Elevated blood sugar damages blood vessels and leads to atherosclerosis (plaque formation) in blood vessels, a leading cause of strokes.
Smoking: Stop smoking if you smoke. This also causes plaque to build up in blood vessels.
There are many factors that go into stroke risk and how severe or lasting the impacts might be, but patients have a better chance at reducing or reversing damage if they recognize the symptoms and get into medical treatment right away.
A stroke can be a life-changing event, and it takes time to recover. Every stroke patient’s recovery is different, but there is a positive prognosis for many people who experience a stroke. In summary, TIME IS BRAIN! BE FAST and call 911 if you or someone you know is experiencing signs and symptoms of a stroke.
Dr. Jeff Markin is a family medicine physician practicing at Kaiser Permanente’s Veradale Medical Center.
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