In a stroke, every second counts. Do you feel confident you would recognize a stroke when it happens? It’s not hard to identify a stroke, if you know what to look for. In this article, we’ll cover the causes, symptoms, and treatment of strokes. But first, some background:
What is a Stroke?
A stroke, or cerebrovascular accident (CVA), is similar to a heart attack, just in the brain instead of the heart. In a heart attack, a blood vessel leading to the heart becomes blocked, causing reduced blood flow to the heart. The same things happens in the brain, causing a stroke. When less blood is coming to the brain, the brain cells lose oxygen and start dying. As their brain cells die, the stroke victim loses control of any abilities dominated by that area of the brain.
There are two main kinds of strokes, called hemorrhagic stroke and ischemic stroke.
- Hemorrhagic stroke is caused either by a leaking blood vessel or a brain aneurysm burst. In both cases, blood streams into the cranial cavity and puts pressure on the brain, depriving it of oxygen and damaging brain tissue and cells. Hemorrhagic strokes are much less common than ischemic strokes, but also much more deadly. They account for only 15% of strokes, but 40% of stroke deaths. The main culprits for hemorrhagic stroke are uncontrolled high blood pressure and aging blood vessels.
- Ischemic stroke happens when a blood clot forms in a blood vessel and blocks to the flow of blood from reaching the brain. High blood pressure is also a leading cause of ischemic stroke. Blood clots can block blood flow in two ways. The clot can form somewhere else in the body, such as the heart, and travel to the brain, lodging itself in a small blood vessel in the brain. Or, it can build up inside an artery leading to the brain. The second form of blood clot, caused a thrombus, is common among patients with atherosclerosis—a buildup of plaque inside the arteries.
Risk factors for stroke include family history of stroke, old age, sex, and ethnicity—more women have strokes than men, and blacks are at higher risk than whites. You can’t change those factors, but there are some things you can do to minimize your risk of stroke:
- Stay physically active, as much as possible
- Maintain a healthy weight
- Maintain healthy cholesterol levels
- Keep your blood pressure controlled
- Don’t smoke
What is a Mini-Stroke?
A mini-stroke is a temporary blockage in the brain. It’s also called transient ischemic attack, or TIA. Patients with a TIA will usually have stroke-like symptoms that will go away on their own. If you or someone you loves experiences a TIA, don’t brush it off. You still need to go to the hospital to see why it happened. People who have a mini-stroke are very likely to have a full CVA in the future.
If it’s a Stroke, Think FAST
When someone has a stroke, they need medical attention immediately to get the greatest impact from treatment. In the case of ischemic stroke, we can drastically reduce or even reverse the effects of a stroke if we start treatment within three hours. An easy way to remember the symptoms of a stroke is the acronym FAST. Use it as a checklist if you think someone is having a stroke.
F—Face
Is their face lopsided or drooping on only one side? If you’re not sure, ask them to smile. Any drooping will be more noticeable then.
A—Arms
Ask the person to raise both arms. If one arm drifts down, or they can’t lift it at all, it’s a sign of stroke.
S—Speech
How are they speaking? Is their speech clear or slurred? If you can’t tell, ask them to repeat a simple phrase, such as, “Good morning world.”
T—Time
It’s time to call 911. Also, note the time the first symptom appeared. This can affect treatment decisions.
Other symptoms of stroke include sudden confusion, vision problems, difficulty walking, a severe headache, and a numb or weak feeling—especially on only one side of the body. If you’re alone and you start feeling any of these symptoms, call 911 immediately.
Remember that the FAST symptoms don’t need to be severe in order to be a stroke. Even slight facial droop or slurred speech can indicate a stroke. If the symptoms stop as suddenly as they come, and the person is back to herself, you should still call 911. She probably had a TIA, and will need testing and observation in the hospital.
Treating a Stroke
Treatment depends on the type of stroke. For ischemic strokes, treatment involves busting the clot to allow blood flow to resume. There are two ways to do this:
- A medication called Alteplase IV r-tPA is an IV-administered medication that dissolves the clot. It has great results in reducing the long-term effects of stroke, but it’s only effective if the patient receives it within three hours of having a stroke. Many people miss the window for treatment. That’s why it’s so important to identify a stroke and get the patient to the emergency room as soon as possible.
- Physically removing the clot is a good way to treat a stroke that isn’t eligible for tPA. Patients must meet certain criteria to undergo this procedure. There are a few ways to remove the clot, including using a catheter with a cage-like device that “grabs” the clot and removes it.
Hemorrhagic stroke, while less common, is more serious and difficult to treat. About 15% of patients with brain hemorrhage die before they get to the hospital. At the hospital, the main goal is to stop the bleeding. This can be done by inserting a catheter-led coil to prevent further rupture, or surgery to secure the blood vessel and drain the pooling blood.
Recovering from a Stroke
Stroke will affect every patient differently. The severity and scope of impairment depends on many factors, such as how big the clot was, which part of the brain it affected, and if the patient was able to get tPA. Many stroke survivors see improvement over a period of months or years. There are two areas to focus on in stroke recovery:
- Preventing addition strokes. Having a stroke makes it much more likely you’ll have one in the future. Your doctor will recommend lifestyle changes to minimize the risk of a recurring stroke. This can include controlling your blood pressure, quitting smoking, and eating better.
- Stroke rehabilitation. Rehab is about getting your life back. Stroke rehab involves intense therapy to help you return to your previous ability level, or get as close as possible. While many stroke survivors remain impaired, many others are able to return home after successful rehabilitation at facilities like Regency‘s. Our goal is to restore stroke survivors’ daily function and quality of life. To accomplish that, our specialized staff provides physical, occupational, and speech therapy to help stroke patients relearn how to walk, talk, care for themselves, and regain independence.
To learn more about Regency Nursing’s stroke rehabilitation programs, contact us here.