What is a Stroke?

Stroke is a condition that occurs when blood flow to the brain is interrupted. When blood flow is blocked or lost, localized damage occurs, causing a stroke. There are two main types of stroke, ischemic and hemorrhagic. During an ischemic stroke, the blood flow is blocked by a clot or narrowing of the blood vessel. Eighty percent of all strokes are ischemic. A hemorrhagic stroke is when a blood vessel ruptures or breaks and causes bleeding in or around the brain.

Stroke Symptoms

Stroke symptoms vary depending on the severity and location of the damage and may go away and return, but typically may include:

• Sudden numbness or weakness of the face, arm or leg
• Sudden confusion, trouble speaking or understanding
• Sudden trouble seeing in one or both eyes
• Sudden trouble walking, dizziness, loss of balance or coordination
• Sudden, severe headache

If you or someone you know is experiencing any of these symptoms, call 911 immediately!

BE FAST

Use this acronym to check for signs of stroke:

B is for Balance.  Loss of balance or coordination, dizziness.

E is for Eyes.  Blurry vision, double vision, cannot see out of one eye.

F is for Face. Ask the person to smile. Does one side of the face droop?

A is for Arms. Ask the person to raise both arms. Does one arm drift downward?

S is for Speech. Ask the person to repeat a word or sentence. Are the words slurred?

T is for Time. If the person shows any of these symptoms, time is important. Call 911 immediately.

• Note the time the symptoms first started. In some patients, a clot-busting drug can be given to reduce brain damage if given within three hours of onset.
• If you have stroke symptoms, immediately call 911. Do not drive yourself.
• If you’re with someone who may be having stroke symptoms, immediately call 911. Don’t take “no” for an answer because TIME LOST is BRAIN LOST.
• When communicating with 911 or the hospital make sure and use the word “STROKE.”

Time lost=Brain lost

Minutes matter in stroke care. A person who receives immediate care has a significantly better chance of survival and recovery. Stroke is the third leading cause of death. However, many people are unaware of the warning signs. Fewer than 5 percent of stroke victims reach a hospital in time to receive optimal care.

Stroke Risk Factors

What risk factors for stroke can’t be changed?

• Age. The chance of having a stroke more than doubles for each decade of life after age 55. While stroke is common among the elderly, a lot of people under 65 also have strokes.
• Heredity. Stroke risk is greater if a parent, grandparent, sister or brother has had a stroke.
• Race. African Americans have a much higher risk of death from a stroke than Caucasians. This is partly due to higher rates of high blood pressure and diabetes in African Americans.
• Gender. Stroke is more common in men than in women. In most age groups, more men than women will have a stroke in a given year. However, more than half of total stroke deaths occur in women. At all ages, more women than men die of stroke. The use of birth control pills and pregnancy pose special stroke risks for women.
• Prior stroke, TIA, or heart attack. If you have suffered from any of these in the past, you are at a higher risk of having a stroke

What stroke risk factors can be changed, treated, or controlled?

• High blood pressure. High blood pressure or hypertension (HTN) is the number one cause of stroke. High blood pressure can damage the small blood vessels of the brain. High blood pressure is the most important controllable risk factor for stroke.
• Cigarette smoking. Tobacco use in any form, especially cigarette smoking, is very bad for your health and studies have shown cigarette smoking to be an important risk factor for stroke. The use of oral contraceptives (birth control pills) combined with cigarette smoking greatly increases stroke risk in women. For help with tobacco cessation, please call 1-800-QUIT-NOW.
• Diabetes. Diabetes is a risk factor for stroke even when being treated. Many people with diabetes also have high blood pressure, high blood cholesterol and are overweight which can increase their risk even more. Diabetes causes disease of small blood vessels in the brain and can lead to a stroke. Keeping your blood glucose within the normal range (70-105 fasting) will lower your risk for stroke.
• Carotid or other artery disease. Carotid artery disease and peripheral artery disease both raise your risk of stroke. Carotid artery disease is a build-up of plaque in the large arteries of your neck while peripheral artery disease is a build-up of plaque in the larger arteries that carry blood to your legs and arms. Treatment of your blood pressure, diabetes, cholesterol and quitting smoking can reduce your risk for these problems and help reduce your risk for stroke
• Atrial Fibrillation. This heart rhythm disorder raises the risk of stroke. The heart’s upper chambers quiver instead of beating regularly, which can let the blood pool and clot. If a clot breaks off, enters the bloodstream and lodges in an artery leading to the brain, a stroke results.
• Other heart disease. People with coronary heart disease or heart failure have a higher risk of stroke than those with hearts that work normally. An enlarged heart, disease of the heart valves and some birth-related heart defects also raise the risk of stroke.
• Sickle Cell disease (also called Sickle Cell Anemia). This is a genetic disorder that mainly affects African American and Hispanic children. “Sickle-shaped” red blood cells are less able to carry oxygen to the body’s tissues and organs. These cells also tend to stick to blood vessel walls, which can block arteries to the brain and cause a stroke.
• High blood cholesterol. People with high blood cholesterol have an increased risk for stroke. High blood cholesterol can be reduced by eating right (avoiding fried, fatty foods) and exercising routinely. It may also require medication. The recommended level of LDL (low-density lipoprotein) is at least less than 100 and HDL (high-density lipoprotein) is greater than 50 for women and greater than 40 for men.
• Alcohol intake. Heavy drinking can lead to multiple medical complications, including an increased risk of stroke. If you drink alcohol, do so in moderation. Recommendations: no more than two drinks per day for men and no more than one drink per day for nonpregnant women. Alcohol can also interact with other drugs you are taking.
• Drug use. Drugs that are abused, including cocaine, amphetamines and heroin, have been associated with an increased risk of stroke. Strokes caused by drug abuse are often seen in the younger population.
• Poor diet. Diets high in saturated fat, trans fat and cholesterol can raise blood cholesterol levels. Diets high in sodium (salt) can contribute to increased blood pressure. Diets with excess calories can contribute to obesity. Include healthy eating habits that include reduced intake of saturated fat, transfat and cholesterol. A diet containing five or more servings of fruits and vegetables per day may reduce the risk of stroke.
• Physical inactivity and obesity. Being inactive, obese or both can increase your risk of high blood pressure, high blood cholesterol, diabetes, heart disease and stroke. Risk factors include elevated waist circumference (equal to or greater than 40 inches for men and equal to or greater than 35 inches for women) and a body mass index (BMI) greater than 25. Try to get at least 30 minutes of moderate physical activity five days a week, or 20 minutes of vigorous physical activity three days a week, with your doctor’s approval.
• Obstructive Sleep Apnea (OSA). OSA is a proven risk factor for stroke, high blood pressure, and heart disease. Snoring is the most common symptom of sleep apnea. A family history of snoring and/or sleep apnea increases your risk of OSA.

Stroke prevention

The great news is that stroke can be prevented and most risk factors are controllable. Talk with your doctor about ways you can lower your risk of stroke and check your blood pressure, cholesterol levels, and fasting blood glucose levels regularly. Exercise regularly and only drink alcohol in moderation.