1) What is a Stroke?
- A stroke or “brain attack” is a sudden decrease in cerebral blood flow when one of the brain arteries is either blocked or bursts
Stroke is the fourth leading cause of death and the leading cause of disability in the United States
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2) What are the consequences of a stroke?
- The decrease in blood flow may cause one area of the brain to die
- The symptoms of the stroke will depend on the area affected. For example, if the speech area is affected, then the patient will present with speech difficulties; if an area within the parietal cortex is affected, then the patient may present with numbness on the opposite side of his body, if certain parts of the occipital cortex (the back of the brain) are affected, then the patient may present with visual difficulties, etc.
3) What can cause a stroke?
- The blockage of a brain artery may be caused either by atherosclerosis (accumulation of cholesterol which causes hardening of the arteries and decreases their diameter, clogging them and hence decreasing blood flow) or by a clot
4) Are there different types of stroke?
- There are two types of strokes: ischemic and hemorrhagic
- Ischemic strokes are caused by blockage of a brain artery
- Hemorrhagic strokes are caused by bursting of a brain blood vessel which may happen in patients with weak arteries and high blood pressure or in patients with aneurysms (thin-walled bubble formed on a blood vessel wall due to weakening of it)
5) What are some risk factors for Stroke?
A) High blood pressure: it can cause the burst of a small artery in the brain, causing a hemorrhagic stroke (bleed). A normal blood pressure is considered below 120/80 mmHg; and over 140/90 mmHg is considered high
B) High cholesterol: cholesterol build up on the walls of the arteries and can occlude them (hence decreasing blood flow). Consult your doctor to keep cholesterol under normal values. Total cholesterol reading should be less that 200, HDL (good cholesterol) reading should be above 40, and LDL (bad cholesterol) reading should be less than 100 (less than 70 in diabetic patients)
C) Diabetes: The risk for stroke from diabetes ranges from two to six times higher. Consult your doctor to keep diabetes under control
D) Smoking: smoking can make blood vessels more fragile and promote cholesterol build up on the walls of the arteries. 50% reduction in stroke can be seen within one year of smoking cessation. Avoid smoking
E) Sleep Apnea: It is recommended that all patients with sleep apnea are treated
F) Heart disease: atrial fibrillation is a term that describes an irregular heart beat that can cause blood to pool into parts of the heart and form clots. Those clots may be later pumped out of the heart and travel to a brain blood vessel occluding it. Your doctor should treat this condition
G) Lack of Exercise: ask your doctor the type of exercises recommended
6) Warning signs of Stroke
You should call IMMEDIATELY (with no delay) 911 if any of the following symptoms. ACT FAST
F= FACE (Ask the person to smile. Is there facial droop on one side of the face?)
A= ARM ( Ask the person to drift an arm or a leg. Is there drifting when raising it in the air?)
S= SPEECH (Ask the person to repeat a simple sentence, such as, “today is a bright and sunny day”. Is the speech slurred speech or there is inability to speak?)
T=TIME. If you observe any of these signs CALL 911 IMMEDIATELY
- There are other signs you may notice, such as confusion, eye deviation, sudden memory loss, visual difficulties or visual loss, numbness in a limb, vertigo, and gait difficulties, severe headache of unknown cause
- Take note of the first time the symptoms occur and CALL 911 IMMEDIATELY
- There is FDA approved clot-dissolving medication (TPA) that can be given ONLY within the first 3-4.5 hours of the symptoms onset. This medication may reduce long term disability
IMPORTANT: CALL 911 IMMEDIATELY IF ANY NEUROLOGICAL SYMPTOMS. DO NOT WAIT