What is stroke?
Stroke is a disease that affects the blood vessels of the brain or spinal cord. The most common type of stroke is an ischemic stroke that affects the brain. An ischemic stroke occurs when a blood vessel to the brain becomes blocked, depriving part of the brain of oxygen and nutrients, and may eventually lead to that part of the brain dying. The second most common type is a hemorrhagic stroke, which occurs when a blood vessel ruptures or bursts, sending blood either into the brain or around the brain.
What are the signs and symptoms of a stroke?
The typical signs and symptoms of a stroke are the sudden onset of one or more of the following:
nConfusion, trouble speaking or understanding speech
nNumbness or weakness of the face, arm or leg, especially on one side of the body
nTrouble seeing in one eye or both eyes
nTrouble walking, dizziness, loss of balance or coordination
nSevere headache with no known cause
Who is most likely to have a stroke?
There are several things that we cannot change that increase our risk of stroke. Age is a strong risk factor for stroke, and the older we become, the higher our risk of stroke. The likelihood of having a stroke nearly doubles every 10 years after age 55. Your risk of stroke also increases if you have a family history of stroke or you have had a prior stroke.
There are also several things that we can manage or treat that increase your risk of stroke. These include hypertension or high blood pressure, diabetes or high blood sugars, smoking cigarettes and high cholesterol levels. If you have any of these risk factors, they need to be aggressively treated in order to lower your risk of stroke. High blood pressure is one of the strongest risk factors for stroke and should be treated so that your blood pressure is normal.
Other risk factors for stroke include a poor diet, physical inactivity, obesity and atrial fibrillation (a specific heart rhythm disturbance that increases your stroke risk). Carotid artery blockages from atherosclerosis or hardening of the arteries also increase your risk. You can lessen your stroke risk by not drinking alcohol excessively and by not using drugs such as cocaine, amphetamines and heroin.
Can anything be done to prevent or reduce risk of having a stroke?
In order to prevent or reduce the risk of a stroke, it is important to treat all the risk factors listed above. In addition, if a patient has an ischemic stroke, we often use some type of blood thinner to decrease the risk of stroke. The choice of blood thinner depends on what has caused the stroke and risk of having bleeding problems on the blood thinner choice.
What should you do if someone is showing signs of a stroke?
If you think you or someone you know is having a stroke, it is best that you call 911 so that you can get to the hospital as soon as possible. There is a simple pneumonic that is helpful called FAST:
F — face drooping
Does one side of the face droop or is it numb? Ask the person to smile. Is the person’s smile uneven or lopsided?
A — arm weakness
Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
S — speech difficulty
Is speech slurred? Is the person unable to speak or hard to understand? Ask the person to repeat a simple sentence, like “The sky is blue.” Is the person able to correctly repeat the words?
T — time to call 911
If someone shows any of these symptoms, even if the symptoms go away, call 911 and say, “I think this is a stroke” to help get the person to the hospital immediately. Time is important! Don’t delay, and also note the time when the first symptoms appeared. Emergency responders will want to know.
How are strokes treated?
If you can get to the hospital quickly enough, you may be eligible to receive intravenous clot-busting medicine or a catheter-based approach can be used to remove the clot if you are having an ischemic stroke. However, the time window to receive these treatments is quite short, on the order of hours, so it is very important that you get to the hospital as soon as possible. The next step in the process of treating a stroke is to do some tests to hopefully determine why the stroke occurred. This will help us decide how we can decrease the chance of having another stroke. Involving our therapists, such as physical therapy, occupational therapy and speech therapy will help in the recovery process.
What special stroke treatments are offered at IU Health?
IU Health Methodist Hospital is the first, and currently only, Comprehensive Stroke Center in Indiana. In order to become a Comprehensive Stroke Center the hospital had to undergo a rigorous certification process proving it can appropriately care for all patients that have any type of stroke. Comprehensive Stroke Centers have available all the necessary types of doctors, nurses, therapists and health care providers to take excellent care of people with strokes. They must also participate in quality control and quality improvement projects so that they stay on top of new developments in stroke care.
Dr. JD Fleck is a neurologist at Indiana University Health.