Provider Quality

May is National Stroke Awareness Month, a time to raise awareness about the symptoms and treatment for stroke. Stroke is the fifth leading cause of death in the United States. It is also a leading cause of disability.

What is a stroke?

A stroke occurs when blood supply to the brain is interrupted, either by a blockage or a rupture of a blood vessel (artery) that goes to the brain. The blood going to the brain carries oxygen, which the brain needs to work. When the brain does not get oxygen for even a few minutes, part of the brain will die or become damaged.

There are two major types of strokes. Most strokes are ischemic strokes, which occur when a blood vessel supplying blood to the brain is blocked from a blood clot, other particles, or buildup of fatty deposits called plaque. The other type of stroke is a hemorrhagic stroke, which occurs when a blood vessel ruptures and bleeds, such as from uncontrolled high blood pressure or rupture of an aneurysm (an abnormal bulge or weakness in the blood vessel wall).

Some people also experience what is sometimes called a “mini-stroke.” A mini-stroke actually is a Transient Ischemic Attack (TIA). This occurs when the blockage in the brain artery is temporary and resolves within a few minutes to 24 hours. TIAs are often considered a warning sign for the possibly of a major stroke, especially if people do not get treatment.

What are risk factors for a stroke?

The risk factors for a stroke are the same to the risk factors for most forms of cardiovascular disease (diseases of the heart and blood vessels). They include:

• High blood pressure: the leading cause of strokes.
• High blood cholesterol: Causes the plaque that clogs blood vessels.
• Diabetes: high sugar levels in the blood causes organ damage and form plaque.
• Obesity: Excess body fat places an extra burden on the body and is also associated with high blood pressure, diabetes, and worse cholesterol levels.
• Sickle cell disease: The abnormally shaped blood cells in this blood disorder can get stuck in blood vessels and cause a stroke.
• Heart disease: Certain heart conditions increase the risk for stroke such as plaque in the heart arteries (atherosclerosis), irregular heart rhythms (atrial fibrillation), or enlarged heart chambers (cardiomyopathy) that increase the risk of forming blood clots that can travel to the brain.
• Lifestyle: Behaviors such as physical inactivity, diets high in saturated fats, trans fat, and cholesterol, high alcohol intake, and smoking have been associated with an increased risk for stroke.

Increased age, certain race/ethnicity groups (Black, Hispanic, Native American, and Native Alaskan), and genetics/family history are also risk factors for stroke.

What are the symptoms of a stroke and what should you do?

Different parts of the brain control different functions in our bodies such as our movements, our thoughts, our speech, our understanding of language, and our breathing. As a result, symptoms of a stroke depend on the affected part of the brain and the size of affected brain tissue. Symptoms of a stroke commonly include:

• Sudden weakness, numbness, or paralysis of one side of the face or body.
• Sudden confusion or inability to speak or understand.
• Sudden change in vision.
• Sudden difficulty walking or keeping balance.
• Sudden severe headache with no obvious cause.

The key thing to remember is that every minute counts! If you notice symptoms, call 911 immediately, do not delay. The faster that needed treatment can be given, the more brain cells that can be saved and damage avoided. Some of the most effective treatments can only be given within a specific time window, so note when symptoms began and call 911. Do not drive or have someone drive you to the hospital - call 911 immediately so that the emergency medical team can begin treatment as soon as possible.

Use the letters in F.A.S.T. to identify a possible stroke:

F -- Face: Can the person smile evenly or does one side of the face droop?

A -- Arms: Can the person raise both arms evenly or does one arm drift downward?

S -- Speech: Can the person speak normally, or do they sound strange or slurred?

T -- Time: If you see any of these signs, call 9-1-1 immediately.

What happens after a stroke?

The symptoms and severity of residual effects after a stroke will depend on the part of the brain that was affected, how much brain tissue was damaged, and how quickly treatment was given. Rehabilitation therapy with a comprehensive care team is usually key to progress and recovery after a stroke. There are also many resources available to stroke survivors and their families.

What can be done to prevent a stroke?

The good news is that 80% of strokes may be preventable. You can take action to lower your risk. The key is controlling your risk factors.

• Know your numbers. Get your blood pressure and cholesterol levels checked regularly and make sure they are in the normal range.
• Don’t smoke. Quit smoking or don’t start smoking, and avoid tobacco smoke.
• Check blood sugar levels. If you have diabetes, keep blood sugars controlled.
• Eat healthy. Choose a diet that includes plenty of fruits and vegetables, fish, nuts, whole grains, and fiber, and eat foods low in saturated fats, trans fats, and added sugars. Limit alcohol intake.
• Be physically active. Move more. Guidelines recommend that adults should try to get at least 150 minutes of moderate exercise or 75 minutes of vigorous exercise per week or a combination of both.
• Keep up with your care. Get regular checkups, take any prescribed medications, and talk to your doctor about a prevention plan that is right for you.

References

Centers for Disease Control - cdc.gov/stroke

American Stroke Association - stroke.org

National Center for Health Statistics. Underlying Cause of Death 1999-2020, Multiple Cause of Death Files, 1999-2020. CDC WONDER Online Database. Centers for Disease Control and Prevention; 2022. Accessed May 4, 2022.