"Time is Brain" when it comes to stroke
Rapid responses from Jayne Ward, D.O., Stroke Center Medical Director –
WHAT IS ACUTE STROKE?
A stroke means brain tissue damage is occurring because of loss of blood and oxygen. The person will notice a sudden onset of symptoms. One minute the person is fine, and suddenly, the person notices an inability to move one side of the body, and may have difficulty speaking. If the person is alone, call 9-1-1 immediately. If someone is with the individual, have him or her call 9-1-1. A stroke is a medical emergency.
Immediate therapy in the Emergency Department is critical. Once there, a brain scan is done to see whether it’s a bleeding stroke or an ischemic stroke. Close to 85% of strokes are ischemic strokes. Two to three percent of patients may be candidates for a clot-busting drug to reduce stroke damage and improve stroke outcome. The time window for the effectiveness of clot-busting drugs is under three hours. Regardless of the type of stroke, TIME IS BRAIN. Early warning signs of stroke require immediate medical attention.
Using a multidisciplinary stroke team approach, most strokes can be treated in a Primary Stroke Center.
Click here to view a rupture of plaque in the carotid arteries.
WHAT IS AN ISCHEMIC STROKE?
Eighty-five percent of strokes are "ischemic" strokes. This occurs because a clot in one of the intracranial arteries prevents the brain from receiving an adequate blood supply.
WHAT IS A BLEEDING STROKE?
Only 15% of strokes are "hemorrhagic", or bleeding strokes. This means bleeding is occurring on the brain..
WHAT IS A TRANSIENT ISCHEMIC ATTACK (TIA)?
TIAs are ‘warning strokes’. They produce stroke-like symptoms, but no lasting damage. If you experience stroke-like symptoms that go away, call 9-1-1 immediately. ‘Warning strokes’ are just that – you are at significant risk for stroke. Get treatment right away.
WHAT RISK FACTORS FOR STROKE CAN BE CONTROLLED OR TREATED?
- High Blood Pressure – If your blood pressure is consistently 140/90, see your physician and get on high blood pressure medication, and a diet and exercise regimen to lower your blood pressure. Even if you feel well, take your blood pressure medication as prescripted. Everyone should have his or her blood pressure checked regularly in a medical setting. Don’t rely on blood pressures at stores that have areas for "cuff checks." You may not get an accurate reading.
- Smoking – This is a major, preventable risk factor. The nicotine and carbon monoxide in tobacco reduce blood oxygen levels. The also damage blood vessel walls, making it easier for clots to form. If you smoke, and use birth control pills, you double your risk for stroke.
- Diabetes Mellitus – Having diabetes increase a person’s risk for stroke. These individuals often have high blood pressure, high blood cholesterol, and are overweight. Make sure your blood sugar levels are controlled. Lose weight if needed. Get regular blood pressure and fasting cholesterol checks.
- Carotid or other artery disease – The carotid arteries in your neck supply blood to the brain. A carotid artery narrowed by plaque build-ups could become blocked by a blood clot. If you have heart disease in your family, or have had a heart attack, make sure your doctor or surgeon checks your carotid arteries on a regular basis.
- Peripheral Artery Disease – This means blood vessels carrying blood to leg and arm muscles have narrowed. If you feel aching or tingling in your arm or leg muscles, go to your doctor for a check-up.
- Atrial Fibrillation – The heart’s upper chambers quiver, instead of beating rhythmically. This lets blood pool and clot. If you feel your heart rhythm isn’t right, go to your doctor for a check-up. Unchecked, a clot could break away, enter the bloodstream, and lodge in a carotid artery.
Click here to view a atrial fibrillation.
- Use of excessive alcohol – One drink for women and two drinks for men per day are all that’s recommended if you indulge. More alcohol can raise high blood pressure.
- High Blood Cholesterol – Total blood cholesterol that is 240 mg/dl is a major factor for heart disease that raises your stroke risk. LDL (bad) blood cholesterol – greater than 100 mg/dl --and triglycerides, or blood fats – greater than 150 mg/dl may substantially raise your risk for heart disease and stroke. Low levels of HDL (good) blood cholesterol may also increase stroke risk.
- Physical Inactivity and/or Obesity – Being inactive and/or obese increases your risk for stroke. Your blood vessels, like any muscle, need strength to work "for" you. The recommendation is 30 minutes of brisk activity, like walking, every day.
- Certain blood disorders – A high red blood cell count thickens the blood and makes clots more likely. Doctors can treat this condition by prescription blood thinners.
- Sickle Cell Disease – This genetic disorder primarily affects African-Americans. "Sickled" red blood cells are less able to carry oxygen throughout the body. The cells tend to stick to blood vessel walls, which can block arteries.
- Illegal Drug Use – Intravenous drug use is a major risk factor for stroke. Cocaine use has been linked to heart disease and strokes.
WHAT RISK FACTORS FOR STROKE CAN YOU NOT CONTROL?
- Heredity – Stroke risk is greater if a parent, grandparent, sister or brother has had a stroke. African-Americans have a higher risk of stroke than Caucasians, in part because of their tendency toward high blood pressure, diabetes and obesity.
- Sex – Men are more prone to stroke than women. Women, though, count for more than half of stroke deaths. Women who are pregnant or who are taking birth control pills are at greater risk for stroke.
- Age – The older you are, the more vulnerable you are to stroke.
- Prior stroke or heart attack – Your heart or brain has already had damage. The risks increase if an individual does not modify their behavior by taking prescribed medications, getting regular physical activity, losing weight, eating heart-health foods, and reducing sodium in their diet.