Stroke is a medical emergency and the third leading cause of death in the U.S. It occurs when a blood vessel in the brain bursts or, more commonly, when a blockage develops. Without treatment, cells in the brain quickly begin to die. The result can be serious disability or death. If a loved one is having stroke symptoms, seek emergency medical attention without delay.
Stroke Symptoms
Signs of a stroke may include:
- Sudden numbness or weakness of the body, especially on one side.
- Sudden vision changes in one or both eyes.
- Sudden, severe headache with unknown cause.
- Sudden problems with dizziness, walking, or balance.
- Sudden confusion, difficulty speaking or understanding others.
Call 911 immediately if you notice any of these symptoms.
Stroke Test: Talk, Wave, Smile
The F.A.S.T. test helps spot symptoms. It stands for:
Face. Ask for a smile. Does one side droop?
Arms. When raised, does one side drift down?
Speech. Can the person repeat a simple sentence? Does he or she have trouble or slur words?
Time. Time is critical. Call 911 immediately if any symptoms are present.
Stroke: Time = Brain Damage
Every second counts when seeking treatment for a stroke. When deprived of oxygen, brain cells begin dying within minutes. There are clot-busting drugs that can curb brain damage, but they have to be used within three hours of the initial stroke symptoms. Once brain tissue has died, the body parts controlled by that area won't work properly. This is why stroke is a top cause of long-term disability.
Diagnosing a Stroke
When someone with stroke symptoms arrives in the ER, the first step is to determine which type of stroke is occurring. There are two main types, and they are not treated the same way. A CT scan can help doctors determine whether the symptoms are coming from a blocked blood vessel or a bleeding one. Additional tests may also be used to find the location of a blood clot or bleeding within the brain.
Ischemic Stroke
The most common type of stroke is known as an ischemic stroke. Nearly nine out of 10 strokes fall into this category. The culprit is a blood clot that obstructs a blood vessel inside the brain. The clot may develop on the spot or travel through the blood from elsewhere in the body.
Hemorrhagic Stroke
Hemorrhagic strokes are less common but far more likely to be fatal. They occur when a weakened blood vessel in the brain bursts. The result is bleeding inside the brain that can be difficult to stop.
“Mini-Stroke” (TIA)
A transient ischemic attack, often called a "mini-stroke," is more like a close call. Blood flow is temporarily impaired to part of the brain, causing symptoms similar to an actual stroke. When the blood flows again, the symptoms disappear. A TIA is a warning sign that a stroke may happen soon. It's critical to see your doctor if you think you've had a TIA. There are therapies to reduce the risk of stroke.
What Causes a Stroke
A common cause of stroke is atherosclerosis -- hardening of the arteries. Plaque made of fat, cholesterol, calcium, and other substances builds up in the arteries, leaving less space for blood to flow. A blood clot may lodge in this narrow space and cause an ischemic stroke. Atherosclerosis also makes it easier for a clot to form. Hemorrhagic strokes often result from uncontrolled high blood pressure that causes a weakened artery to burst.
Risk Factors: Chronic Conditions
Certain chronic conditions increase your risk of stroke. These include:
- High blood pressure
- High cholesterol
- Diabetes
- Obesity
Taking steps to control these conditions may reduce your risk.
Risk Factors: Behaviors
Certain behaviors also increase the risk of stroke:
- Smoking
- Getting too little exercise
- Heavy use of alcohol
Risk Factors: Diet
A poor diet may increase the risk for stroke in a few significant ways. Eating too much fat and cholesterol can lead to arteries that are narrowed by plaque. Too much salt may contribute to high blood pressure. And too many calories can lead to obesity. A diet high in fruits, vegetables, whole grains, and fish may help lower stroke risk.
Risk Factors You Can't Control
Some stroke risk factors are beyond your control, such as getting older or having a family history of strokes. Gender plays a role, too, with men being more likely to have a stroke. However, more stroke deaths occur in women. Finally, race is an important risk factor. African-Americans, Native Americans, and Alaskan Natives are at greater risk compared to people of other ethnicities.
Stroke: Emergency Treatment
For an ischemic stroke, emergency treatment focuses on medicine to restore blood flow. A clot-busting medication is highly effective at dissolving clots and minimizing long-term damage, but it must be given within three hours of the onset of symptoms. Hemorrhagic strokes are more difficult to manage. Treatment usually involves attempting to control high blood pressure, bleeding, and brain swelling.
Stroke: Long-Term Damage
Whether a stroke causes long-term damage depends on its severity and how quickly treatment stabilizes the brain. The type of damage depends on where in the brain the stroke occurs. Common problems after a stroke include numbness in the arms or legs, difficulty walking, vision problems, trouble swallowing, and problems with speech and comprehension. These problems can be permanent, but many people regain most of their abilities.
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