As a physician, there is a phrase we often say when it comes to stroke: time is brain.
Having a stroke can change a person’s life in minutes. Every minute a stroke goes untreated, approximately 1.9 million brain cells die. Yet many people often miss the warning signs or wait too long to seek help. The good news is that many strokes can be prevented, and early treatment can dramatically improve outcomes. Here are 5 things everyone should know about stroke.
A stroke (also known as cerebral vascular accident or CVA) occurs when a portion of the brain suddenly loses its blood supply. Brain cells depend on oxygen-rich blood, and when that blood supply gets cut off, cell death quickly follows. There are two main kinds of stroke:
Ischemic stroke (“blocked pipe”): This is the most common type, comprising about 87% of all strokes. This happens when a blood clot blocks blood flow to the brain.
Hemorrhagic stroke (“burst pipe”): This occurs when a blood vessel in the brain ruptures and bleeds. The bleeding itself damages brain tissue and increases pressure inside the skull.
There is also something called a Transient Ischemic Attack (TIA) or “mini stroke.” In a TIA, stroke symptoms may go away within minutes or hours, but a TIA should never be ignored. Think of it as your body sounding an alarm that a larger stroke may be coming.
2. What are the most common warning signs of stroke: Think FAST
The easiest way to remember stroke symptoms is the mnemonic FAST:
F — Facial drooping. Ask the person to smile. Does one side droop? Can they puff out their cheeks on both sides, or is one side uneven?
A — Arm weakness. Can they raise both arms? Does one drift down after a few seconds? Don’t forget that strokes can affect the lower limbs, too. Are they dragging one leg as they attempt to walk?
S — Speech difficulty. Is their speech slurred or are they not making sense? Does it seem like they are trying to say something but nothing meaningful is coming out?
T — Time to call 911. Do not drive yourself. Do not wait. Remember, time is brain. Every minute counts.
Sudden numbness, tingling, or weakness, especially on only one side
Vision changes or blurry vision
Dizziness or loss of balance
Sudden confusion or altered mental status
A sudden, severe headache
Treatment varies depending on the type of stroke. For ischemic strokes, doctors may use a clot-busting medication called Tissue Plasminogen Activator or TPA, which can only be given if patients arrive quickly at the ER and meet specific criteria. Some patients may meet criteria for a procedure where doctors can insert a catheter into their blood vessel to physically remove the clot.
For hemorrhagic strokes, the focus is on stopping the bleed, decreasing pressure in the brain, and some patients may even require surgery.
After the emergency passes, next steps often involve preventive medication (such as Aspirin or Plavix) and rehabilitation; physical therapy, speech therapy, and occupational therapy can help patients regain strength and independence. Early stroke treatment followed by intensive rehabilitation can preserve brain function and reduce the risk of long-term disability.
The bottom line is this: most strokes are preventable. The biggest opportunities to prevent strokes include:
Control your blood pressure. High blood pressure (>140/90) is one of the biggest risk factors for stroke.
Manage diabetes. Adults with diabetes are twice as likely to have a stroke as those without the condition primarily due to remodeling of the blood vessels.
Lower your cholesterol. Cholesterol makes up plaques that can cause blocked vessels (ischemic strokes).
Quit smoking. Smokers have 2 to 4 times increased risk of stroke than non-smokers. Talk to your physician about ways to help quit.
Exercise. The American Heart Association recommends 150 minutes of moderate-intensity exercise to help reduce the risk of stroke. This is equal to 30 minutes, 5 times per week.
Eat healthier. Diets rich in fruits, vegetables, whole grains, nuts, and healthy fats lower stroke risk. Mediterranean and DASH diets have shown significant benefits in risk reduction.
Maintain a healthy weight. For every 5–10% body weight you lose, you can expect your blood pressure to drop by 5–10 points, which can reduce your stroke risk and minimize blood pressure medications.
Limit excessive alcohol use and avoid stimulant drugs.
Treat irregular heart rhythms, such as atrial fibrillation. Certain heart rhythms can increase the risk of clot formation, which can travel to the brain. If you have one of these irregular heart rhythms, ask your doctor about ways to prevent stroke.
Learn the warning signs. Talk with your doctor about your risk factors and how to decrease your risk of stroke. Encourage your family members to do the same.
And remember: if you ever think someone may be having a stroke, do not wait. Call 911. Because when it comes to strokes, minutes truly do matter.
Dr. Joanna Moore is a resident physician who sees patients of all ages and provides obstetrical services at Lone Star Family Health Center, a non-profit 501(c)(3) Federally Qualified Health Center operating facilities in Conroe, Spring, Willis, Grangerland, and Huntsville, and serving as home to a fully integrated Family Medicine Residency Program to increase the number of Family Medicine physicians for Texas and our community.