Stroke Awareness, Prevention, Risk Factors, Effects, Signs and Symptoms
Important Information You Should Know
What is a stroke?
A stroke, or "brain attack," occurs when a blood vessel in the brain becomes blocked or bursts. The brain cannot store oxygen, so it relies on a network of blood vessels to provide it with blood that is rich in oxygen. A stroke results in a lack of blood supply, causing surrounding nerve cells to be cut off from their supply of nutrients and oxygen. When tissue is cut off from its supply of oxygen for more than three to four minutes, it begins to die.
Types of Stroke
Strokes can appear as hemorrhagic strokes, ischemic strokes or transient ischemic attacks.
➜ Hemorrhagic stroke - This type of stroke takes place when a weakened blood vessel in the brain ruptures. A hemorrhage, or bleeding from the blood vessel, occurs suddenly. The force of blood that escapes from the blood vessel can also damage surrounding brain tissue. Hemorrhagic stroke is the most serious kind of stroke. About 13% of all strokes are hemorrhagic. There are two types of hemorrhagic strokes: intracerebral and subarachnoid. Intracerebral hemorrhages are more common and occur when a blood vessel in the deep tissue of the brain ruptures. Subarachnoid hemorrhages usually occur when an aneurysm (a blood-filled pouch ballooned out from an artery) ruptures and bleeds into the space between the brain and the skull. This type of hemorrhagic stroke is most often caused by high blood pressure.
➜ Ischemic stroke - This type of stroke occurs when a blood vessel in the brain develops a clot and cuts off the blood supply to the brain. A blood clot that forms in a blood vessel in the brain is called a thrombus. A blood clot that forms in another part of the body, such as the neck or lining of the heart, and travels to the brain is called an embolus. Blood clots often result from a condition called ?atherosclerosis, the build-up of plaque with fatty deposits within blood vessel walls. About 87% of all strokes are ischemic. Treatment for ischemic strokes depends on how quickly after the symptoms start the stroke victim arrives at the hospital. In eligible patients, a medication called tPA (tissue plasminogen activator) may be given. This medication works to dissolve the clot and help restore blood flow. In other patients, a stroke specialist may recommend a mechanical thrombectomy. This is where a specialized doctor threads a catheter through an artery in the groin up through the body to the brain and uses a clot retrieval device to grab the clot and pull it out.
➜ Transient ischemic attack (TIA) - A TIA should be treated as seriously as a stroke. A TIA has the same symptoms as a stroke, but they only last several minutes, or up to 24 hours. Unlike a stroke, a TIA does not kill the brain cells, so there is no lasting damage to the brain. A TIA is considered a serious warning sign of stroke. About 1 in 3 people who have a TIA will go on to have a stroke.
What lasting effects can a stroke cause?
The effects of a stroke depend on the extent and the location of damage in the brain. Among the many types of disabilities that can result from a stroke are:
➜ Inability to move part of the body (paralysis)
➜ Weakness in part of the body
➜ Numbness in part of the body
➜ Inability to speak or understand words
➜ difficulty communicating
➜ Difficulty swallowing
➜ Vision loss
➜ Memory loss, confusion or poor judgment
➜ Change in personality; emotional problems
Why does a stroke affect different parts of the body?
Nerve cells in the brain tissue communicate with other cells to control functions including memory, speech and movement. When a stroke occurs, nerve cells in the brain tissue become injured. As a result of this injury, nerve cells cannot communicate with other cells, and functions are impaired. If a stroke occurs on the right side of the brain, the left side of the body is affected, and vice versa.
How can stroke be prevented?
If you want a to prevent a stroke, you must understand the risk factors that lead to stroke as well as the strategies that are used to reduce stroke. Make sure that you know the warning signs. If you see stroke warning signs, call 9-1-1 or seek medical attention right away. Most of the stroke warning signs are painless:
➜ Sudden numbness or weakness of the face, arm or leg, particularly on one side of the body.
➜ Sudden difficulty understanding or speaking. May have either slurred speech or confused speech.
➜ Sudden difficulty seeing in one eye or both eyes.
➜ Severe dizziness and/or sudden loss of balance, coordination, or ability to walk
➜ Sudden, severe headache for no reason
Know Your Risk Factors for Stroke
What are risk factors?
Risk factors are behaviors or traits that make you more likely to develop a disease or condition. Having one or more risk factors does not mean that you definitely will develop a condition, only that you are more likely to do so.
More than 795,000 people suffer from stroke in the U.S. each year, but up to 50% of all strokes are preventable. Stroke is the leading cause of disability in the United States. Many of the risk factors can be treated, modified, or controlled. However, some risk factors for stroke cannot be changed.
Controllable Risk Factors
➜ Hypertension, or high blood pressure, is the single most important risk factor for stroke. A blood pressure of 140/90 or above in adults is considered to be high. The usual target for blood pressure treatment in adults is to keep the blood pressure at 120/80 or below.
➜ Smoking remains the most important preventable cause of premature death in the country. If you smoke, quit, and if you don't smoke, don't start. Look for smoking cessation resources in your community.
➜ Heart disease, especially atrial fibrillation (a type of irregular heartbeat), is a significant risk factor for stroke. If you have heart disease, carefully follow your treatment plan.
➜ Diabetes mellitus increases stroke risk, especially for strokes due to damage of small blood vessels. The usual target for control is an HbA1c of <7% or a fasting blood sugar of 80-120 mg/dl.
➜ Existing carotid and/or coronary artery disease. The carotid arteries in your neck supply most of the blood to your brain. A carotid artery that has been damaged by fatty build-up of plaque inside the artery wall may become blocked by a blood clot, causing a stroke.
➜ Illegal drug use. Street drugs, such as crack, cocaine, and marijuana have been shown to increase the risk of stroke. Some of these drugs directly affect the blood vessels in the brain causing a stroke. Others cause damage to the heart, which can lead to stroke.
Uncontrollable Risk Factors
➜ Age: People of all ages, including children, have strokes. However, the risk of stroke increases as age increases.
➜ Gender: Stroke is more common in men than in women. In most age groups, more men than women will have a stroke in a given year. However, women account for more than half of all stroke deaths. Women who are pregnant have a higher stroke risk. Also at higher risk are women who take birth control pills and who also smoke or have risk factors such as high blood pressure.
➜ Race: The risk of stroke varies with race and ethnicity. African Americans and Hispanics are more likely to have strokes than Caucasians. The risk of stroke is also high among Native Americans and Alaskan Natives.
➜ Family history: Your stroke risk is greater if a parent, grandparent, sister, or brother has had a stroke.
➜ Prior stroke or heart attack: A person who has already had a stroke or heart attack is at much higher risk of having a second stroke.
Your doctor can evaluate your risk for stroke and help you control your risk factors. Regular check-ups are important in detecting problems before they become serious.
If you would like to learn more, you might want to visit our stroke risk calculator at this website: http://my.clevelandclinic.org/health/tools-quizzes/stroke-risk-calculator.
Signs and Symptoms of Stroke / Calling 911
Call 9-1-1 immediately if any of the following major stroke warning signs occur:
➜ Sudden weakness or numbness that occurs in the face, arm or leg, particularly on one side of the body.
➜ Sudden difficulty seeing in one or both eyes.
➜ Sudden confusion, difficulty speaking or difficulty understanding. May have either slurred speech or confused speech.
➜ Sudden problems with walking, severe dizziness; or loss of balance or coordination
➜ Sudden, severe headache, for no reason
➜ Difficulty swallowing
A Stroke is a Medical Emergency
It is important to realize that stroke warning symptoms are the signs of an emergency. For every minute that brain cells are deprived of oxygen during a stroke, 1.9 billion brain cells die. Also, the chances for survival and recovery are much better when the right treatment begins within the first few hours of noticing stroke symptoms. Remember to note the times that the symptoms began or the last time that person was seen acting normally.
How to Help a Stroke Victim
While you are waiting for an emergency vehicle to arrive, the person with the stroke symptoms should lie down. Watch the person suspected of having a stroke and lift the chin to open the airway. Check for breathing and pulse. If necessary, perform cardiopulmonary resuscitation (CPR).
If the person is breathing but unconscious, roll him or her onto his or her side. (Do not move the person if you suspect a head, neck, or back injury.)
If the person is conscious, try to reassure and comfort him or her. Loosen constricting clothing or jewelry. If the person is having difficulty swallowing, try to turn him or her onto the side. Do not give the person anything to eat or drink.
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