To Your Health

by Vital Information About Strokes

By Paulette Avery, R.N., M.S.N.

Strokes, like heart attacks, can be prevented. Equally important, their effects can be minimized when treatment begins promptly. Knowing this is vitally important since stroke, the leading cause of adult disability in the U.S., is the third most common cause of death. Each year about 150,000 people die from stroke, and nearly 550,000 become permanently disabled.

The most common type of stroke, ischemic stroke, occurs when a blood clot blocks a blood vessel in the brain and cuts off circulation to one area of brain tissue. The result can be permanent loss of function, such as paralysis on one side of the body, loss of speech, decreased ability to think and perceive, or death. What occurs in the brain with a stroke is very similar to what happens in the heart when someone has a heart attack, so it may help to think of a stroke as a "brain attack."

Unfortunately, people know less about stroke prevention and treatment than they do about heart disease, and as a result, may not make lifestyle changes that could prevent stroke or seek treatment promptly when a stroke occurs. Two recent surveys indicate that about one-third of the people surveyed, including stroke victims, could not identify even one risk factor for stroke. Studies indicate that many stroke victims do not seek medical care or begin treatment until an average of 24 hours after the onset of symptoms. The modifiable risk factors for stroke are high blood pressure, smoking, a high red blood cell count, excessive alcohol intake, cocaine use, and atrial fibrillation. If you have any of these risk factors, consider making appropriate lifestyle changes or seeking medical treatment. Additional risk factors that can t be controlled include a prior stroke, diabetes, age, race, and a family history of stroke.

Research over the last decade has greatly increased knowledge about the brain and the effect of a stroke. Just as the damage from a heart attack can be minimized with prompt treatment, so can the damage from an ischemic stroke, if the patient receives proper treatment within a few hours of the incident. A drug called tissue plasminogen activator (t-PA) can dissolve the clot in the blood vessel, restore circulation to the brain, and minimize permanent damage. Ideally, the drug should be given within 90 minutes of the stroke, but it can have some beneficial effect as late as six hours later. A study by the National Institute for Neurological Disorders found that victims of ischemic stroke who were treated with t-PA in the first few hours were one-third more likely to have minimal or no disability compared to patients receiving a placebo.

Careful screening, including a CT scan to rule out hemorrhagic stroke, must be done to identify which patients are candidates for t-PA. In addition to patients with hemorrhagic stroke, t-PA treatment is not appropriate for women who are pregnant or lactating, nor for patients with recent trauma or surgery, systemic hemorrhage, or coagulation problems.

Be alert to the following signs and symptoms of stroke:

sudden weakness in the face, arm, or leg on one side of the body;

sudden difficulty with speech or trouble understanding speech;

sudden severe headache with no known cause;

sudden loss of vision or dimness in one eye;

unexpected dizziness, unsteadiness, or sudden falls, particularly if any of the above signsare also noted.

If you suspect stroke in yourself or someone else, call 911 immediately. Getting prompt treatment may mean the difference between life and death. It could also mean the difference between permanent disability and a chance for recovery.

Paulette Avery is a registered nurse and a freelance writer specializing in health issues.