Stroke: Risk Factors, Signs and Symptoms, and Treatment
Stroke is the term healthcare providers use when a part of the brain dies because it goes without blood and oxygen for too long. There are two main types of stroke: ischemic stroke, which is caused by a blockage in a blood vessel in the brain, and hemorrhagic stroke, which is caused by bleeding in the brain or surrounding area.
Transient ischemic attacks are episodes in which a person has signs or symptoms of a stroke (numbness; inability to speak) that last for a short time, but without any sign of stroke on brain scans such as MRI or CT. Symptoms of a TIA usually last between a few minutes and a few hours. A person may have one or many TIAs. People recover completely from the symptoms of a TIA. A TIA is a warning sign that a person is at high risk for a stroke; immediate treatment can decrease or eliminate this risk. It is important to get help right away if you think you may be having a TIA or a stroke.
Risk factors for stroke include:
•Age older than 40
•Heart disease, diabetes, high blood pressure, or high cholesterol
•Smoking, obesity, inactive lifestyle, or illegal drug use (especially cocaine or methamphetamines)
•History of TIA, history of blood clots, or family history of stroke
•Use of blood thinning medications such as warfarin
Signs and symptoms of stroke often develop suddenly and may temporarily improve or slowly worsen depending upon the type of stroke and area of the brain affected. Knowing the signs and symptoms of a stroke can be lifesaving. Classic stroke symptoms can be recalled with the acronym FAST. Each letter in the word stands for one of the things you should watch for:
•Face–Sudden weakness or droopiness of the face, or problems with vision
•Arm–Sudden weakness or numbness of one or both arms
•Speech–Difficulty speaking, slurred speech, or garbled speech
•Time–Time is very important in stroke treatment. The sooner treatment begins, the better the chances are for recovery. Therefore, call an ambulance (dial 9-1-1) right away.
Anyone who has signs or symptoms of a stroke needs immediate medical attention in an emergency department or hospital. Most clinics and medical offices do not have the ability to perform the tests needed to diagnose stroke or the ability to provide the specialized treatment needed to limit damage to the brain. After doing a physical exam and reviewing the patient’s history, the health care provider usually orders blood tests and an imaging test (CT scan or MRI scan) of the brain and the surrounding blood vessels in the neck and head that supply the brain with blood. The imaging allows the healthcare provider to see the area of the brain affected by the stroke, as well as to confirm the type of stroke (ischemic or hemorrhagic). Heart testing may be recommended, such as an echocardiogram and electrocardiogram. Other tests may be done as well.
The treatment of a stroke depends upon the type of stroke, the time that has passed since the first symptoms occurred, and the patient’s other medical problems. The initial care of a person with hemorrhagic stroke includes several components.
•Determining the cause of the bleeding.
•Controlling the blood pressure.
•Stopping any medication that could increase bleeding (warfarin, aspirin).
•Measuring and controlling the pressure within the brain.
For people who have an ischemic stroke, the goal of treatment is to restore blood flow to the affected area of the brain as quickly as possible, which means within the first hours after the stroke begins. The main early treatments for ischemic stroke are:
Thrombolytic “clot buster” therapy with medications given in an IV.
•Opening of a blocked artery with stent retriever devices.
The effects of a stroke can be temporary or permanent, and a person may lose function partially or completely. The medical team caring for the patient can give guidance to family members regarding the risk of long-term disability or death. However, the outcome can vary greatly from person to person, and it is not always possible to predict what will happen. Your healthcare provider is the best source of information for questions and concerns related to your medical problem.