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Save yourself from a stroke

Created date

March 20th, 2012

Almost 800,000 strokes occur each year, says Rodney D. Bell, M.D., board-certified neurologist and stroke expert at Thomas Jefferson University Hospital in Philadelphia, Pa. That s about one every 40 seconds. The most common type is an ischemic stroke, which is caused by a blockage in an artery that carries oxygen-rich blood to the brain. Blood clots are often the cause. Diseases such as atherosclerosis (especially in the carotid arteries) and atrial fibrillation are common culprits in clot formation. Hemorrhagic strokes are the other main type. This type of stroke happens when bleeding occurs in the brain from a leaking or bursting artery. These can be caused by high blood pressure or the presence of an aneurysm (a weakened, bulging portion of an artery). Transient ischemic attacks (TIA) or mini-strokes occur when blood flow is temporarily interrupted to a portion of the brain. Symptoms are the same as with a stroke, but effects tend to last only a few hours. TIAs are typically caused by blood clots. Having one or several TIAs means that you are at great risk for a stroke.

Call 911

Stroke symptoms vary depending upon which part of the brain is affected. Common symptoms are difficulty speaking; vision problems; or weakness, numbness, or paralysis in the arms, legs, or face, Bell says. Less common symptoms may be confusion or a feeling that the room is spinning. A stroke, even a TIA, is a medical emergency. Early stroke symptoms and TIA symptoms can be identical, says Vrinda Suneja, M.D., medical director at Run, an Erickson Living community in Novi, Mich. Do not drive yourself or someone else to the hospital. Call 911 immediately. Emergency ambulance personnel may be able to start crucial treatment measures right away. Some people deny that they re having a stroke, Bell explains. If the first symptom you have is a minor speech problem, such as not being able to find the right word, you might not think it s an urgent matter. After all, that happens to all of us.

Life-saving early treatment

Clot buster medications, such as tissue plasminogen activator (tPA), are an essential part of treatment. If tPA is started within four hours of the onset of an ischemic stroke, it can make a huge difference in how much damage is done and how well you recover, Bell says. About 30% of people who wouldn t otherwise be functional can be functional after a stroke if they get tPA. Aspirin or other medications may also be given if tPA is unavailable. Other people may need surgery to unclog the carotid arteries. To stop the bleeding in hemorrhagic strokes, the goal is to lower blood pressure by adjusting medication, or in some cases, brain surgery to clip the bleeding portion of the artery.

Your life after a stroke

Once you ve had a stroke, it s a lifelong journey to stay well and function at your best, says Anita Pinkney, M.S., OTR/L, rehabilitation manager for LifeBridge Health in Baltimore, Md. You need to practice what you ve learned in rehabilitation for the rest of your life. Rehabilitation teaches you how to compensate for what you ve lost and get back as much functioning as possible, Pinkney explains. It can be difficult to learn new habits and accept a new way of living. Advances in rehab techniques, technology, assistive devices, and home modifications make life easier after a stroke. You might have problems with paralysis, muscle weakness, or speech. Other post-stroke effects may include swallowing problems, a loss of bowel or bladder control, or mood and behavior changes.

A common complication

Depression is common after a stroke, Suneja says. Debilitation and a difficult recovery can make you feel low. Some people may attribute depression symptoms such as fatigue, loss of appetite, or aches and pains to other things. Treating depression can make a big difference in how well you recover. It is vital to have family or friends who will be available to support you for both the short term and the long term, Pinkney says. Support groups can also help.

Prevent strokes

Control your blood pressure and cholesterol, Bell says. A good way to do this is to follow the DASH [Dietary Approaches to Stop Hypertension] diet. DASH has been shown in many studies to dramatically lower blood pressure in a matter of weeks. DASH involves lowering dietary sodium, increasing vegetables, fruits, whole grains, and fiber, and only eating a set amount of lean meats and low-fat or fat-free dairy products. Details can be found at the American Heart Association s website ( Stop smoking and get active, Suneja advises. Even walking is good exercise. Stroke prevention measures are vital, Pinkney says. And if you ve already had a stroke, you need to work the rest of your life to make sure you don t have another one.

Stroke risk factors

Family history of stroke Unhealthy cholesterol levels Lack of physical activity Poor diet Obesity Smoking High blood pressure Diabetes Depression

Warning signs call 911

Sudden weakness Paralysis, especially on one side of the body Confusion Difficulty speaking or understanding speech Vision problems Breathing difficulties Dizziness, trouble walking, loss of balance or coordination, and unexplained falls Loss of consciousness Sudden, severe headache