5 Things You Need to Know About Stroke

By Ernst Lamothe Jr

Adam Kelly is a physician specializing in neurology at UR Medicine Comprehensive Stroke Center.

Stroke prevention is crucial because strokes can cause significant disability — and death.

Sometimes referred to as a brain attack, stroke occurs when the blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot, bursts or ruptures.

When that happens, part of the brain doesn’t receive the blood and oxygen it needs, so brain cells die.

One in six deaths from cardiovascular diseases are due to stroke and every 40 seconds someone in the United States has a stroke, according to the Centers for Disease and Prevention.

“Stroke prevention is important because the vast majority of strokes are preventable through control of common risk factors and lifestyle choices,” said Adam Kelly, a physician specializing in neurology at UR Medicine Comprehensive Stroke Center.

These include controlling blood pressure, getting regular physical activity, taking in a healthy diet and quitting smoking. Following these recommendations plus some other healthy choices can help people avoid about 90% of strokes.

By managing risk factors such as high blood pressure, diabetes and high cholesterol individuals can reduce their chances of experiencing a stroke.

Kelly explains five aspects about strokes.

1 — Know the Symptoms

Common symptoms of a stroke include sudden numbness or weakness in the face, arm or legs — especially on one side of the body. In addition, there is confusion, trouble speaking or understanding speech, vision problems, dizziness, loss of balance or coordination and severe headaches.

Strokes are often compared to heart attacks due to their potential for serious and life-threatening consequences. Understanding causes of strokes is slightly complicated considering how it differs by gender, age and ethnicity.

“Stroke symptoms usually come on fast, often without a warning and that is one way we distinguish stroke from other neurologic conditions,” said Kelly. “The specific symptoms we commonly see include weakness or numbness of half of the body, drooping of one side of the face, sudden change in vision, slurring of speech or trouble getting words out or sudden loss of balance.”

2 — Stroke conditions and confusion

Having a stroke means that the blood supply to a part of the brain is interrupted or reduced, leading to damage to brain cells. This can result in various neurological deficits depending on the location and severity of the stroke.

“The most common condition that stroke gets compared to is heart attack or myocardial infarction,” said Kelly. “Both conditions share common risk factors like high blood pressure, high cholesterol, diabetes and smoking. Both can come on quickly with little warning. In both cases, the most common cause is blockage of blood flow to part of the affected organ, which in stroke is the brain and in heart attack is the heart. Finally, in both cases, our initial treatment is usually attempting to reopen blocked or narrowed blood vessels using clot-dissolving medications or surgical procedures.”

3 — Time is of essence

Some misconceptions about stroke include the belief that it only affects the elderly. In fact, it occurs at various ages. Another misconception is that strokes always cause paralysis. However, the symptoms and outcomes vary widely.

“A major misconception we see is that stroke symptoms can wait to be checked out. Stroke symptoms are a medical emergency and one of the most time-sensitive medical conditions we face,” said Kelly. “We have options, either medical or surgical, that can reverse or minimize the effects of stroke. They are best delivered in the first few minutes to hours after a stroke occurs. Too often we see people who are having a stroke decide to go to bed and wait to get checked out the following morning if their symptoms persist. Unfortunately, by that point, many of our treatments may no longer be possible. We often use a saying that ‘time is brain,’ meaning that the longer stroke symptoms go on, the more brain tissue is at risk of injury.”

4 — Family history

Family history can play a role in stroke risk as genetics can influence certain risk factors such as high blood pressure and heart disease.

“We do see a familial or hereditary tendency toward stroke in some patients,” said Kelly. “This is almost never due to inheritance of a specific gene from one’s parents, but more likely due to a collection of genes that makes a family more susceptible to stroke, similar to how we see some families more likely to suffer from cancer and diabetes.”

5 — Vital post stroke information

After a stroke, patients can experience a variety of symptoms including weakness, sensory changes, vision loss or other changes, speech or language dysfunction or other neurologic problems. The nature of the symptoms will depend on the size of the stroke and the particular area of the brain that was affected.

“Stroke patients are also more prone to other post-stroke issues including fatigue, depression, memory problems and anxiety. Fortunately, these can often improve considerably with time and participation in activities like physical, occupational and speech therapy,” said Kelly. “Patients and families should feel empowered to discuss any possible post-stroke concerns with their primary care provider, neurologist or other healthcare team members.”