What is a Stroke?
If the blood supply to your brain is interrupted, a stroke can occur. This is a medical emergency where seconds count because the longer the blood flow is stopped, the more brain cells die.
Most strokes are caused by an unexpected blockage of the arteries leading to the brain (ischemic stroke). Hemorrhagic strokes are caused by a blood vessel that bursts and bleeds into the brain. There are also mini-strokes, where the symptoms last for a short time and then dissipate (transient ischemic attack).
No matter the type, stroke happens fast. The signs and symptoms of this urgent illness include:
- Blurred vision
- Difficulty understanding speech
- Difficulty walking
- Arm, face, or leg numbness or weakness
- One side of the mouth may droop
- Severe headache
- Slurred speech
- Trouble with coordination
We use the acronym FAST to remind patients to watch for the signs of stroke:
Face—Can the person smile with both sides of their mouth?
Arms—Can the person raise both arms and hold them there?
Speech—Can the person repeat a sentence without slurring their words?
Time—If you observe any or all of these symptoms, call 911 immediately.
How is a Stroke Treated?
The treatment for stroke depends on whether it is an ischemic or hemorrhagic stroke.
Ischemic stroke treatment focuses on quickly restoring the blood flow to the brain. Dr. Bellew, The Teachin’ Brain Surgeon™, has special expertise in surgical and endovascular treatment of brain aneurysms, arteriovenous malformations, and stroke. He says in the case of ischemic stroke, “We’re able to inject clot buster through the IV or actually go in through the arteries and fix the acute problem by opening whatever artery might be plugged up.”
The clot busting medication is called tissue plasminogen activator (TPA). If TPA can be given within the first three hours of ischemic stroke symptoms, it can improve recovery from a stroke. The patient may also receive an antiplatelet medicine, or blood thinner. In some cases, a surgical procedure known as a thrombectomy can remove the blood clot that caused the stroke by clogging an artery.
Hemorrhagic stroke treatment focuses, first, on controlling the bleeding that’s putting pressure on the brain and stabilizing the patient. You may receive medication to stop the bleeding. If the bleeding stemmed from a ruptured blood vessel, surgery may be needed to repair it. The surgery may also remove the blood that builds inside the brain. There are also medications that may help with some of the side effects of this condition, including spiking blood pressure, blood sugar issues, brain swelling, fever, or seizures.
In both types of stroke, Dr. Bellew says, “The important thing is to identify what caused the stroke and what we can do to keep it from happening again.”
What Are the Risk Factors of Stroke?
While stroke comes on suddenly, there are typically genetic, lifestyle, and medical risk factors for the disease.
Genetic risk factors for stroke include your family history for the disease. Age plays a factor; people over 55 have a higher stroke risk. African Americans have a higher risk of stroke than people of other ethnic backgrounds. Men are at higher risk for stroke however women who use birth control pills or take estrogen for hormone therapy are at higher risk than women who do not.
Lifestyle risk factors for stroke include a sedentary lifestyle and obesity or being overweight. Heavy, regular binge drinking or the use of illegal drugs such as methamphetamine or cocaine can also lead to stroke.
Medical risk factors for stroke can include cigarette smoking or even frequent exposure to secondhand smoke. Some of the illnesses linked to obesity, such as diabetes or high cholesterol put you at risk for stroke. Obstructive sleep apnea has been linked to stroke risk, as has cardiovascular disease, and even COVID-19.
Dr. Bellew says, “There are situations where somebody has a lot of risk factors for stroke; however, stroke can be prevented by limiting these risk factors.”
Can I Prevent a Stroke?
You can prevent a stroke. There are certain risk factors that you can control; genetic factors are less controllable but there are lifestyle changes you can make right now to lessen your risk.
In these situations, Dr. Bellew says, “If they continue to work with their primary care doctor over the years, they should be able to mitigate those problems and control them as much as possible, reducing the chances of stroke.”
Some of the things you can do right now to lessen your risk include:
- Drink only in moderation, with no more than one drink a day
- Exercise regularly at least five days per week
- Lose weight to fall within your body mass index (BMI)
- Lower your high blood pressure, ideally to 120/80
- Stop smoking
- Treat any complicating illnesses such as an irregular heartbeat (atrial fibrillation) or diabetes
Dr. Bellew says, “Just taking a blood thinning medication can greatly reduce the risk of stroke.” Blood thinner medications keep blood clots from forming, which could lead to a stroke.
While you may have heard taking a low dose baby aspirin can help prevent stroke, talk with your doctor first. Aspirin is part of a well-accepted treatment plan for patients with a history of stroke, but there are risks associated with taking an aspirin every day that could outweigh the benefit.