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May is Stroke Awareness Month.

Thursday, May 12, 2016

May is Stroke Awareness Month.  Out of the myriad of awareness months, this is one of the most important because of the sheer numbers of people affected.  Stroke is the number five cause of death in the United States, killing nearly 130,000 people per year. To put that in perspective, someone in the United States has a stroke every 40 seconds and someone dies of stroke every four minutes.  But stroke is more disabling than fatal.  Approximately, 800,000 people in the United States have a stroke each year and according to a 2016 report from the American Heart Association, it is projected this number will increase by 20% (from 2012 numbers) by 2030.  Many of those people will suffer long term disability or memory loss.  The need for awareness and education is, therefore, more critical than ever.  Defining stroke, understanding the risk factors and warning signs, and knowing the treatment options are all part of the learning process.  

Stroke occurs when blood flow to the brain is interrupted.   Blood carries oxygen and when the brain is deprived of blood rich oxygen, brain cells die.  In fact, nearly two million brain cells die each minute a stroke goes untreated.  There are two basic types of stroke:  ischemic and hemorrhagic.  87% of strokes are classified as ischemic.  An ischemic stroke occurs when a clot or a mass blocks a blood vessel, cutting off blood flow to the brain.  A hemorrhagic stroke occurs when a weakened blood vessel ruptures, spilling blood into the brain.   A TIA (transient ischemic attack) often called a “mini stroke” is a blockage but is it temporary.  The symptoms are exactly the same as stroke but usually last less than five minutes.   People are at risk for stroke primarily because of high blood pressure although there are other risk factors including smoking, atrial fibrillation, diabetes, stress, and a sedentary lifestyle.

According to the National Institutes for Health, 80% of strokes can be prevented.  This is because high blood pressure, the leading risk factor for stroke, can be treated.  77% of people who have a first stroke have blood pressure higher than 140/90 mmHg; however, almost 20% of American adults with high blood pressure don’t know they have it.   Knowing your blood pressure number is very important in the fight against stroke.  To maintain healthy blood pressure and reduce the risk of stroke, physicians will often prescribe medications and advocate for a healthy lifestyle. The American Heart Association recommends following “Life’s Simple 7” to achieve ideal health:  don’t smoke, be physically active, eat a healthy diet, maintain a healthy body weight, and control cholesterol, blood pressure, and blood sugar.  In addition, knowing the stroke warning signs is critical to limiting the negative effects of a stroke.  

Recognizing the warning signs and calling 911 are crucial when it comes to limiting the severity of a stroke.  Literally every minute counts.  The American Stroke Association promotes the F.A.S.T. acronym to help people remember what to do:

  • F – FACE DROOPING –have the person smile – is one side drooping?

  • A – ARM WEAKNESS – have the person raise his or her arms – is one arm drifting down? (is one side of the body not responding or moving properly)

  • S – SPEECH DIFFICULTY – have the person repeat a phrase – is the speech slurred? Or is there difficulty in finding words?

  • T – TIME TO CALL 911 – call 911 IMMEDIATELY if you or someone you know is experiencing any of these symptoms

F – FACE DROOPING –have the person smile – is one side drooping?

A – ARM WEAKNESS – have the person raise his or her arms – is one arm drifting down? (is one side of the body not responding or moving properly)

S – SPEECH DIFFICULTY – have the person repeat a phrase – is the speech slurred? Or is there difficulty in finding words?

T – TIME TO CALL 911 – call 911 IMMEDIATELY if you or someone you know is experiencing any of these symptoms

Time is of the essence for all stroke patients.  The sooner one is diagnosed, the sooner treatment can begin. Stroke medical treatments work to either open the blockage or treat the rupture. For ischemic strokes, there are two basic treatments: the administration of tPA (tissue plasminogen activator) or an endovascular procedure called a mechanical thrombectomy.  tPa works by dissolving the clot and improving blood flow to the part of the brain deprived of blood flow.  If administered within 3 hours, tPA may improve the chances of recovering from a stroke.  According to the National Institutes of Health, stroke patients who receive tPA within 90 minutes of symptom onset are almost three times more like to recover with little or no disability.   Many stroke victims do not get to the hospital in time for tPA treatment; that is why it is important to identify the stroke quickly and call 911 immediately.  Endovascular procedures involve inserting a catheter with miniature instruments through the skin into a blood vessel for treatment. One such procedure is a mechanical thrombectomy which allows doctors to remove large blood clots from the brain with small instruments inserted via a catheter. The procedure is typically done within six hours of acute stroke symptoms, and only after a patient receives tPA.  Hemorrhagic strokes may also be treated with endovascular procedures or by other surgical treatments.

Remember time is incredibly important.  If you or someone you are with exhibits facial drooping, arm weakness, or speech difficulty, call 911 immediately.  You will be transported to a designated primary stroke center such as UR Noyes Health. Being a designated stroke center means a specially trained clinical team meets the stringent standards set by New York State for stroke care. The Noyes Health team is further advanced through affiliation with the University of Rochester Medical Center that allows emergency providers to connect with a team of interventional stroke neurologists 24/7. This brings the specialized resources of UR Medicine, a comprehensive stroke center, to Dansville and surrounding communities.  

To learn more about stroke prevention, symptoms, and treatment, go to: www.timeisbrainatnoyes.org or http://www.strokeassociation.org.  To test your stroke knowledge, take a quiz at: http://strokeheroquiz.org/.  

Lorraine Wichtowski is a community health educator at Noyes Health in Dansville.  If you have questions or suggestions for future articles she can be reached at lwichtowski@noyeshealth.org or 585-335-4327.  

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