Be Stroke Savvy

We all know when it comes to a heart attack, we need to act quickly in order to save lives. A stroke is really a ‘brain attack’ and requires the same quick action. “If you’re witnessing someone having stroke like symptoms, the goal is to call 911 and get them help fast,” says Dr. James Fleck, Neurologist at Indiana University Health Methodist Hospital.

There are two main types of stroke, explains Dr. Fleck:

  • Ischemic stroke: the most common type of stroke, this occurs when a blood vessel becomes blocked so that part of your brain doesn’t get it’s normal blood flow and doesn’t work well.
  • Hemorrhagic stroke: This occurs when a blood vessel leaks and causes bleeding problems of the brain.

It’s true that we can’t know when or where a stroke will strike, but we can learn as much as possible about stroke and take steps toward a healthy lifestyle. Dr. Fleck explains that risk factors for stroke are divided into modifiable risks (things we can do something about) and non-modifiable risks (things we can’t control).

Risk factors we can’t change:

  • Age: risk of stroke doubles every decade once you get to age 50
  • Gender: men are more likely to have a stroke
  • Family history: if someone in your family had a stroke, your risk is increased

Risk factors we can change:

  • High blood pressure
  • Smoking
  • High cholesterol
  • Diabetes
  • Excessive alcohol use

“There are a lot of things we can do to reduce our risk of stroke,” says Dr. Fleck, “but they are all things we should be doing anyway, to maintain a healthy lifestyle.”

Think FAST

Despite a healthy lifestyle, stroke can happen to anyone at any age. So how do you know if it’s really a stroke? The main thing to remember is that stroke symptoms are acute, meaning they begin suddenly rather than progressing over weeks or months.  It might be a stroke if you, or someone you know experiences quick onset of the following:

  • Weakness or numbness, typically on one side of their body
  • Inability to communicate, slurred speech or not understanding
  • Loss of coordination, making it hard to walk about
  • Dizziness

Think FAST if you suspect someone is having a stroke:

  • F (Face): If one side of a person’s face suddenly becomes droopy, that could be a sign of stroke.
  • A (Arms): If you suspect someone is having a stroke, ask them to lift their arms out in front of themselves. If one arm drifts down, or they can’t hold it up, that could be a sign of stroke
  • S (Speech): Monitor the speech of a suspected stroke victim for signs that they they are slurring words, can’t seem to form words correctly or don’t seem to understand you.
  • T (Time): When someone has a stroke, acting quickly to get help will save their life!

Timing is Everything

The fact is, the quicker you seek treatment when someone is having a stroke, the better chance they have of recovering. It used to be that there was nothing to be done except rehabilitation following a stroke. “Now we have some options available to treat the stroke you’re having, but our time window is very small--within a few hours,” says Dr. Fleck. “So you should not be sitting at home hoping the symptoms go away or perhaps not recognizing that it’s a stroke.”

The main treatment option is intravenous injection (into the vein) of tissue plasminogen activator (TPA), to try to break up the clot that’s causing the problems. “If we can do that soon enough it may make your symptoms go away completely or at least markedly improve,” says Dr. Fleck. “It may make the stroke much smaller than it was going to be and therefore less disability will occur. The whole idea is to get blood flow back as quickly as possible to that part of the brain that was affected.”

Another option, found at larger hospitals, including IU Health Methodist, is to have an interventional Neuro-Radiologist use a catheter to reach the blocked blood vessel and remove the obstruction. “We can’t get to all blood vessels that way, because some are too small,” explains Dr. Fleck. “But those catheter procedures are done on large blood vessels and on clots that would normally cause extensive damage. It’s always better to get to the hospital and see what your options are rather than waiting.”


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