A stroke is a brain injury that occurs when blood flow is stopped for longer than a few seconds, the brain cannot get blood and oxygen. Brain cells can die, causing permanent damage. The two main types of strokes are ischemic strokes (caused by a blocked artery) and hemorrhagic strokes (caused by a ruptured artery). Transient ischemic attacks(TIAs) are “warning strokes” that produce symptoms similar to a stroke but cause little to no lasting damage. Both type of strokes are serious brain injuries that may lead to long-term disabilities and even death. In fact, strokes are the number one cause of adult disabilities, and the fifth leading cause of death in the United States.

Prevention

Thankfully, up to 80% of strokes can be prevented with the right diet and exercise. Eating diets low in fats and salts, participating in ample physical activity, avoiding cigarettes and alcohol are all ways to keep blood pressure regulated as well as actively reduce the risk of the occurrence of a stroke. There are, however, some stroke risk factors that cannot be prevented. These include age, gender, race, and heredity. Learn more: Stroke Risk Factors

Stroke Symptoms (F.A.S.T.)

FAST is an easy way to remember and identify the most common symptoms of a stroke. Recognition of stroke and calling 9-1-1 will determine how quickly someone will receive help and treatment. Getting to a hospital rapidly will more likely lead to a better recovery.

F __FACE: Ask the person to smile. Does one side of the face droop?

A__ARMS: Ask the person to raise both arms. Does one arm drift downward?

S__SPEECH: Ask the person to repeat a simple phrase. Is their speech slurred or strange?

T__TIME: If you observe any of these signs, call 9-1-1 immediately.

Call 9-1-1 immediately if you observe any of these symptoms. Note the time of the first symptom. It is important and can affect treatment decisions.

Treatment

A stroke is a medical emergency! Call 911 or seek urgent medical care at the first signs of a stroke! If you are having stroke symptoms get to a hospital as quickly as possible! If the stroke is caused by a blood clot, a clot-busting drug may be given to dissolve the clot. Most of the time, patients must reach a hospital within 3 hours after symptoms begin. Some people may be able to receive these drugs for up to 4 – 5 hours after symptoms begin.
Treatment depends on how severe the stroke was and what caused it. Most people who have a stroke need to stay in a hospital.

Treatment in Hospital

Clot-busting drugs (thrombolytic therapy) may be used if the stroke is caused by a blood clot. This medicine breaks up blood clots and helps bring back blood flow to the damaged area. However, not everyone can get this type of medicine.

• For these drugs to work, a person must be seen and treatment must begin within 3 hours of when the symptoms first started. A CT scan must be done to see whether the stroke is from a clot or from bleeding.
• If the stroke is caused by bleeding instead of clotting, clot-busting drugs (thrombolytics) can cause more bleeding.

Other treatments depend on the cause of the stroke:

• Blood thinners such as heparin or warfarin (Coumadin) may be used to treat strokes due to blood clots. Aspirin or clopidogrel (Plavix) also used.
• Other medicine may be needed to control symptoms such as high blood pressure.
• Sometimes, a special stroke team and skilled radiologists may be able to use angiography to highlight the clogged blood vessel and open it up.
• If bleeding occurred, surgery is often needed to remove blood from around the brain and to fix damaged blood vessels.
• Surgery on the carotid artery may be needed due to carotid artery disease
• Nutrients and fluids may be needed, if person has trouble swallowing. Given through a vein (intravenously) or a feeding tube in the stomach (gastrostomy tube). Swallowing trouble may be temporary or permanent.
• Physical therapy, occupational therapy, speech therapy, and swallowing therapy will all begin in the hospital.

Long-term Treatment

The goal of treatment after a stroke is to help the patient recover as much function as possible and prevent future strokes. The recovery time and need for long-term treatment is different for each person. Problems moving, thinking, and talking often improve in the weeks to months after a stroke. A number of people who have had a stroke will keep improving in the months or years after the stroke. Following a Stroke issues may include :

• Bladder and bowel problems
• Living at home instead of a nursing facility
• Muscle and nerve problems
• Speech problems
• Stroke rehabilitation
• Support Groups
• Swallowing and eating problems
• Thinking and memory problems

Signs and Tests

Your Doctor’s Complete Exam may include:

• Check for problems with vision, movement, feeling, reflexes, understanding, and speaking. Repeating this exam as necessary.
• Listen for an abnormal sound/blood flow, called a “bruit,” in the carotid arteries in your neck.
• Check your blood pressure, which may be high.
  Tests can help your doctor find the type, location, and cause of the stroke and rule out other disorders.
• Angiogram of the head can show which blood vessel is blocked or bleeding
• Carotid duplex (ultrasound) can show if the carotid arteries in your neck have narrowed
• CT scan of the brain is often done soon after symptoms of a stroke begin. An MRI scan of the brain may be done instead or afterwards
• Echocardiogram (EKG) may be done if the stroke could have been caused by a blood clot from the heart
• Electrocardiogram (ECG) and heart rhythm monitoring — to show whether an irregular heartbeat (such as atrial fibrillation) caused the stroke
• Magnetic resonance angiography (MRA) or CT angiography may be done to check for abnormal blood vessels in the brain
• Lab tests: Blood cholesterol, sugar levels, Blood clotting tests (prothrombin time or partial thromboplastin time), Complete blood count (CBC)

Expectations (prognosis)

You may recover completely, or have some permanent loss of function. Over half of people who have a stroke are able to function and live at home. Other people are not able to care for themselves. The outlook depends on:

• The type of stroke
• How much brain tissue is damaged
• What body functions have been affected
• How quickly you get treated

If treatment with clot-busting drugs is successful, the symptoms of a stroke may go away. However, patients often do not get to the hospital soon enough to receive these drugs, or they cannot take these drugs because of a health condition. People who have a stroke due to a blood clot (ischemic stroke) have a better chance of surviving than those who have a stroke due to bleeding in the brain (hemorrhagic stroke). The risk for a second stroke is highest during the weeks or months after the first stroke. Then the risk begins to decrease.

Complications

• Breathing food into the airway (aspiration)
• Dementia
• Falls
• Loss of mobility
• Loss of movement or feeling (part/s of body)
• Muscle spasticity
• Poor nutrition
• Pressure sores
• Problems speaking and understanding
• Problems thinking or focusing