Know the Risks & Signs of Stroke

By Christine Birden, Nurse Practitioner

iStock.com/marina_ua

Stroke: Act FAST

According to the 2019 Update from the American Heart Association (AHA), someone dies of a stroke every 3.7 minutes. Strokes are the second most common cause of death worldwide. And for some of the 7.2 million stroke survivors, they are left with a long-term disability.

These are sobering statistics.

The good news from the AHA is that strokes are “preventable, treatable and beatable.”

What Causes Strokes

The majority of strokes happen when a blood clot blocks blood flow, and the oxygen it carries, to the brain. To work properly, your brain needs oxygen. The National Institute of Neurological Disorders and Stoke estimates that your brain makes up only 2% of your body weight, but it uses 20% of the oxygen you breathe. Your arteries deliver oxygen-rich blood to all parts of your brain. When a blot clot blocks this delivery, brain tissue becomes damaged or dies. This is called an ischemic stroke.

Another, less common type of stroke is hemorrhagic. This occurs when a blood vessel in the brain bursts, causing bleeding and damage to the brain tissue.

A transient ischemic attack, otherwise known as a TIA is often called a “mini -stroke.” It is different from the two major types of stroke because there is a “temporary” blockage of blood flow to the brain. A TIA is also a medical emergency, because if it is not treated properly it could be followed within hours or days by a major, disabling stroke.

A Pound of Prevention

While there are some uncontrollable risk factors that put you at higher risk for stroke, such as age, gender or having a family history of stroke, many risk factors are in your control. Like so many other medical conditions, the key to prevention is a healthy lifestyle. Staying active and watching what you eat goes a long way. The Centers for Disease Control (CDC) offers the following guidance for preventing a stroke:

  • Healthy Diet: Choosing healthy meal and snack options can help you prevent stroke. Be sure to eat plenty of fresh fruits and veg Eating foods low in saturated fats, trans fat, and cholesterol and high in fiber can help prevent high cholesterol.
  • Healthy Weight: Being overweight or obese increases your risk for stroke. To determine whether your weight is in a healthy range, doctors often calculate your body mass index (BMI).
  • Physical Activity: Physical activity can help you stay at a healthy weight and lower your cholesterol and blood pressure levels.
  • No Smoking: Cigarette smoking greatly increases your chances of having a stroke. If you don’t smoke, don’t start. If you do smoke, quitting will lower your risk for stroke.
  • Limited Alcohol: Avoid drinking too much alcohol, which can raise your blood pressure. Men should have no more than two drinks per day, and women only one.

Signs and Symptoms

Identifying signs of stroke early is essential in ensuring the best possible outcome. According to the American Stroke Association, look for a sudden numbness or weakness of the face, arms or legs; sudden confusion or trouble speaking or understanding others; sudden trouble seeing in one or both eyes; sudden trouble with walking, dizziness or loss of balance or coordination; or sudden severe headache with no known cause.  

A quick and concise way to recognize the signs of a stroke is the mnemonic: F.A.S.T., developed in 1998 in the U.K. 

F: Face Drooping – does one side of the face droop or is it numb? Ask the person to smile. Is the smile uneven or lopsided? 
A:  Arm Weakness – is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward? 
S:  Speech Difficulty – Is speech slurred? Is the person unable to speak or hard to understand? Ask the person to repeat a simple sentence. 
T: Time to Call 911

Time Out

With a stroke, time is of the essence. If you are actively having a stroke, there is only one Food & Drug Administration (FDA) approved drug treatment, tissue plasminogen activator (tPA). tPA is given through an IV and works by dissolving the clot and improving blood flow to the part of the brain being affected. Typically, the initial time window for treating stroke was about three hours. However, a new study by has expanded that window now to as long as 24 hours.

In response to this study, Dr. Farhan Siddig, an endovascular neurosurgeon with Texas Health Fort Worth and Texas Health Physicians Group, said “We’ve been trying to push the envelope for the past several years. We’ve done a lot of studies to increase the time window. You’re losing several million brain cells per minute when you have a stroke — something that we want to prevent,” he said.

To best protect yourself from a stroke, be aware of your uncontrollable risks, such as family history, and talk to your doctors about what you can do to manage the things you can control to reduce your chances. Also, memorize the signs and if you or anyone you know think you might be having a stroke, seek medical attention immediately.

To learn more about stroke prevention, visit the National Stroke Association (NSA) website.  The NSA is a division of the AHA.