A stroke is basically an attack on the brain. It occurs when a blockage or hemorrhage disrupts the flow of blood to the brain, the control center of the nervous system, cutting off the vital supply of oxygen and nutrients. The very name “stroke” underscores it acts quickly, causing the average person to lose about 1.9 million brain cells for every minute the condition goes untreated. Once the brain cells die, the abilities to move, speak, think, and control other body functions are often impaired—at least temporarily.
Stroke is one of the leading causes of long-term adult disability, affecting about 795,000 people in the U.S. each year. And it particularly targets the older population, with half of all strokes occurring in people over age 75 and one-third in those over 85. In addition to being an ageist disease, it’s sexist—more likely to affect men 75 and younger, though women who have strokes are more likely to suffer lasting disabilities or to die from them.
But the hopeful news is that because of recent medical innovations, strokes can now be prevented and treated.
The What and Why of Strokes
The more strokes are studied, the more differences are being found in their causes and effects.
Very simply put, there are two types:
- Ischemic strokes—caused when a major blood vessel in the brain is blocked, either by a blood clot or a buildup of fatty deposits and cholesterol known as plaque; about 85% of all strokes are of this type.
- Hemorrhagic strokes—occurring when a blood vessel in the brain breaks, causing blood to spill into nearby tissues and putting pressure on the brain, which in turn irritates and damages it.
While strokes can affect anyone at any age and stage, there are a number of factors that increase the risk—including high blood pressure, heart disease and irregularities, diabetes, high cholesterol and lipids, and a history of transient ischemic attacks (TIAs). Some behaviors may also contribute: smoking, lacking regular exercise, excessive drinking, and abusing drugs intravenously. And recently, geographic and demographic risks have also been uncovered—revealing that people who live in the southeast or in a locale with extreme temperatures or who have low incomes are proportionately more at risk for strokes.
Is It a Stroke?
People having strokes stroke will often simply collapse or complain of a sudden severe headache; they may then become disoriented and unable to communicate effectively. And because there is some immediate brain damage, they may not understand or be able to express that they are in duress and in need of medical help.
While symptoms vary among individuals, other common ones may include:
- Numbness or weakness in the face, arms, or legs—usually confined to one side of the body
- Vision problems, such as blurred vision or blindness in one or both eyes
- Sudden dizziness or problems with balance, moving, or walking
- Brief loss or change of consciousness—such as a seizure or a fainting spell
- Nausea or vomiting, and
- TIAs, or “mini-strokes”—with symptoms that are less profound and generally last only momentarily, though they can sometimes be precursors to full-fledged strokes.
Because strokes are so prevalent, often hard to discern—and especially because getting medical help quickly is so essential, the National Stroke Association has come up with an easy-to-remember acronym to help alert bystanders recognize the signs of a stroke in another person: FAST.
F—FACE: One side of the face is numb or drooping. Ask the person to smile. Does one side of the face droop?
A—ARMS: One arm is weak or numb. Ask the person to raise both arms. Does one arm drift downward?
S—SPEECH: Speech is slurred or unintelligible. Ask the person to repeat a simple phrase. Is it slurred or strange?
T—TIME: If you observe any of these signs, call 9-1-1 immediately.
Medical experts underscore the need to treat a stroke, or even the possibility of one, as a medical emergency. “It’s really worth the effort it takes to dial 911,” emphasizes John Marler, s neurologist with the National Institute of Neurological Disorders and Stroke. “It’s hard to decide to do that; you’re not always sure what’s going on. But it’s going to pay back in terms of going home and living your life.”
Once a stroke is suspected, healthcare providers will generally perform a number of tests and scans to determine whether there are blockages to bloodflow and to pinpoint the location of any damage. Medical interventions—infusing a clot with medication to dissolve it, operating to remove an obstruction, or intervening to stop the bleeding in the brain—will often minimize the damage a stroke can cause.
New treatments and procedures developed recently offer the new hope of complete recovery for an increasing number of people who have suffered strokes, though that may take some time and patience. After the condition is diagnosed and the acute symptoms are controlled, a regimen will generally be prescribed for the stroke sufferer that may include physical, occupational, and speech therapy as well as blood-thinning medications, or anti-platelets such as aspirin. If needed, lifestyle changes, such as quitting smoking, losing weight, and eating a healthier diet may also be urged.
Resources For Help
A number of organizations offer information and guidance for those who want to learn about strokes or who have suffered one, as well as those who care for them.
- National Stroke Association has compiled a number of resources—including a multi-media library, information on stroke support groups, and a stroke helpline, accessible at 1-800-787-6537.
- American Stroke Association offers information about preventing strokes, as well as advice for recovering for patients and caregivers.
- National Institute of Neurological Disorders and Stroke maintains a website featuring educational materials including a toolkit on hosting a local stroke awareness event.