Stroke

In this post I’ll be talking about Strokes (also known as Cerebral Vascular accidents). It is the fifth leading cause of death in the United States.  It also is a major cause of disability and in terms of treatment, missed work, etc costs an estimated $34 billion dollars a year in the U.S. alone. Although the risk for stroke rises as we age, according to the CDC website 34% of strokes were in people younger than 65.

There are two kinds of stroke. One is hemorrhagic, meaning that is caused by bleeding. The other is ischemic, meaning that it is caused by a a blockage in a blood vessel. The symptoms, however are determined by the location and size of the stroke. Symptoms include: Facial Droop, double vision, confusion, garbled speech, limb weakness (especially if it occurs on one side of the body), numbness, and headaches.

It is important that if one suspects he or she is having a stroke that medical care be obtained quickly. There is a 3 hour window of opportunity from the start of symptoms that ischemic strokes can optimally be treated with clot dissolving medications. More than three hours after the start of symptom and the likely hood of poor outcomes increases – and the riskier it is to use medications to try and unblock arteries.

An acronym used to keep in mind regarding stroke is the word FAST (Face – is the face symmetrical: is one side drooping? Arms – weakness in one arm. Speech – is it normal? Time – call 911 immediately if it seems someone’s having a stroke).

Ischemic strokes are the most common. Based on symptoms one can’t tell if a stroke is ischemic or hemorrhagic, so it’s better to get to a hospital quickly. At this point in time there may be fewer acute treatments to stop hemorrhagic strokes, but even then supportive treatment is available.

Sometimes symptoms resolve quickly (within a few minutes). This is called a Transient Ischemic Attack, or TIA. This should not be ignored because people who have had a TIA are at increased for having a major/bigger stroke.

Although there isn’t anything that can be done about some risk factors such as age, there are many things one can do to reduce the risk of having a stroke:

1) Control your blood pressure if you have high blood pressure.

2) Lower your cholesterol if you have high cholesterol.

3) Control your diabetes if you are diabetic.

4) If you smoke, stop. If you don’t smoke, don’t ever start.

5) if you have an irregular heart rate, talk to your doctor about whether you need to be on blood thinners as certain irregular heart rhythms increase your risk of ischemic strokes.

6) Exercise (this will help with numbers 1-3 above)

 

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