Stroke Recovery Requires Fast, Expert Care

By Thomas Chippendale, MD, PhD, Scripps Health

Every 45 seconds, someone in the United States suffers a stroke. The third-leading cause of death in the United States and a major cause of serious, long-term disability such as paralysis, speech problems, confusion and muscle weakness, stroke affects about 795,000 people every year.

Stroke is caused by a blockage in a blood vessel that supplies oxygen and nutrients to the brain. The blockage may be caused by a build-up of plaque that eventually blocks the flow of blood, or by a clot that travels from elsewhere in the body and lodges in the vessel. In 85% of strokes, blood flow is blocked by an obstruction; these are known as ischemic strokes. The remaining 15% are hemorrhagic or "bloody "strokes. These occur when an artery ruptures in the brain, and the resulting mass of blood, known as a hematoma, destroys or damages brain tissue. Whether a stroke is ischemic or hemorrhagic, the lack of blood flow starves brain cells of the oxygen and other nutrients they need to survive. If they die, the part of the body they control can be irreversibly damaged.

Immediate medical care is critical to open the blocked blood vessels and prevent the loss of brain tissue. A massive team effort is required between paramedics, emergency room physicians, neurologists and neurosurgeons to quickly evaluate and diagnose the nature of the stroke and treat the patient as quickly as possible. If the blood vessels can be opened within three to six hours, there is a significant chance of recovery.

Since 2000, the Joint Commission, an independent, not-for-profit organization that accredits and certifies more than 15,000 health care organizations and programs in the United States, has surveyed hospitals for certification as Primary Stroke Centers (PSC). Primary Stroke Center standards of care reflect the guidelines established by the American Stroke Association; the PSC designation confirms that the hospital has a team of physicians available 24/7 that provides the most up-to-date and efficient stroke care, along with the tools and expertise to treat acute stroke quickly and competently to minimize or even reverse damage to the patient’s health. All five Scripps hospital campuses are designated as Primary Stroke Centers.

Know the Warning Signs
With stroke treatment, every second counts. Seek emergency care immediately if you experience any of the following warning signs, even if the symptoms are minor or last only a few seconds. Transient ischemic attacks (TIA) are minor or “warning” strokes with symptoms that last for a short time and often seem to resolve themselves. However, TIAs are strong indicators of a possible major stroke, and require immediate attention.

* Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
* Sudden confusion, trouble speaking or understanding
* Sudden trouble seeing in one or both eyes
* Sudden trouble walking, dizziness, loss of balance or coordination
* Sudden, severe headache with no known cause

If you suspect someone is having a stroke, the National Stroke Association recommends using the F.A.S.T. test to recognize stroke symptoms:

* FACE: Ask the person to smile. Does one side of the face droop?
* ARMS: Ask the person to raise both arms. Does one arm drift downward?
* SPEECH: Ask the person to repeat a simple sentence. Does the speech sound slurred or strange?
* TIME: If you observe any of these signs, time is of the essence. Call 911 or get to the nearest stroke center or hospital as soon as possible.

Know Your Risk
Stroke can affect anyone of any age, race or gender at any time. However, there are some known risk factors that may increase your chances of suffering a stroke. Men are more likely than women to have a stroke at younger ages, but women’s risk increases with age. African Americans have nearly twice the risk of a first-time stroke compared with whites. If you have had a previous stroke or TIA, or have a family history of stroke, your risk may be higher. Other medical conditions that may increase risk include diabetes, high cholesterol, high blood pressure, heart disease, atrial fibrillation and carotid artery disease; talk to your doctor about managing these to decrease your risk. Finally, you can lower your risk through lifestyle changes, such as losing excess weight, eating a healthy diet, exercising regularly, not smoking and using alcohol in moderation.

May is National Stroke Awareness Month and Scripps is offering free stroke awareness community events and physician lectures. For a schedule of events and more information about stroke risk, prevention and treatment, visit www.scripps.org/stroke. “To Your Health” is brought to you by the physicians and staff at Scripps Health.

Are you at risk for a stroke?
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