by Sunil Rayan, Surgeon
You may have heard the news recently that cancer is now the leading cause of death in the United States, knocking heart disease down to the number two position.
But do you know the third leading cause? It’s stroke, and it affects some 700,000 Americans every year.
Even when it isn’t fatal, a stroke can still be extremely debilitating. It is the leading cause of disability among adults, leaving 15 to 30 percent of its victims permanently disabled.
A stroke is an interruption of blood flow to the brain caused by a clot in an artery that feeds the brain. When blood flow is cut off, brain cells cannot get the oxygen and other nutrients they need to survive, and they die. In most stroke cases, the clot forms elsewhere in the body and migrates to the brain; in some cases, the blood clot is in the brain itself.
Stroke is characterized by symptoms that come on very suddenly. These can include:
- Numbness or weakness on one side of the body
- Confusion or problems talking or understanding speech
- Difficulty seeing with one or both eyes
- Difficulty walking, dizziness, or lack of coordination
- Severe headache
If you think you are having a stroke, go to the emergency room immediately. Medication known as thrombolytic therapy can dissolve a blood clot and restore blood flow to the brain, but it must be administered within three hours of the start of the stroke.
If you even suspect that you may be having a stroke, seek emergency help right away. It is better to be safe than sorry.
Most of the time, stroke happens without warning. However, about 50,000 people per year experience a transient ischemic attack (TIA) or “mini-stroke.”
Caused by a temporary blockage in an artery, TIA produces the same symptoms as a conventional stroke, but usually resolves within an hour and results in no permanent injury to the brain. However, TIA can be a warning sign of a future stroke; nearly a third of people who have one or more TIAs will have a stroke at some point in the future.
TIA cannot predict when the next stroke will occur, but about 25 percent of TIA victims have another stroke within 90 days. Recognizing and treating TIA can reduce your risk of having a full-blown stroke, so get help immediately.
While anyone is susceptible to stroke, there are a number of factors that can increase your risk. Among these are:
- High blood pressure
- Heart disease
- High cholesterol
- Carotid artery disease
- Over 65 years of age
- Family history of stroke or carotid artery disease
- African-American ethnicity
While age and background can’t be changed, there are steps you can take to reduce risks related to medical and lifestyle factors. If you have heart disease, high blood pressure or high cholesterol, aspirin or other medications may help reduce your risk.
If you have diabetes, be sure to manage your blood sugar levels. And if you smoke, quit!
Your carotid arteries are located on either side of the neck and are a major source of blood supply to the brain. If they become narrowed or blocked over time due to carotid artery disease, a stroke can result.
Fortunately, plaque in the carotid arteries can be easily identified through a fast, non-invasive ultrasound examination performed in the physician’s office. We recommend you have this screening exam if you:
- Have coronary artery disease or peripheral vascular disease
- Have been diagnosed with carotid bruit
- Have a family history of carotid disease or stroke
- Are over 70 years old
- Are over 60 years old and smoke
Should the ultrasound reveal any potential obstructions or problems, the next step is to see a board-certified vascular surgeon who specializes in carotid disease. There are several surgical options that can remove the blockage and help keep the passageway clear, thus reducing the danger of stroke.
Stroke can be a severe, debilitating event, but with careful risk management and lifestyle changes, the risk can be reduced. Ask your physician if you are at increased risk for stroke, and how you can keep your risk low.
This Scripps Health and Wellness information was provided by Sunil Rayan, M.D., at Scripps Memorial Hospital Encinitas and Scripps Memorial Hospital La Jolla.