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Your brain needs oxygen to function, and it receives oxygen in the blood. If something like a clot deprives your brain of the oxygen it needs, your brain cells will die, along with the functions they control, such as memory, movement, or speech. This is a stroke.
According to the American Stroke Association, stroke is the leading cause of adult disability and the fifth leading cause of death in the U.S., affecting 800,000 people annually. The good news is that up to 80 percent of strokes are preventable. The sooner you receive a diagnosis and begin treatment, the greater are your chances for recovery.
Know the warning signs
Knowing the sudden signs of stroke is the first step toward recovery. BE FAST can help you remember them:
- Balance: loss of balance or coordination
- Eyes: trouble seeing from one or both eyes
- Face: unevenness or drooping on one side
- Arm: inability to hold up both arms, with one arm drifting back down
- Speech: slurring, confusion, inability to speak or understand
- Time: Call 911 now!
Types of stroke
There are two types of stroke. Ischemic stroke, which accounts for about 87% of all events, occurs when a clot blocks a vessel carrying blood to the brain. Hemorrhagic stroke occurs when a blood vessel bursts and spills blood into or around the brain, creating swelling and pressure, and damaging cells and surrounding tissues. Although less than 15% of strokes are hemorrhagic, they comprise 40% of all stroke deaths.
A transient ischemic attack (TIA), whose stroke-like symptoms last fewer than 24 hours before disappearing, results from a briefly disrupted blood flow to the brain. TIAs generally do not cause permanent brain damage but are a serious warning sign of a potential stroke.
Know your risks
Preventing stroke starts with knowing the risk factors:
- High blood pressure
- Atrial fibrillation or irregular heartbeat
- Diabetes
- High cholesterol
- Smoking
- Overweight
- Sedentary lifestyle
Maintaining a healthy lifestyle—eating plenty of fruits and vegetables, quitting smoking, limiting alcohol consumption, and exercising regularly—is the best way to reduce your stroke risk. Some risk factors are uncontrollable but knowing them can help you understand your risk.
Treatment
Ischemic stroke: Since these strokes are caused by a blood clot blocking an artery, the goal of therapy is to recanalize the occluded vessel.
Clot-breaking drugs: These drugs can be used to break up clots. One such drug is tissue plasminogen activator (tPA), which works by dissolving blood clots quickly, and can be used when given within 3 to 4.5 hours after stroke symptoms began.
Mechanical thrombectomy: This is the standard of care for patients who have large clots. During this procedure, the doctor inserts a catheter into a large blood vessel inside the patient’s head and uses different tools to retrieve the clot. This surgery may be performed up to 24 hours after stroke symptoms begin.
Hemorrhagic stroke: These strokes are caused by bleeds and may require different treatments.
Endovascular treatment: If the bleed is caused by a ruptured aneurysm, a catheter may be navigated to the area of the bleed through a blood vessel, and block the area of bleeding using a variety of devices.
Surgery: Sometimes open surgery is needed in which a craniotomy is needed to either evacuate the blood or clip an aneurysm.
Rewards of rehabilitation
Complete recovery following a stroke is possible. Nevertheless, more than two-thirds of survivors emerge with some disability. The type of disability depends on where in the brain the stroke occurs and how much damage results. A small stroke may cause temporary weakness in an arm or leg, while a large stroke may cause loss of speech or permanent paralysis on one side of the body.
Timely rehabilitation after a stroke can help you regain independence and improve your quality of life. Rehabilitation may include physical, speech, or occupational therapy, nutritional counseling, psychological counseling, and medical interventions to control risk factors such as diabetes and hypertension. The sooner you begin, the more fully you are likely to recover.
Visit phelps.northwell.edu to learn more about the Stoke Center at Phelps, which has received the Gold Plus Performance Achievement Award from the American Heart and American Stroke Associations every year since 2009.
