The word stroke comes from a Greek word meaning to be struck down, and that is pretty much what happens. Suddenly, you find yourself unable to walk, talk, or even smile as you did before. It is a medical emergency. As with any emergency, time is of the essence, but with early identification and timely treatment in the emergency room, the worst effects of most strokes can be avoided. If you or a family member is at risk of a stroke, you can prepare yourself to act rapidly by learning as much as you can about strokes and your risk of having one.
Stroke is the third leading cause of death in the United States, behind heart disease and cancer. But while the heart attack mortality rate has fallen considerably over the past few decades, stroke deaths have not declined nearly as much. This is probably because Americans are generally less knowledgeable about strokes, what causes them, risk factors, warning signs and possible consequences.
A stroke is basically a brain attack. It occurs, in most cases, because normal blood flow to the brain has been blocked because of diseased blood vessels and/or a blood clot. This is known as an ischemic stroke, accounting for about 80 to 90 percent of cases. A stroke can also be caused by an intracerebral hemorrhage, a sudden rupture of an artery inside the brain, or by a subarachnoid hemorrhage, the rupture of an artery in a location that leads to blood filling spaces surrounding the brain rather than inside it.
Know Your Risk
Risk factors for stroke include:
• Age: after age 55, the risk of stroke doubles with each passing decade. Yet 28 percent of Americans who suffer a stroke are younger than 65.
• Carotid artery disease: When the carotid arteries supplying blood to the brain become occluded by plaque, there is a high risk that a clot will form and cause a total blockage.
• Blood pressure: Persons with uncontrolled hypertension are seven times more likely to have a stroke than those who keep their blood pressure under control, either through lifestyle or medicine.
• Diabetes: A diabetic has a risk 2.5 times higher than that of a person without diabetes.
• Atrial fibrillation: An abnormal heart rhythm increases the risk of blood clots, which are a frequent cause of stroke. For a person diagnosed with atrial fibrillation, no matter how severe the symptoms, the risk of a stroke is about five percent each year.
• Ethnic background: the incidence of stroke is 93 per 100,000 African American males and 79 per 100,000 African American females compared to 62.8 per 100,000 for Caucasian males and 59 per 100,000 for Caucasian females.
• Previous stroke: About 25 percent of those who survive a stroke will have another within the next five years.
Stroke affects more than 700,000 Americans each year, and 25 to 30 percent have no known cause. You can be prepared by understanding that a stroke can occur at any time and that it is a major medical emergency requiring rapid action. During a stroke, 32,000 brain cells die every second until treatment occurs.
Symptoms are sometimes dramatic but not always. In fact, the person having a stroke may not know it or may be in denial. To help you remember the warning signs, the commonly used acronym is FAST. Learn more>>
Other signs include sudden confusion, dizziness, or severe headache with no known cause.
One of the most powerful warning signs is a TIA (transient ischemic attack) or mini-stroke. This usually involves one of the above symptoms such as facial weakness or loss of vision that passes within a short time. Don’t just ignore it or pretend that it didn’t happen. It may be that a clot has formed in a blood vessel and momentarily blocks blood flow. The clot moves on but it may encounter another blockage further on down the line. Or another clot may form and cause a blockage.
A mini-stroke gives your brain cells a break as you head to the emergency room. The risk of a full-blown stroke remains high for several months. If you live alone and know you have a high risk, keep in mind that any sudden deficits caused by a stroke could make it difficult or impossible for you to reach the phone to call 911. Be prepared by keeping a phone close to you. Even if your speech becomes gibberish, the dispatcher might recognize the signs and trace your call to get you the help you need.
For some reason, stroke doesn’t invoke the same fear that is associated with the other two major killers, heart attack and cancer. Yet, of those three, stroke carries the lowest risk of survival. About 15 percent die shortly after the stroke; another 10 percent, within the first year.
The greatest risk of death and serious disability, however, occurs with the least common types, intracerebral hemorrhage and subarachnoid hemorrhage. Pressure in the brain can cause serious damage until it is relieved.
When a patient with an ischemic stroke gets to the hospital quickly enough, clot-dissolving medications can be administered to get blood flowing again. The good news is that nearly a quarter of stroke victims survive with only minor impairments.
Do you know your risks? Find information and resources for making healthy lifestyle choices to reduce your risk for stroke. Learn more>>