Stroke Awareness and Prevention
by Ron Van Ness-Otunnu, MD, FACEP
Stroke is a medical emergency that is a leading cause of death and disability. Recognizing the signs of stroke and seeking medical attention can prevent significant, permanent damage to the brain. Stroke is caused by interruption of blood carrying oxygen to brain cells. The interruption may be due to blockage, rupture, or damage to the lining of a blood vessel. If oxygen does not reach brain cells, affected areas of brain die quickly. Because different parts of the brain serve specific functions, symptoms of a stroke will vary depending upon the area of brain that is starved of oxygen. Stroke symptoms may include:
- sudden paralysis, weakness, numbness, tingling or discoordination of an arm or leg
- feeling off balance when standing or inability to walk steadily
- slurred or impaired speech
- confusion or difficulty comprehending
- sudden loss of vision in one eye or in part of a visual field of both eyes
- rapid onset, progressive headache
- difficulty swallowing resulting in aspirating (inhaling) food or liquid
A stroke symptom that lasts for minutes to hours and then resolves is called a “transient ischemic attack” (TIA). Like stroke, TIA requires immediate medical attention. Prompt evaluation is critical as a TIA may be the only warning sign before a stroke. Sometimes, what is thought to be a TIA may actually be a developing stroke.
Risk factors that we can change to prevent stroke include high blood pressure, high cholesterol, diabetes, obesity or physical inactivity, poor dietary habits, and tobacco use. As blood vessels age, disease can accumulate that increase stroke risk, and so age older than 80 years and genetic predisposition are risk factors not within our control to change.
Stroke prevention involves controlling modifiable risk factors. This means regular primary care evaluation to address high blood pressure, cholesterol, diabetes and obtain help to stop smoking. Your health care provider may recommend medication to treat diabetes, high blood pressure, or cholesterol levels that have not responded to a trial of diet and exercise. Your provider may consider starting a daily aspirin or similar medication if you are at risk for atherosclerosis, a build-up of cholesterol and fats in the lining of arteries. A type of medication called a “statin” may also be considered to manage cholesterol.
Improving diet and exercise habits are important aspects of prevention. Appropriate exercise consists of moderate or vigorous activity, such as brisk walking or using an exercise cycle most days of the week, lasting at least 40 minutes at a time. Before you begin an exercise plan, consult your doctor. Avoid high salt content or processed food, fried or fast food, sweets or sugary drinks such as soda, and sauces, toppings, or other foods that are high in saturated fat. Healthy choices include a balanced diet rich in fruits, vegetables, nuts, fish, beans, and low fat dairy products. Meats and refined grains such as white rice and white bread should only be consumed in moderation. Limit alcohol consumption to no more than one glass of red wine per day for a woman, and no more than two glasses per day for a man.
Once you witness or experience signs or symptoms of stroke, seeking immediate emergency medical care is crucial. Rapid medical management is the only way to save a brain at risk. A type of medication administered in the emergency department called a “tissue plasminogen activator” that breaks up a clot in certain types of stroke can only be used immediately after the onset of symptoms. Once that window of opportunity closes, such medication cannot be used and effects of stroke can be permanent and significantly disabling.
Start on a path to prevention today and live an active, healthier life. If you do suffer stroke or TIA symptoms, call 911 to get the medical attention you need. When it comes to stroke, minutes matter for brain cells at risk: act fast!