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May is stroke awareness month. Yet, every month should be stroke awareness month.
Strokes occur in over 700,000 people each year. While stroke treatments may be available if the patient gets to the hospital quickly, only 10-15 percent of all stroke patients arrive in sufficient time to potentially reverse the stroke. As a result, knowledge of stroke symptoms and prevention may make the difference between life and death or severe disability.
Many people remember the term 'FAST' as a way to recognize stroke symptoms (F= face uneven smile or weakness; A = arm weakness, sensory loss or numbness; S= speech slurring, strange speech or no speech at all; T= time is critical-call 911 immediately!). These will help identify many, but not all stroke symptoms. Other symptoms to watch for include sudden confusion, which may represent injury to the language centers in the brain; worst headache of one's life, especially with a stiff neck; fainting, double vision, or sudden drunken-like unsteadiness.
It is human nature to question whether a serious symptom is really happening. Many patients wait to see if the symptoms will resolve before going to the hospital. Given the devastating damage that may occur from a stroke, it is always best to err on the side of caution and call 911 immediately. This is truly a medical emergency. Do not go to the hospital by private vehicle as it delays treatment. For every minute that brain cells do not receive blood flow, over 1 million brain cells may die, reducing the likelihood of survival and functional recovery. It is also important to provide the paramedics with the cell phone number of a trusted relative, as well as a list of all of the medications.
While medicine has made advances in stroke treatment, our best treatment is to prevent it before it happens. We need to remember the 'silent killers.’ High blood pressure is a major cause of stroke, and many patients do not have adequate blood pressure control. Even more do not have their blood pressure checked periodically to even know if it is high. Most people do not feel poorly when their blood pressure is elevated. Over the last 50 years, treatment of hypertension has significantly reduced the incidence of strokes and heart attacks.
Diabetes can also exert significant damage upon small blood vessels in the brain as well as amplify other vascular risk factors. Diabetic patients do not feel poorly when their blood sugar rises, making careful monitoring necessary.
One in five patients over the age of 80 have atrial fibrillation. This irregular heart rhythm produces clots in the heart that can eject to the brain and produce severe strokes. Anticoagulant medication can slow the blood’s ability to clot and significantly reduce the risk of stroke. Newer anticoagulant medications have a lower bleeding risk than warfarin with similar benefit.
Both smoking and breathing other people’s cigarette smoke also increase the risk of stroke by disrupting the blood’s ability to carry oxygen. It also promotes atherosclerosis, an inflammatory reaction in blood vessels. Avoiding breathing cigarette smoke also will significantly reduce this risk.
Careful monitoring and treatment of blood cholesterol and a Mediterranean diet are also important.
Lastly, stroke and heart attack risks begin early in life. We can leave an incredible legacy to our children and grandchildren by teaching them proper eating habits, daily exercise, and avoidance of smoking. This will reduce their risk of developing stroke and heart attack.
The SSM Health Dean Medical Group and SSM Health St. Mary’s Hospital-Madison stroke program is certified by the Joint Commission for Hospital Accreditation and has received the American Heart Association-American Stroke Association’s highest honor, the Get with the Guidelines Gold Plus Elite award in recognition of stroke care.
Dr. H. Steven Block is a vascular neurologist and medical director of the SSM Health Dean Medical Group and SSM Health St. Mary's Hospital - Madison stroke program. Learn more about Dr. Block.
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