Stroke Awareness

A stroke, also known as transient ischemic attack or cerebrovascular accident, happens when blood flow to the brain is blocked. This prevents the brain from getting oxygen and nutrients from the blood. Without oxygen and nutrients, brain cells begin to die within minutes. Sudden bleeding in the brain can also cause a stroke if it damages brain cells.

A stroke is a medical emergency. A stroke can cause lasting brain damage, long-term disability, or even death. Signs of a stroke can range from mild weakness to paralysis or numbness on one side of the face or body. Other signs include a sudden and severe headache, sudden weakness, trouble seeing, and trouble speaking or understanding speech.

If you think you or someone else is having a stroke, call 9-1-1 right away. Do not drive to the hospital or let someone else drive you. Call an ambulance so that medical personnel can begin life-saving treatment on the way to the emergency room. During a stroke, every minute counts.

At the hospital, a stroke team will assess your condition and treat your stroke with medicine, surgery, or another procedure. Your recovery will depend on how severe your stroke was and how quickly you got treatment. A rehabilitation plan may help you do the same things you used to do before your stroke.

Symptoms

The signs and symptoms of a stroke often develop quickly. However, they can develop over hours or even days, such as when a transient ischemic attack (TIA) turns into a stroke.

The type of symptoms depends on the type of stroke and the area of the brain that is affected.

Signs of a TIA or stroke may include:

-Sudden numbness or weakness, especially on one side of the body

-Sudden confusion or trouble speaking or understanding speech

-Sudden trouble seeing in one or both eyes

-Sudden trouble walking, dizziness, or loss of balance or coordination

-Sudden severe headache with no known cause

The FAST test can help you remember what to do if you think someone may be having a stroke:

F—Face: Ask the person to smile. Does one side of the face droop?

A—Arms: Ask the person to raise both arms. Does one arm drift downward?

S—Speech: Ask the person to repeat a simple phrase. Is their speech slurred or strange?

T—Time: If you observe any of these signs, call 9-1-1 right away. Early treatment is essential.

If you think you or someone else is having a TIA or stroke, don’t drive to the hospital or let someone else drive you. Call an ambulance so that medical personnel can begin life-saving treatment on the way to the emergency room. During a stroke, every minute counts.

Complications

A stroke can cause lasting brain damage, long-term disability, or even death. When you have a stroke, your doctor may rate how severe it is. A more severe stroke means more brain tissue was damaged. When there has been significant damage, your doctor may call it a massive stroke. This can mean more severe complications.

After having a stroke, you may develop complications such as:

-Dangerous blood clots. Being unable to move around for a long time can raise your risk of developing blood clots in the deep veins of the legs. In some cases, blood clots can break loose and travel to the lungs. Your stroke care team may try to prevent these complications with medicine or a device that puts pressure on your calves to keep your blood flowing.

-Difficulty speaking. If a stroke affects the muscles you use to speak, you may have trouble communicating as easily as before.

-Loss of bladder or bowel control. Some strokes affect the muscles used to urinate and have bowel movements. You may need a urinary catheter (a tube placed into the bladder) until you can urinate on your own. Use of these catheters can lead to urinary tract infections. You may also lose control of your bowels or be constipated.

-Loss of bone density or strength. This usually happens on one side of the body. Physical activity as part of rehabilitation can help prevent this loss. Your care team may also evaluate you for osteoporosis.

-Loss of vision, hearing, or touch. Your ability to feel pain or temperature may be affected after a stroke, or you may have trouble seeing or hearing as well as before. Some of these changes could affect your ability to cook, read, change your clothes, or do other tasks.

-Muscle weakness or inability to move. A stroke can make your muscles become weak and stiff or cause them to spasm. This can be painful or make it hard to stand or walk around on your own. You may also have problems with balance or controlling your muscles. This puts you at risk of falling.

-Problems swallowing and pneumonia. If a stroke affects the muscles used for swallowing, you may have a hard time eating or drinking. You may also be at risk of inhaling food or drink into your lungs. If this happens, you may develop pneumonia.

-Problems with language, thinking, or memory. Stroke may affect your ability to focus on a task or make decisions quickly. It also raises the risk of dementia.

-Seizures. This is more common in the weeks after a stroke and is less likely as time goes on. If you have seizures, your stroke team may give you medicine.

-Swelling in the brain. After a stroke, fluid may build up between the brain and the skull or in the cavities of the brain, causing swelling. Doctors may drain fluid from the brain or cut away part of the skull to relieve the pressure on your brain.

Diagnosis

Your doctor will diagnose a stroke based on your symptoms, your medical history, a physical exam, and test results. Your doctor will want to find out the type of stroke you’ve had, its cause, the part of the brain that is affected, and whether you have bleeding in the brain. If your doctor thinks you’ve had a transient ischemic attack (TIA), he or she will look for its cause to help prevent a future stroke.

Diagnostic tests

Your doctor will order tests to help rule out other health problems with similar signs or symptoms.

Your doctor will order an imaging test to look at the blood vessels in your brain. This will help determine what type of stroke you have and where exactly it happened. The quicker these tests can be done, the better your doctor can treat you. Tests to diagnose stroke include the following:

-Computed tomography (CT) uses X-rays to take clear, detailed pictures of your brain. It is often done right after a stroke is suspected. A brain CT scan can show if there is bleeding in the brain or damage to the brain cells from a stroke.

-Magnetic resonance imaging (MRI) uses magnets and radio waves to create pictures of your brain. An MRI may be used instead of—or in addition to—a CT scan to diagnose a stroke. This test can detect changes in brain tissue and damage to brain cells.

-Other imaging tests to look for narrowed blood vessels in the neck or an aneurysm or tangled blood vessels in the brain.

Your doctor may also order the following blood or heart tests.

Blood tests. Your doctor may test the blood and platelet count and glucose (sugar) levels in your blood to make sure they are stable and to see if a certain medicine can treat your stroke. Your doctor may also do blood tests to see how well your blood is clotting and to look for muscle damage.

Electrocardiogram (EKG). An EKG can help detect heart problems that may have led to a stroke. For example, this test can help diagnose atrial fibrillation or a previous heart attack.

Lumbar puncture (also called a spinal tap), if the imaging scan does not detect any bleeding in the brain but your doctor still thinks you may have had a hemorrhagic stroke. The doctor will use a needle to collect fluid from around your spine. The fluid will be tested for substances from broken-down blood cells.

Medical history and physical exam

Your doctor will ask you or a family member about your risk factors for stroke. Tell your doctor if you or someone in your family has had a stroke. Your doctor will also ask about your signs and symptoms and when they began.

During the physical exam, your doctor will check you for:

-Confusion

-Coordination and balance

-Mental alertness

-Numbness or weakness in your face, arms, and legs

-Trouble speaking or seeing clearly

The exam will help your doctor determine how severe your stroke was and plan your treatment.

Your doctor will look for signs of carotid artery disease, a common cause of ischemic stroke. He or she will listen to your carotid arteries with a stethoscope. A whooshing sound called a bruit may suggest changed or reduced blood flow due to plaque buildup in the carotid arteries.