A stroke is when the brain doesn’t get enough oxygen.
The most common cause of a stroke is a blockage in a blood vessel to the brain, which is often
due to a blood clot getting trapped where the blood vessel narrows.
When the blood vessel gets blocked off, blood can no longer flow past the clot, and oxygen
can’t get to the brain tissue, and the tissue quickly starts to die.
Sometimes the clot might dissolve on its own before permanent damage occurs.
This is known as a transient ischemic attack (TIA) or mini-stroke and symptoms typically
go away on their own within a few hours.
If a person is having a TIA, they should still go to the hospital because it could be a warning
that a larger stroke is about to occur.
Knowing the signs and symptoms of a stroke can make a big difference in how quickly someone
gets care, and in turn, how well they recover.
Remembering the word FAST will help you remember the signs of a stroke.
F stands for face - usually one side of the face starts to droop and becomes hard to move.
This can sometimes cause someone to smile crookedly.
A is for arm weakness or the inability to hold both arms out straight in front of the
body.
But it’s not just the arms, sometimes, a stroke can also cause weakness in the legs.
S is for speech which can either mean that someone is slurring their speech or having
trouble understanding what others are saying.
And finally, T is for time - Call emergency services immediately when these symptoms appear.
A stroke should be treated within the first few hours to increase the chance of a good
recovery.
Strokes may also involve other symptoms, but these are the classic signs.
So remember, Face, Arm, Speech, Time: FAST
If the health care team suspects a stroke when a person arrives at the hospital, a head
CT scan can help to determine the underlying cause so that the person can be properly treated
as quickly as possible.
There are two treatments that can be offered in the first few hours of a stroke.
After several hours have passed these treatments will no longer work because the tissue can’t
be saved afterwards.
TPA—sometimes known as “the clot buster medicine”—works by dissolving the blood
clot and allowing blood to flow back through the previously blocked vessel.
In addition, a there’s also thrombectomy, which is a minimally invasive procedure that
can be used to remove larger clots from the brain.
After a stroke, the main goal is to prevent another stroke.
The most common modifiable risk factor for stroke is hypertension, or high blood pressure.
Lowering blood pressure back to the normal range can result in the greatest decrease
in stroke risk.
Next comes smoking which approximately doubles the risk of another stroke, but this additional
stroke risk disappears within 2 to 4 years of quitting.
It takes most people several attempts to quit before they are successful, so it’s important
not to be discouraged after a failed attempt.
There’s diabetes, a disease that causes high blood sugar which damages blood vessels.
And finally, high cholesterol which can lead to narrowing of blood vessels.
Both of these can predispose someone to getting a stroke.
The good news is that all of these risk factors can be reduced through a combination of lifestyle
changes and medication.
For medications, daily aspirin can be used to reduce the chance that a blood clot will
form in the future.
Also, though, blood thinners can be prescribed instead if someone has an abnormal heart rhythm
like atrial fibrillation, since clots are more likely to occur in the heart and travel
to the brain.
After a stroke, recovery can be slow and sometimes people still see small improvements for a
year or more.
Depending on the type of stroke, individuals that have had a stroke may work with speech
therapists, physical therapists, and occupational therapists to regain physical strength and
an ability to communicate effectively.
Depression is very common following a stroke and shouldn’t be ignored.
It turns out that when it’s properly addressed and treated, in addition to feeling better
people actually regain physical strength.
That’s why having the support of family and friends, as well as the health care professionals
has been shown to make such a difference.
In general, outcomes can be difficult to predict and while most stroke patients have some permanent
neurologic deficits, many people recover well over time - even those who weren’t treated
within hours.
Overall, the goal is to provide tools to maximize quality of life after a stroke and prevent
another stroke from happening in
the future.