Detecting and Treating Stroke

Stroke is the third most common cause of death in the United States, with nearly 750,000 new cases reported each year. A stroke is a brain attack that occurs when the blood supply to part of the brain is cut off or decreases. If the blood supply is cut off for several hours, the brain cells die. Stroke is seen most often in older people, though it can occur in people of all ages, even children.

There are two main types of stroke: hemorrhagic and ischemic. A hemorrhagic stroke occurs when a blood vessel in part of the brain becomes weak and bursts open, causing blood to escape into the brain. This most often happens to people who have defects in the blood vessels in the brain. An ischemic stroke may be caused by clogged arteries, which happens when cholesterol, fat and other substances collect on the artery walls, forming a sticky substance called plaque. About 90 percent of strokes are ischemic strokes.

Factors that can increase the risk of having a stroke include being age 55 years or older; having high cholesterol or high blood pressure; excessive cigarette smoking; heart attack; and personal or family history of stroke. Other factors include physical inactivity, diabetes, being overweight, heavy drinking, use of illicit drugs such as cocaine and cardiovascular disease such as heart failure, a heart defect or a heart infection.

The symptoms of a stroke normally appear suddenly. The person may feel sick initially and complain of a sudden headache. He or she may have numbness in their face or limbs, mainly down one side of the body. He or she may also experience sudden weakness, confusion and unexplained dizziness. People having a stroke may appear confused and have trouble talking or understanding what is being said to them. They could have trouble walking or keeping their balance and have vision problems. Sometimes a seizure or loss of consciousness may occur. A person may lose one or more of their functions, depending on what part of the brain was damaged. He or she may lose his or her speech, part of his or her vision or lose the ability to perform certain movements.

As with a heart attack, every minute counts in getting immediate medical attention to a stroke victim so brain damage and future disability are minimized. Most patients must reach the hospital within three hours after the symptoms begin, and some may receive medication or drugs up to four to five hours after symptoms begin.

To treat a stroke, a doctor may administer oxygen and insert an intravenous drip to provide adequate fluids and nutrients to the affected person. Thrombolytic therapy or clot-busting drugs are used if the stroke was caused by a blood clot; this medicine breaks up the blood clots and helps bring blood flow back to the damaged area. However, this does not work for everyone. In the case of an ischemic stroke, aspirin is commonly given to reduce the risk of death or the occurrence of a second heart attack.

Depending on the type and cause of the stroke, blood thinners or anticoagulant drugs may be given to stop new clots from forming and prevent future strokes. In some cases, a special stroke team and skilled radiologists use angiography to highlight the clogged blood vessel and open it up. Surgery is often needed to remove blood from around the brain if bleeding occurred and to fix damaged blood vessels. Surgery may also be performed if there is a blockage in a neck artery in order to remove the build up of plaque to prevent a future stroke.

After treatment, occupational, physical, speech and swallowing therapy may begin in the hospital. The recovery time and need for long-term treatment of stroke varies from person to person. Once the patient is feeling better, she or he will be encouraged to make certain lifestyle changes, which may include changing the diet, quitting smoking and increasing physical activity.