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Strokes: a medical emergency

By RACHAEL MILLER

According to the American Stroke Association, strokes are the fifth-leading cause of death and a leading cause of disability in the United States. Every year, nearly 800,000 people in the U.S. suffer a stroke, with 140,000 of these resulting in death. Americans who are overweight, have high blood pressure, high cholesterol, diabetes or who smoke are at the greatest risk for experiencing a stroke. The risk of stroke is also higher among individuals 65 years or older, but can and do occur at any age. It is important for everyone to understand what strokes are, what can be done to prevent strokes and what needs to be done when stroke-like symptoms are present.

Most symptoms of a stroke are acute or have a sudden onset, but, on occasion, the symptoms are gradual. When symptoms are present, it is extremely important to seek medical attention as quickly as possible in order to help reduce the risk of disability or death. Remember the acronym B.E.F.A.S.T (Balance, Eyes, Face, Arms, Speech, Time). You or your family member may be suffering a stroke if the following symptoms present:

  • a sudden loss of balance or trouble walking;
  • dizziness;
  • sudden blurred vision or loss of vision in one or both eyes;
  • sudden onset of a severe headache;
  • facial droop;
  • slurred speech or difficulty speaking;
  • confusion;
  • numbness or weakness, usually on one side.

If one or more of these symptoms are present, call 9-1-1 immediately. It is very important to note the specific symptoms being experienced or witnessed, as well as the time the person was last seen without symptoms. This time is called the Last Known Well (LKW) and is important. Be sure to relay this information to Emergency Services personnel and/or the hospital medical staff. This information allows the medical team to determine what type of treatments are needed and available to the patient.

There are three main types of strokes: transient ischemic attack (TIA), ischemic stroke and hemorrhagic stroke. Transient ischemic strokes (TIAs) are commonly called “mini-strokes,” and occur when blood flow to the brain is cut off for a short time. Symptoms of a TIA resemble a stroke, but usually last a short time with no permanent damage. These symptoms usually resolve within 24 hours. However, it is important to note that 33% of people who experience a TIA will eventually have a more serious stroke with nearly half of these occurring within a year after the initial TIA.

Ischemic stroke is the most common type and accounts for 87% of all strokes. Ischemic strokes occur when the blood flow to the brain is obstructed by a blood clot or a buildup of plaques in the arteries of the brain or neck. The only treatment available for this type of stroke is clot removal; either with medication or by surgically removing the clot.

Hemorrhagic strokes are sometimes referred to as “brain bleeds” and are caused by a weakened blood vessel rupturing and allowing blood to collect in and around the brain. This puts pressure on the brain and causes blood loss to the surrounding tissues. Hemorrhagic strokes require immediate emergency care with treatments focused on controlling the bleeding, reducing pressure on the brain and may require surgical intervention. All strokes are medical emergencies.

Preventative measures are the best way to help reduce the risk of stroke. As stated previously, individuals who are overweight, have high blood pressure, high cholesterol, diabetes or who smoke are at greatest risk. These risk factors are modifiable and/or manageable. Maintaining a healthy weight is one key factor in preventing risks for stroke and can be achieved through a healthy diet and exercising regularly.

Another important preventative measure is to stop smoking. Smoking greatly increases the chances of having a stroke. According to a randomized, double-blind, controlled study completed by the American Academy of Neurology, smoking was estimated to be responsible for 12% to 37% of all strokes and is considered one of the leading preventable causes. The chances of having a stroke related to smoking is reduced by nearly 30% in individuals who have kicked the habit.

High blood pressure, high cholesterol and diabetes can also be controlled, reduced and/or managed by a healthy diet, exercising regularly and taking prescribed medications as directed. Keeping scheduled appointments with your regular primary care provider is also important in helping to manage and maintain your health-related issues to minimize your risk for stroke.

Rachael Miller, RN, is a staff nurse in the Emergency Department and stroke coordinator for Vidant Beaufort Hospital. She can be reached at 252-975-4319.