Guest column: Recognize symptoms, know your risk and prevent stroke

A stroke is referred to as a brain attack because it cuts off vital blood and oxygen to the brain cells that control everything we do - including speaking, walking and breathing. Every year, stroke affects approximately 800,000 Americans; is the fifth leading cause of death; and is a leading cause of disability. One out of four people who experience stroke has a recurrence. The good news, however, is that many strokes can be prevented. Moreover, recent research shows that a decrease in stroke-related deaths is most likely due to stroke prevention efforts nationwide.

Types of strokes

Hemorrhagic stroke accounts for about 13 percent of stroke cases. Hemorrhagic strokes result from a weakened vessel that ruptures and bleeds into the surrounding brain. The blood accumulates and compresses the surrounding brain tissue. The two types of hemorrhagic strokes are intracerebral hemorrhage, when a ruptured blood vessel causes bleeding inside the brain; and subarachnoid hemorrhage, which is bleeding in the space between the brain and the tissue covering the brain.

Ischemic stroke accounts for about 87 percent of all cases. Ischemic strokes occur as a result of an obstruction within a blood vessel supplying blood to the brain. The underlying condition for this type of obstruction is the development of fatty deposits lining the vessel walls, or atherosclerosis. These fatty deposits can cause two types of obstruction:

● Cerebral thrombosis refers to a thrombus, or blood clot, that develops at the clogged part of the vessel.

● Cerebral embolism refers generally to a blood clot that forms at another location in the circulatory system, usually the heart and large arteries of the upper chest and neck. A portion of the blood clot breaks loose, enters the bloodstream and travels through the brain's blood vessels until it reaches vessels too small to let it pass. A second important cause of embolism is atrial fibrillation, which can create conditions where clots can form in the heart, dislodge and travel to the brain.

While a transient ischemic attack, or TIA, is often labeled a mini-stroke, it is more accurately characterized as a warning stroke - a warning you should take very seriously. A TIA is caused by a clot; the only difference between a stroke and a TIA is that with a TIA, the blockage is transient. TIA symptoms occur rapidly and last a relatively short time. Most TIAs last less than five minutes; the average is about a minute. When a TIA is over, it usually causes no permanent injury to the brain.

Know your risk for stroke

Everyone has some stroke risk. A few stroke risk factors are beyond your control, such as being over the age of 55, being a male, being an African-American, having diabetes and/or having a family history of stroke. If you have one of these risk factors, it is even more important that you learn about the lifestyle and medical changes you can make to prevent a stroke. Here are a few important stroke-prevention guidelines from the National Stroke Association:

• Know your blood pressure. If it is elevated, work with your physician to help keep it under control.

• Get tested to find out whether you have an irregular heartbeat, also known as atrial fibrillation. If you have this condition, work with your physician to manage it.

• If you smoke, stop. Smoking doubles the risk for stroke.

• If you drink alcohol, do so in moderation.

• Know your cholesterol number. If it is high, work with your physician to control it.

• If you are diabetic, follow your physician's recommendations carefully to control your diabetes.

• Include exercise in the activities you enjoy in your daily routine.

• Enjoy a lower-sodium, lower-fat diet.

• Ask your physician if you have circulation problems. If so, work with your physician to control them.

Seek immediate medical attention

Stroke is an emergency. For every minute that brain cells are deprived of oxygen during stroke, the likelihood of brain damage increases. If you have any of the following stroke symptoms, call 911 and seek immediate medical attention. The most common stroke symptoms are:

• Sudden numbness or weakness of the face, arm or leg - especially on one side of the body.

• Sudden confusion; trouble speaking or understanding.

• Sudden trouble seeing in one or both eyes

• Sudden trouble walking; dizziness; loss of balance; or coordination.

• Sudden severe headache with no known cause.

Research indicates that patients receiving care at a Primary Stroke Center, such as Northern Arizona Healthcare's Flagstaff Medical Center, have a higher incidence of survival and recovery than those treated in hospitals without this type of specialized care. FMC's stroke team includes full-time neurology coverage, either in-house or via Telestroke with the Mayo Clinic. When stroke patients arrive at FMC's emergency room, Telestroke allows a remote assessment by a stroke specialist via special audiovisual equipment that enables the specialist to observe diagnostic head imaging, cardiac monitors and a patient's performance during a structured neurological examination.

Act F.A.S.T.

According to the National Stroke Association, a person experiencing a stroke can be treated if bystanders act F.A.S.T:

• F - Face: Look for an uneven smile.

• A - Arm: Check if one arm is weak.

• S - Speech: Listen for slurred speech.

• T - Time: Call 911 right away.

As part of Stroke Awareness Month in May, Flagstaff Medical Center is offering a free Stroke Screening event from 10 a.m. to 2 p.m. on Tuesday, May 3, in the lobby of the McGee Auditorium at FMC. Medical professionals will provide free blood pressure checks, glucose checks, BMI measurements and offer dietary and smoking cessation consultations.

For more information on stroke and stroke prevention, access resources available, such as the monthly Stroke Survivor Support Group held at FMC and the Stroke Boot Camp sponsored by Entire Care Rehab & Sports Medicine in Flagstaff. Or contact your doctor. And remember to act F.A.S.T. if you or anyone you know develops symptoms of a stroke. TIME IS BRAIN!

Christine Maher, R.N., B.S.N., B.A., is the STEMI/Stroke Program Coordinator with Northern Arizona Healthcare's Flagstaff Medical Center.

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