When someone has a stroke, minutes can make a difference.
Stroke happens when a blood vessel that supplies oxygen and nutrients to the brain becomes blocked, often by a blood clot that travels from elsewhere in the body. The longer the vessel remains blocked, the worse the damage may be. Deprived of oxygen, the brain tissue begins to die, and the functions controlled by the dying areas —such as speech, movement or cognitive abilities — can be severely and irreversibly damaged. If enough of the brain tissue dies, the stroke will be fatal.
Immediate medical care is critical to prevent the loss of brain tissue. If the blood vessels can be opened within three to six hours, there is a significant chance of recovery.
“A paradigm shift in the way we manage strokes has occurred during the last few years,” said Frank Coufal, M.D., neurosurgeon and co-director of the Comprehensive Stroke Center at Scripps Memorial Hospital La Jolla. “Our community should be increasingly mindful of this change so that they can take advantage of the new life-saving technologies that are available.”
(In addition to the Comprehensive Stroke Center in La Jolla, three Scripps Health hospital campuses are designated as primary stroke centers, including Scripps Mercy Hospital Chula Vista.)
Know the Symptoms and Act F.A.S.T.
Despite medical advances, stroke is the No. 5 cause of death in the United States, killing nearly 130,000 people a year (128,978). That’s one in every 20 deaths, according to the American Heart Association/American Stroke Association.
The chance of having a stroke approximately doubles for each decade of life after age 55. While stroke is common among the elderly, a lot of people under 65 also have strokes.
The sooner stroke is identified and treated, the better the chances for survival and recovery. If you suspect someone is having a stroke, the American Heart Association/American Stroke Association recommends using the F.A.S.T. test:
• FACE: Ask the person to smile. Does one side of the face droop?
• ARMS: Ask the person to raise both arms. Does one arm drift downward?
• SPEECH: Ask the person to repeat a simple sentence. Does the speech sound slurred or strange?
• TIME: Time is crucial with stroke treatment. If you observe any of these signs — even if the symptoms don’t last –call 911 and get the person to the nearest stroke center or hospital as soon as possible. Make a note of the time when the first symptoms appeared, as this can be important to treatment.
In addition to F.A.S.T. symptoms, other stroke signs can include sudden confusion, problems understanding speech, vision problems in one or both eyes, dizziness or problems with movement or coordination, and severe headache.
New Treatment May Reverse Damage
New proven treatments can minimize or even reverse stroke damage. A procedure known as an embolectomy may be used on patients who have had a major stroke and are treated within six hours of the onset of the stroke. Due to the severity of the stroke, these patients have suffered a significant disability, such as weakness on one side of the body, problems talking or seeing, or loss of movement. In such cases, the physician may be able to insert a long, thin tube called a catheter through the patient’s groin, direct it up to the blocked blood vessel, and deploy a type of stent that immediately opens the blood vessel and attaches to the clot. The physician is then able to remove the clot and immediately restore blood flow to that area of the brain.
“I have seen patients who come in having had devastating strokes – they can’t walk, they can’t talk, they can’t see on one side – and physicians use this device,” said Mary Kalafut, M.D., neurologist and co-director of the Scripps Comprehensive Stroke Center. “The blood flow is restored and they are completely back to normal. This is very exciting technology.”
Technology Offers Insight into Stroke Causes
In some cases, physicians may not be able to determine why patients have had strokes even after they do complete work-ups. Now, a new technology may be able to help. A tiny device – about half the size of a pinkie finger – implanted just beneath the skin of the chest can monitor a person’s heartbeat continuously for up to three years to detect a condition known as atrial fibrillation (Afib), which causes the heart to beat erratically and is a leading cause of stroke. Often, patients with Afib don’t know they have it because it comes and goes, and may not be active during a routine physical. By monitoring patients for several months, this device enables physicians to identify Afib and, if necessary, prescribe blood-thinning medication to prevent blood clots and reduce stroke risk.
Like other types of cardiovascular conditions, stroke risk can be reduced by not smoking, getting regular exercise, eating a heart-healthy diet, maintaining a healthy body weight and keeping blood pressure, cholesterol and blood sugar under control.
“To Your Health” is brought to you by the physicians and staff of Scripps. For more information, please visit www.scripps.org/SNS or call (858) 914-2297.
