Know the signs of stroke and how to reduce your risk
There are many times in life when it is important to act fast, and one of the times when speed is most critical is when someone is having a stroke.
May is Stroke Awareness Month, and Dr. John Clark, a neurologist with Lawrence Neurology Specialists, said people should take time to learn to spot the signs of a stroke and to reduce their own risk factors.
“I tell my patients the best treatment for stroke is no stroke,” he said. “What that means is to identify and then reduce or eliminate risk factors. The top three risk factors are smoking, diabetes and high blood pressure. Following those top three would be high cholesterol and family history.”
Symptoms of a stroke can include a loss of balance or coordination, face drooping, weakness in the arms, slurred speech, confusion, numbness, trouble seeing or severe headache, according to the American Stroke Association’s website. Clark urged people who noticed symptoms to call 911 immediately.
“Strokes are treated most effectively by seeking medical attention fast — within three hours,” Clark said. “If people who are having a stroke are fast, they are a candidate to receive the clot busting drug tPA, which can significantly improve recovery.”
One of the best ways to identify stroke, Clark said, is simply by your health history and physical examination. However, supporting tests such as an MRI or CT imaging of the brain can help identify risks, too.
“There is often a misconception that strokes always have a devastating ending,” Clark said. “This is not the case. It depends on the size of the stroke and location. If a small stroke affects an area of the brain not controlling functions like speech, strength or sensation, there may be minimal or no symptoms at all. Other patients may have more severe symptoms at the start of the stroke but will recover some of those previous functions with time.”
Clark said the brain has plasticity, meaning portions that are not damaged can take over some of the functions of an area that’s damaged by a stroke. Additionally, there are options that can improve an outcome even more.
“There is a clot retraction technique that can be done in conjunction with tPa that is given … through the vein,” he said. “This combination can improve an outcome significantly.”
One strategy that LMH Health uses for some cases is what Clark called a “drip and ship” treatment.
“If someone comes into our ER with a stroke, we begin treatment at LMH Health immediately,” he said. “If we identify a large clot, we promptly send the patient via ambulance or helicopter to a radiologist at KU Medical Center or St. Luke’s who is specialized to extract the clot causing the stroke.”
Though there are treatment option for stroke, it is important not to delay care. Even if you’re not experiencing pain or discomfort now, you could still see lasting harm from a stroke, Clark said.
“Something patients should know is that having a stroke does not mean you are going to be in pain,” Clark said. He said that certain kinds of strokes, such as when a clot blocks a blood vessel in the deeper regions of the brain like the brainstem, can cause pain, but this isn’t too common.
“Unlike heart attacks, which are commonly associated with chest pain, stroke doesn’t always have pain as a warning sign,” Clark said.
Dr. Sanjeev Kumar, a neurologist who also works at Lawrence Neurology Specialists, said that in the United States alone there are around 800,000 strokes a year. In 77% of those cases, it’s the first stroke the patient has had, and these likely could have been prevented with lifestyle changes.
“Of these hundreds of thousands of strokes, around 90% of them could have been prevented through risk factor modification,” he said. “This includes hypertension, diabetes, atrial fibrillation, dyslipidemia, cigarette smoking, kidney disease, sleep apnea and alcohol intake.”
Kumar said these health concerns can all be addressed by specialists. For instance, if you suffer from sleep apnea or heavy snoring, a sleep specialist may be able to help.
Kumar also emphasized that strokes can affect people across all ages.
“Strokes can affect anybody, even the young,” Kumar said. “In fact, strokes in those less than 50 to 55 years of age are increasing. … Stroke deaths are also higher in non-Hispanic Blacks. We have seen strokes in all age groups, but also in the young due to COVID-19.”
Strokes can cause permanent damage. Kumar said half of all stroke survivors will have a moderate to severe disability afterward. He urged people to be vigilant about stroke risk, stroke identification and getting to the emergency department as soon as possible.
“You lose two million neurons per minute due to stroke,” Kumar said. “One drop of brain loss is equal to one week of life lost, and one second saved to treatment saves 2.2 hours of life.”
There’s also a condition similar to stroke called a warning stroke or a transient ischemic attack (TIA). A TIA has similar effects as a stroke, but it only lasts minutes to hours and leaves no permanent damage. But while TIA might not cause permanent harm, Kumar said it shouldn’t be ignored. Often, those who experience a TIA are more likely to have a stroke in the future. The occurrence of a TIA should be a warning sign to seek attention immediately, intervene early and prevent a future stroke, he said.
“LMH Health is equipped to take care of your stroke needs,” Kumar said. “We have been recertified again this year as a primary stroke center and have three board-certified neurologists who are prepared and ready to care for you. … You are important, and never delay your care.”
— Jessica Brewer is the social media and digital communications specialist at LMH Health, which is a major sponsor of the Journal-World’s Health section.