Strokes occur when areas of the brain stop receiving blood and oxygen. The affected areas of the brain may die or become severely damaged. All of the bodily functions controlled by that area of the brain will be affected. Sometimes the loss of body function is permanent. Sometimes the function is partially or completely restored over time.
When blood and oxygen are prevented from reaching the heart, we commonly call it a “heart attack.” Because of the similarity, some have proposed calling a stroke a “brain attack.” The most important thing to do when a stroke is suspected is to act fast — VERY FAST.
There are two ways a stroke can occur. Firstly, a blood vessel can become blocked, preventing blood from getting to the downstream area of the brain. This is called an ischemic stroke.
Secondly, a blood vessel can rupture and prevent delivery of blood to the brain tissue downstream. This is called a hemorrhagic stroke. The vast majority of strokes are of the ischemic type.
About one million people suffer from strokes in the U.S. every year. Stroke is one of the leading causes of death and the leading case of long-term disability.
Stroke risk factors
• Age: Your risk for stroke
increases significantly over age 60,
especially if other risk factors listed
below are present:
• Family history of strokes
• Ethnicity: African Americans
have the highest incidence of
stroke over all ethnic groups.
• Personal history of stroke:
30 percent of stroke victims
will have another within five years.
• History of “transient ischemic
attacks” (mini strokes)
• High blood pressure
• Heart disease
• High alcohol consumption
• Sleep apnea
Stroke warning signs
• Sudden changes in vision such as blurry vision or double vision or blockage of your visual field like “someone is pulling a curtain shade down over your eye”
• Sudden numbness or weakness on one side of the body or face
• Sudden trouble in speaking or understanding what others are saying to you
• Sudden severe headache
• Sudden trouble in walking or trying to keep your balance
There is a condition some call a “mini-stroke,” medically called a “transient ischemic attack,” listed in the stroke risk factor list above. These are the symptoms of a stroke that last a few minutes to a few hours and then disappear without any long-term effects, caused by a temporary blockage of one of the blood vessels supplying your brain. These are loud warning signs that you are at risk for a real stroke in the future and should be reported to your doctor immediately.
Effects of a stroke
Some effects of a stroke maybe permanent or they may be recovered partially or permanently over time. These effects may include paralysis, weakness, difficulty talking, difficulty swallowing, changes in vision, difficulty walking, memory changes and loss, personality changes and depression. In a phrase, strokes can be devastating.
Of course the best treatment is prevention. Make sure you are minimizing your risk factors. There are many tests a doctor can do to evaluate your risk. These include a physical exam, blood test, and selected imaging studies.
Sometimes medical treatment or surgical intervention is required to prevent a stroke if blood vessels are found to be blocked or severely restricted (ischemic) or if blood vessels are found to be weak (“ballooned” out) and likely to rupture. If warning signs of a stroke are present, it is time to act FAST (see below).
If a stroke has occurred, the treatment will be based on the type of stroke. Rehabilitation may follow and be long and difficult, but oftentimes worthwhile and rewarding.
Be sure to work with your doctor and get engaged with a support group. Accept help from family and friends. Don’t pity yourself; get out there and keep on living life to the best of your ability.
If a stoke is suspected,
F = facial changes. This includes facial drooping on one side or a crooked, uneven smile when a person is asked to smile.
A = arms. Ask the person to raise their arms to the side and see if they can hold them at the same level without one arm drifting lower.
S = speech. Have them talk and see if they understand your speech, or if their speech is slurred.
T = time. If any of the above is noticed, time is of the essence. Call 911 immediately.
Be sure to discuss with your doctor ways of reducing your risk factors for stroke. Develop and incorporate these recommendations into your personal health plan and review the health plan with your family regularly and with your physician during your yearly check-ups.
And remember, if you suspect someone is having a stroke ACT FAST!
Charles E. Crutchfield III, MD is a board certified dermatologist and Clinical Professor of Dermatology at the University of Minnesota Medical School. He also has a private practice in Eagan, MN. He has been selected as one of the top 10 dermatologists in the U.S. by Black Enterprise magazine and one of the top 21 African American physicians in the U.S. by the Atlanta Post. Dr. Crutchfield is an active member of the Minnesota Association of Black Physicians, MABP.org.