The Enid News and Eagle, Enid, OK

April 24, 2013

Stroke: Be prepared to act fast

By Judy Rupp, columnist
Enid News and Eagle

— Stroke comes from a Greek word meaning to be struck down, and that is pretty much what happens. Suddenly, you find yourself unable to walk, talk or even smile as you did before. It is a medical emergency.    

Stroke is the third-leading cause of death in the United States, behind heart disease and cancer. But while the heart attack mortality rate has fallen considerably over the past few decades, stroke deaths have not declined nearly as much. This is probably because Americans are generally less knowledgeable about strokes — what causes them, risk factors, warning signs and possible consequences.    

A stroke is a brain attack. It occurs, in most cases, because normal blood flow to the brain has been blocked because of diseased blood vessels and/or a blood clot. This is known as an ischemic stroke, accounting for about 80-90 percent of cases.    

A stroke can also be caused by an intracerebral or subarachnoid hemorrhage, a sudden rupture of an artery causing a flood of blood either inside the brain or in the space surrounding it.

Risk factors include age, occlusions in the carotid arteries that lead to the brain, uncontrolled high blood pressure, diabetes and atrial fibrillation, an abnormal heart rhythm that increases the risk of blood clots. About 25 percent of stroke survivors will have another within the next five years.    

On the other hand, virtually anyone is vulnerable. Stroke affects more than 700,000 Americans each year, and 25-30 percent have no known cause.    

Being prepared means understanding that a stroke can occur at any time and that it is a major medical emergency requiring rapid action. Symptoms are sometimes dramatic but not always. In fact, the person having a stroke may not know it or may be in denial.    

To help you remember the warning signs, the commonly used acronym is BE FAST.  1] Balance: a sudden loss of balance or coordination.  2] Eyes: sudden loss of vision or change in vision. 3] Face: sudden weakness in the face, sometimes resulting in drooping on one side of the face.  As a test, ask the person to smile. 4] Arms: sudden weakness or numbness of the arms or legs, usually on one side.  5] Speech: may be slurred or you may speak gibberish.  Another test: say a simple phrase and ask the person to repeat it.  6] Time: is of the essence.  If you see or experience any of these signs yourself, call 911 immediately.

Other signs include sudden confusion, dizziness or severe headache with no known cause.

One of the most powerful warning signs is a TIA (transient ischemic attack) or ministroke. This usually involves one of the above symptoms, such as facial weakness or loss of vision that passes within a short time.

Don’t just ignore it or pretend that it hasn’t happened. It may be that a clot has formed in a blood vessel and momentarily blocks blood flow. The clot moves on, but it may encounter another blockage further on down the line. Or another clot may form and cause a blockage.

A ministroke gives your brain cells a break as you head to the emergency room. The risk of a full-blown stroke remains high immediately and for several months or even a year.

If you live alone and know you have a high risk, keep in mind that any sudden deficits caused by a stroke could make it difficult or impossible for you to reach the phone to call 911. Being prepared means keeping a phone close to you. Even if your speech becomes gibberish, the dispatcher might recognize the signs and trace your call to get you the help you need.

For some reason, stroke doesn’t invoke the same fear that is associated with the other two major killers — heart attack and cancer. Yet, of those three, stroke carries the lowest risk of survival. About 15 percent die shortly after the stroke; another 10 percent, within the first year.

The greatest risk of death and serious disability, however, occurs with the least common types, intracerebral hemorrhage and subarachnoid hemorrhage. Pressure in the brain can cause serious damage until it is relieved.

When a patient with an ischemic stroke gets to the hospital quickly enough, clot-dissolving medications can be administered to get blood flowing again. The good news is that nearly a quarter of stroke victims survive with only minor impairments.

Rupp is a certified information and referral    specialist on aging for NODA Area Agency on Aging. Contact her at 237-2236.