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Stroke

Stroke is the third leading cause of death in the United States and a leading cause of serious long-term disability. Understanding the factors that increase your risk for stroke may help you prevent one. Recognizing the symptoms and seeking early diagnosis and treatment may improve your chances of complete recovery.

A stroke occurs when the blood supply to part of the brain is suddenly interrupted or when a blood vessel in the brain bursts, spilling blood into the spaces surrounding brain cells. Brain cells die when they no longer receive oxygen and nutrients from the blood, or when there is sudden bleeding into or around the brain. The abrupt interruption of constant blood flow to the brain causes loss of neurological function.

The interruption may be caused by a blockage (ischemic stroke) or by bleeding in the brain (hemorrhagic stroke). About 80 percent of all stroke cases are ischemic. Stroke may occur suddenly, with little or no warning, and the results can be devastating.

Ischemic stroke is linked to narrowing of the arteries. Fat, cholesterol and other substances collect on the artery walls, forming a sticky substance called plaque. A clot may form in an artery that is already narrow, causing a thrombotic stroke, or a clot may break off from a blood vessel in the brain, or from another part of the body, and travel to the brain, causing a cerebral embolism, or an embolic stroke.

If you experience any of the warning signs of stroke, call 911 and seek emergency care immediately. As a dedicated Joint Commission Primary Stroke Center with Disease Specific Certification, Trinity Mother Frances Healthcare System streamlines the diagnosis and treatment process to ensure that stroke patients receive fast, aggressive care.

Common Symptoms

The symptoms of stroke include any of the following:

  • Sudden numbness or weakness, especially on one side of the body
  • Sudden confusion or trouble speaking or understanding speech
  • Sudden trouble seeing in one or both eyes
  • Sudden trouble with walking, dizziness or loss of balance or coordination
  • Sudden severe headache with no known cause


Diagnosis

Patients benefit from the care provided at Trinity Mother Frances Hospital’s Level II Trauma Center and its state-of-the-art brain imaging capabilities, including MRI and CT, functional MRI and interventional neuroradiology. Advanced diagnostic techniques allow our stroke team to precisely identify, localize and determine the cause of the stroke to ensure that the best possible evidence-based treatment is administered.

Your doctor will do the following:

  • Check for problems with vision, movement, feeling, reflexes, understanding and speaking. The exam will be repeated over time to determine whether your stroke is getting worse or improving.
  • Listen for an abnormal sound, called a “bruit,” using a stethoscope to listen to the carotid arteries of the neck
  • Check your blood pressure


Tests that can help your doctor determine the type, location and cause of the stroke and rule out other disorders include:

  • MRI to determine size and location of bleed
  • Angiogram of the head to show which blood vessel is blocked or bleeding
  • Carotid duplex (ultrasound) to show if the carotid arteries in your neck have narrowed
  • CT scan of the brain to determine the type of stroke
  • Echocardiogram to diagnose an irregular heartbeat and determine if the stroke could have been caused by a blood clot from the heart
  • Magnetic resonance angiography (MRA) or CT angiography to check for abnormal blood vessels in the brain


Lab tests also aid in diagnosis, including bleeding time; blood cholesterol and sugar; blood-clotting tests (prothrombin time or partial thromboplastin time); and a complete blood count.

Treatment

A stroke is a medical emergency. Immediate treatment can save lives and reduce disability. Call 911 and seek emergency medical care at the first sign of a stroke.

It is very important for people with stroke symptoms to get to a hospital as quickly as possible. If the stroke is caused by a blood clot (ischemic stroke), a clot-busting drug (tissue plasminogen activator or tPA) may be given to dissolve the clot. In most cases, patients must reach the hospital within 3 hours after the symptoms begin to receive tPA.

Treatment depends on how severe the stroke was and what caused it. Most people who have a stroke are hospitalized for a period of time. The Neuroscience Institute’s 50-bed stroke unit provides acute and step-down care 24/7 delivered by an interdisciplinary team of specialists and subspecialists.

Other treatments depend on the cause of the stroke:

  • In some cases, a stroke team and skilled interventional radiologists may be able to use angiography to highlight the clogged blood vessel and open it.
  • Aspirin or clopidogrel (Plavix) may also be used.
  • Other medicine may be needed to control symptoms such as high blood pressure.
  • If bleeding occurred (hemorrhagic stroke), surgery is often needed to remove blood from the brain and repair damaged blood vessels.


Nutrients and fluids may be needed, especially if the person has trouble swallowing. These may be given through a vein (intravenously) or a feeding tube in the stomach (gastrostomy tube). Swallowing problems may be temporary or permanent.

Physical therapy, occupational therapy, speech therapy and swallowing therapy will all begin in the hospital, and typically continue on an outpatient basis after discharge. The goal of treatment after a stroke is to help you recover as much function as possible and prevent future strokes.

The recovery time and need for long-term treatment differs for each person. Problems moving, thinking and talking often improve in the weeks to months after a stroke. Many people who have had a stroke continue to improve in the months or years after the stroke.

A Word About Stroke Risk Factors

High blood pressure is the number one risk factor for stroke. Other major risk factors are:

  • Atrial fibrillation
  • Diabetes
  • Family history of stroke
  • High cholesterol
  • Increasing age, especially after age 55
  • Race (African Americans are more likely to die of a stroke)
  • Heart disease or poor blood flow to the legs caused by narrowed arteries


The risk of stroke is higher in people who live an unhealthy lifestyle by:

  • Being overweight or obese
  • Drinking heavily
  • Eating too much fat or salt
  • Smoking
  • Taking cocaine and other illegal drugs



Source: National Institutes of Health

For More Information

National Institutes of Health

Stroke Aware
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