Ask the Expert: What to Know about Stroke
SIOUX FALLS, S.D. (May 1, 2007) - Dr. William R. Rossing, member of Neurology Associates of Sioux Falls, and medical director of the Avera McKennan Stroke Center, answers commonly asked questions about stroke. May is National Stroke Awareness Month.The Avera McKennan Stroke Center is the first JCAHO-certified stroke center in the state of South Dakota, and Avera McKennan holds a five-star rating for Clinical Excellence in stroke care from HealthGrades.
Q: In layman's terms, what's a stroke?
A: It's an event in which there's a closure of a blood vessel in the brain that slows or stops blood flow to the brain. This deprives that portion of the brain of oxygen, causing death and damage of those nerve cells. The majority of strokes - 85 percent - are ischemic, or non-bleeding. The remaining 15 percent are hemorrhagic or bleeding strokes, caused by the rupture of a blood vessel or an aneurysm.
Q: What can be the debilitating effects of a stroke?
A: One third of stroke patients die as a result of their first stroke. For those who survive, damage can range from devastating and life changing to very minimal. The vast majority of stroke survivors do improve. That's why aggressive post-stroke rehab is so important.
Q: Is it true that men are at a higher risk?
A: Males are at a somewhat higher risk than females, although it's not a huge split. The main risk factors are uncontrolled high blood pressure, high cholesterol, smoking, diabetes and other vascular issues, such as an abnormal heart rhythm. Interestingly, binge drinking is also a risk factor. Heavy intoxication on a periodic basis can lead to clot formation.
Q: How much does smoking increase my risk?
A: Smoking increases risk two fold.
Q: I'm not even 50 years old. Is it possible for me to have a stroke?
A: We think of stroke as being an old person's disease, but it certainly can occur before age 50. In younger people, congenital heart abnormalities can be the cause. Or, vascular trauma can be brought on by physical activity in sports. Tearing of the arteries in the neck, leading to stroke, can occur in a motor vehicle accident, or even playing tennis.
Q: What symptoms should alarm me?
A: Symptoms of a stroke are rapid in onset. They include interruption of speech; numbness, tingling or weakness in an arm or leg; gait or balance problems; vision problems, such as suddenly becoming blind in one eye; or a severe, unexplained headache with one or more of these other symptoms. If you recognize these symptoms, call an ambulance or get to the Emergency Room as quickly as possible, and note the time when symptoms began. In this day and age, we can intervene with clot-dissolving medications, but we only have a three-hour window in which treatment is most effective.
Q: How fast would the hospital staff take action if I arrived at the ER with stroke symptoms?
A: We have a dedicated stroke team and protocol in place for handling possible strokes. In the first five to 10 minutes, we're doing a physical exam and having blood drawn. Within 25 minutes, we want you in the CT scanner, and within 45 minutes we want that scan back. Our goal is to begin appropriate treatment within 60 minutes.
Q: What if I have stroke symptoms, but they go away?
A: It's probably a TIA, a transient ischemic attack, in which the blockage of brain blood flow resolves quickly and symptoms disappear fully within 24 hours. We consider a TIA to be a warning sign for future stroke. A significant number of patients who have unheeded TIAs will go on to have a stroke in the future. It's unpredictable - it could happen within 48 hours, or in two years.
Q: What can I do to prevent stroke?
A: If you're a smoker, quit. Control your high blood pressure and diabetes, and manage high cholesterol. These are the key things. It's also helpful to eat healthy, maintain a healthy weight and exercise.
