According to the US National Stroke Organization, approximately 800,000 people suffer from a stroke each year. Every four minutes a person dies from this disease, but 80% of cases are actually predictable. It is the fifth leading cause of death in the United States and is the leading cause of disability in adults. There are three different types of stroke, which have similar symptoms but require different treatments. During a stroke episode, the blood supply to part of the brain is cut off and the cells are unable to receive oxygen. If normal flow cannot be restored immediately, brain cells are irreparably damaged, resulting in significant physical or mental disabilities. It is therefore essential to learn to recognize the symptoms and risk factors, in order to receive adequate medical intervention during a brain attack.
Steps
Part 1 of 3: Identifying the Signs and Symptoms
Step 1. Look for signs of weakness in the facial muscles or limbs
The patient may be unable to hold objects or may suddenly lose balance when standing. Check for signs of weakness on only one side of the face or body. The subject may lower one side of their mouth when smiling or may not be able to raise both arms above their head.
Step 2. Check if the patient appears confused, has difficulty speaking or understanding speech
When specific parts of the brain are affected, the individual may have trouble speaking or understanding what is being said to him. He may be confused by your words, respond in a way that makes it evident that he has not understood what you have said, mumbling the words or making garbled speeches without meaning. All of this could be very frightening to both you and the patient. Do your best to calm him down after calling the ambulance for immediate help.
Sometimes, some people cannot speak at all
Step 3. Ask the subject if vision in one eye or both is impaired
During a stroke, vision can be affected suddenly and severely. Some patients complain of vision loss or double vision in one or both eyes. Ask the individual if he is unable to see or if he sees double (if he cannot speak, tell him to nod to say yes or no if possible).
You may find that the victim turns their head all the way to the left side to see what's in the left field of view, using the right eye
Step 4. Check for loss of coordination or balance
When people lose strength in their arms or legs, you may find that they have difficulty maintaining balance and coordination. You may not be able to grasp a pen or coordinate movements when walking due to loss of function in one leg.
You may also notice general weakness or one that stumbles or falls suddenly
Step 5. Check for sudden severe headache
Stroke is also referred to as a "brain attack" and can lead to a sudden headache that is described as the worst you can ever have. It is often accompanied by nausea and vomiting due to increased intracranial pressure.
Step 6. Pay attention to a transient ischemic attack (TIA)
This disorder occurs in a similar way to stroke (often referred to as a "mini stroke"), but lasts less than five minutes and causes no lasting damage. However, it is necessary to call the emergency services and must be treated to reduce the potential risk of stroke. In fact, after an episode of TIA, there is a high chance of suffering from a consequent disabling stroke within a few hours or a few days. Doctors believe the symptoms are due to a temporary blockage of the arteries in the brain.
- About 20% of people with TIA will have a more severe stroke within 90 days, and about 2% will suffer from a stroke within two days.
- Over time, those affected by TIA may end up suffering from multi-infarct dementia or memory loss.
Step 7. Memorize the English acronym FAST
The term comes from the English words Face (face), Arms (arms), Speech (spoken) and Time (time) and helps to remember what is important to observe when a person is suspected of having a stroke, as well as the important factor of time.. If you notice the symptoms described above, it is essential to call emergency services immediately. Every minute is of the utmost importance when ensuring the best treatment and a favorable prognosis.
- Face: Ask the victim to smile and see if one side of the face gives down.
- Arms: Ask to raise both arms. Is he able to do it? Does an arm stay down?
- Spoken: Does the subject show aphasia? Can't speak at all? Are you confused by the simple request to repeat short sentences?
- Time: Call for help immediately if you notice these symptoms, you don't have to hesitate.
Part 2 of 3: Treating the stroke
Step 1. Take appropriate action
If you or another person have these symptoms, you need to seek medical attention immediately. All the signs described above are clear indicators of stroke.
- You should contact the nearest emergency service even if the symptoms go away quickly or are not painful.
- Pay attention to the time that elapses from the onset of the first symptom, in order to help the medical staff to define the appropriate treatment.
Step 2. Allow the doctor to take a medical history and medical examination
Even if it is an emergency, the doctor will do a visit and a quick medical history before prescribing tests and treatments. Required tests include:
- Computed tomography. This is a radiological exam that produces a detailed image of the brain immediately after a suspected stroke.
- Magnetic resonance. Allows you to identify brain damage; it can be performed instead of or in addition to computed tomography.
- Carotid ultrasound. It is a painless procedure that shows the narrowing of the carotid arteries. It can help after a TIA episode, when no permanent brain damage is expected. If the doctor finds a 70% obstruction, surgery is needed to avoid a stroke.
- Carotid angiography. Thanks to X-rays, it allows you to visualize the inside of the arteries after inserting a catheter and a dye.
- Echocardiogram. It allows doctors to assess heart health and the presence of known risk factors for stroke.
- A blood test may also be required to look for a low blood glucose level, which in nature appears similar to a stroke, and the ability to clot, which may indicate a high risk factor for a hemorrhagic stroke.
Step 3. Identify the types of stroke
Although the physical symptoms and consequences are similar, there are different types of brain attacks. The doctor will be able to classify the one in progress based on the results of all tests.
- Hemorrhagic stroke: Blood vessels in the brain rupture or leak blood, which is released in or around the brain itself, depending on the specific site where the vessels are located, causing pressure and swelling. This results in damage to cells and tissues. The most common hemorrhagic stroke is intracerebral stroke and occurs within the brain tissue when a blood vessel bursts. Subarachnoid hemorrhage consists of localized bleeding between the brain and the tissue that covers it, precisely in the subarachnoid space.
- Ischemic stroke: This is the most common type and accounts for 83% of diagnosed cases. In this type of stroke, a blockage in an artery of the brain occurs due to a blood clot (also called a thrombus) or arterial buildup (atherosclerosis) which prevents blood and oxygen from reaching brain cells and tissues, reducing the blood flow (ischemia) and consequently causing an ischemic stroke.
Step 4. Prepare for emergency treatment for hemorrhagic stroke
In this case, doctors must act quickly to stop the bleeding. Among the possible treatments are:
- Surgical clipping or endovascular embolization to stop bleeding at the base of the aneurysm, if that was responsible for the stroke.
- Surgery to remove blood that has not been absorbed by brain tissues and to relieve pressure in the brain (common in severe cases).
- Surgery to remove an arteriovenous malformation (AVM), if it is located in an accessible location. An advanced, minimally invasive technique that is used to remove AVM is stereotaxic radiosurgery.
- Intracranial bypass to increase blood flow in some specific cases.
- Immediate cessation of anticoagulant therapy, which makes it more difficult to stop bleeding in the brain.
- Supportive medical care when blood is reabsorbed by the body, such as after a bruise.
Step 5. Prepare for other treatments and medications for ischemic stroke
Both of these approaches are useful for stopping stroke or preventing any brain damage. Some of these options include:
- Tissue plasminogen activator (t-PA) to break down blood clots in the cerebral arteries. The drug is injected into the arm of the victim suffering from a stroke caused by an obstruction. It can be administered within four hours of the start of the attack; the earlier it is given to the patient, the better the prognosis.
- Antiplatelet drugs to stop other clots from forming in the brain and prevent further damage. However, these are medicines that must be taken within 48 hours and can cause greater harm if the person has had a hemorrhagic stroke; therefore it is extremely important that the diagnosis is correct.
- Carotid endarterectomy or angioplasty, if the patient has heart disease. During this procedure, the surgeon removes the inner lining or carotid artery if it is blocked with plaque or if it has become thick and stiff. In this way, the carotid vessels open and allow a greater supply of oxygenated blood to the brain. This is an operation that is performed when the artery is at least 70% blocked.
- Intra-arterial thrombolysis, during which a surgeon inserts a catheter into the groin that reaches the brain, where he can deliver a drug directly to the area around the clot that needs to be cleared.
Part 3 of 3: Identify the Risk Factors
Step 1. Take age into account
This is the most important risk factor when determining the odds of stroke. The risk of a brain attack nearly doubles every ten years by the time the person reaches 55 years of age.
Step 2. Consider possible strokes or TIAs that have occurred in the past
One of the major risk factors consists precisely in previous episodes of stroke or transient ischemic attack ("mini-stroke"). Work actively with your doctor to minimize other risk factors if you already have a history of stroke.
Step 3. Know that women are more likely to die from stroke
Although men are at greater risk of suffering from it, women are more likely to have a fatal stroke. Using birth control pills also increases the risk.
Step 4. Consider atrial fibrillation
It is a fast, irregular and weak heartbeat in the left atrium. This pathology leads to a slowing of blood flow and consequently to a greater risk of blood clots. It is possible to diagnose this disorder through an electrocardiogram.
Symptoms of atrial fibrillation include a feeling of chest throbbing, chest pain, dizziness, shortness of breath and a feeling of exhaustion
Step 5. Pay attention to the presence of arteriovenous malformations (AVMs)
These disorders prevent blood vessels in or around the brain from bypassing normal tissues, thus increasing the risk of stroke. AVMs are often congenital (although not inherited) and occur in less than 1% of the population. However, they are more common in men than women.
Step 6. Get tested for peripheral arterial disease
It is a condition in which the arteries narrow, resulting in a greater number of blood clots that prevent proper blood circulation throughout the body.
- The arteries in the legs are the most frequently affected.
- Peripheral arterial disease is a major risk factor for stroke.
Step 7. Check your blood pressure
When it is high, it puts too much strain on the arteries and other blood vessels. As a result, some points of the vascular walls can easily rupture (hemorrhagic stroke) or they can thin and dilate like a balloon until it protrudes (aneurysm).
Damage to the arteries can also cause blood clots to form which prevent blood from flowing properly, resulting in ischemic strokes
Step 8. Learn about the risks of diabetes mellitus
If you have diabetes, you run a higher risk of stroke due to the health problems associated with the condition. Diabetics also often suffer from problems such as high cholesterol, high blood pressure and other forms of heart disease, all of which can increase the risk of stroke.
Step 9. Lower your cholesterol levels
Hypercholesterolemia is also a risk factor for brain attack; in fact, it causes plaque to build up in the arteries, which can block blood flow and lead to a stroke. Eat a healthy, low-trans-fat diet to keep your cholesterol levels normal.
Step 10. Don't use tobacco products
Smoking damages both the heart and blood vessels; in addition, nicotine raises blood pressure. Both of these factors lead to an increased risk of stroke.
Keep in mind that secondhand smoke also increases the risk of stroke among non-smokers
Step 11. Reduce your alcohol intake
If you drink too much, you can suffer from various conditions, such as hypertension and diabetes, which can lead to an increased risk of stroke.
- Drinking alcohol causes platelets to clump together, which can cause a stroke or heart attack. In addition, alcohol abuse can lead to cardiomyopathy (weakening or failure of the heart muscle) and an abnormality in the heart rhythm, such as atrial fibrillation, which is responsible for the formation of clots that can lead to possible strokes.
- Experts recommend that women drink no more than one alcoholic drink per day, while men drink no more than two.
Step 12. Monitor your weight to avoid obesity
This factor can also cause health problems, such as diabetes and high blood pressure which, as mentioned, can increase the chances of having a stroke.
Step 13. Exercise to keep yourself healthy
Regular exercise can effectively prevent many of the conditions listed above, such as hypertension, high cholesterol and diabetes. Aim to do at least 30 minutes of cardio every day.
Step 14. Consider family origins
Some ethnicities are more prone to stroke than others. This is due to the difference in genetic and physical characteristics. Blacks, Hispanics, Native Americans, and Alaskans are the populations most at risk of stroke, as they are more susceptible.
Black and Hispanic populations are also at greater risk of suffering from sickle cell anemia, characterized by an abnormal shape of red blood cells that makes them more likely to get stuck in blood vessels, potentially increasing the chances of ischemic stroke
Advice
- Memorize the acronym FAST to quickly analyze the situation and get immediate medical attention for the stroke.
- People who suffer from ischemic stroke are more likely to get over the disease if they are treated within the first few hours of symptoms appearing. Treatments can be pharmacological and / or medical interventions.
Warnings
- While TIA does not cause permanent damage, it remains a clear indicator of the possibility of another, more serious stroke or an impending heart attack. If you or a loved one has stroke-related symptoms that seem to resolve within minutes, it is very important that you seek medical attention to reduce the potential risk of a worse problem.
- While this article offers medical information regarding stroke, it cannot replace a medical evaluation. You should always seek immediate professional care if you think you or someone close to you is suffering from a stroke.
