May is National Stroke Awareness Month and the experts would like to remind people to know the signs and symptoms of stroke. Every stroke is a medical emergency because it means that blood flow to part of the brain has been interrupted. Everyone needs to be able to recognize the signs of a stroke and get to a hospital fast because “time is brain.” The longer you wait, the more brain cells could die. Strokes are the fifth leading cause of death in America and a leading cause of adult disability.
Strokes occur when blood flow to an area of brain is cut off. When this happens, brain cells are deprived of oxygen and begin to die. This may sound similar to a heart attack. Sudden bleeding in the brain can also cause a stroke if it damages brain cells. If brain cells die or are damaged because of a stroke, symptoms occur in the parts of the body that these brain cells control. Despite advances in health technology and access to care, strokes are still a major medical concern and education to the public is key to ensure those with symptoms or risks seek immediate medical treatment. Speed of treatment is key to saving brain cells – and your life. Getting the right care is also equally important.
In 2009, stroke was listed as the underlying cause of death in 128,842 persons in the US, resulting in an age-adjusted rate of 38.9 deaths per 100,000 population. The rate was almost twice as high among non-Hispanic blacks (73.6 per 100,000), and the rate of premature death from stroke was also higher among non-Hispanic blacks than their white counterparts (25.0 versus 10.2). Stroke is also more likely to affect people if they are overweight, aged 55 or older, have a personal or family history of stroke, do not exercise much, drink heavily, smoke or use illicit drugs.
The clinical diagnosis of stroke is usually made after the health-care professional performs a history and physical examination. While speed is important in making the diagnosis, it is also important to learn about the circumstances that brought the patient to be seen. For example, the patient just started slurring words about an hour ago versus the patient has been slurring his words since last evening. History may include asking about what symptoms are present, when they began, and if they are improving, progressing, or remaining the same. Past medical history will look for stroke risk factors, medications, allergies, and any recent illnesses or surgeries. Medication history is very important, especially when the patient is taking anticoagulants.
Some of the treatments are directed to prevent life-threatening complications. Many patients with significant stroke deficits may require admission to a rehabilitation hospital and/or longer term nursing facility prior to returning home. Unfortunately, some patients will have had too severe a stroke to be offered that opportunity. Rehabilitation may take weeks and months and usually requires a team approach for success. Physical therapists, occupational therapists, and speech pathologists will coordinate care with the primary health care professional and physical medicine and rehabilitation specialists.
Stroke remains a major killer in the United States and worldwide. In the U.S., 20% of stroke patients will die within a year. However, with the ability to intervene with thrombolytic therapy to reverse the stroke and with more aggressive rehabilitation,the goal is to increase patient survival and function after recovery. Prevention is always the best treatment, especially when the illness can be life-threatening or life-altering.