Friday, January 27, 2012

Get Smart with Stroke

Dr. Steve M. Cordina, assistant professor of neurology at the University of South Alabama College of Medicine and medical director for the USA Stroke Center, said it is very important to take immediate action at the first sign of stroke.

Stroke is the third leading cause of death in the United States and the leading cause of serious, long-term disability. On average, someone in the United States has a stroke every 40 seconds.

According to Dr. Cordina, there are two common types of stroke. “An ischemic stroke results when there is a blockage in the blood vessels to the brain,” he said, “and a hemorrhagic stroke is caused by spontaneous leaking blood vessels in the brain.”

In a transient ischemic attack (TIA), or “mini stroke,” stroke symptoms last less than 24 hours and usually do not lead to damage. “A TIA is a warning sign that a stroke could occur soon,” Dr. Cordina said. “Five percent will have a stroke within the next two days, while 10-20 percent will have a stroke within the next 90 days.”

Dr. Cordina said everyone should be aware of risk factors for stroke. Modifiable risks of stroke include hypertension, high cholesterol, sleep apnea, diabetes, smoking, being overweight, lack of exercise, heart disease, and carotid and vertebral artery disease.

Non-modifiable risks of stroke include age, race, sex, previous stroke or TIA, or family history of stroke.

“It is important not to ignore risk factors,” Dr. Cordina said. “Even though they may not bother you for a long time, they can lead to a major stroke.”

Patients may be eligible to undergo endovascular treatment of an ischemic stroke “blockage” – the most common type of stroke. If given within four and a half hours of the start of symptoms, a clot-busting drug called tissue plasminogen activator (tPA) may reduce long-term disability.

Dr. Cordina urges everyone to learn the warning signs and call 9-1-1 at the first sign of stroke.

“Every minute, millions of neurons die in the stroke patients,” he said. “Time is brain. The faster you get to the hospital, the higher chances of recovery.”        

What are the stroke warning signs? •sudden weakness or numbness of the face, arm or leg, especially on one side of the body
 •sudden confusion
 •trouble speaking or understanding
 •sudden trouble seeing in one or both eyes
 •sudden trouble walking
 •dizziness, loss of balance or coordination
 •sudden, severe headache with no known cause

How do I know to call 911?
Use the FAST test (facial, arm, speech test)
 •Facial - Look for facial droop. Normally, both sides of the face should move equally. It is abnormal for one side of the face to not move at all.
 •Arm drift – Normally, both arms move equally or not at all. It is abnormal for one arm to drift.
 •Speech – Look for abnormal speech. If they are unable to speak or understand, it could be a stroke. Ask the person to repeat a sentence.
Dr. Cordina recently gave an overview of stroke at the December Med School Café lecture. To view the lecture in its entirety, click here.