More About Stroke
Posted by drbob2 on Jul 6, 2008
Stroke is a mighty big problem in MS and the risk of stroke goes up with high blood pressure, diabetes, hypercholesterolemia, heart disease and arterial disease, all of which are, so far, rampant in our state. The two major types of stroke are ischemic (a plugged up artery to the brain) and hemorrhagic (a blood vessel which bleeds into the brain). About 4 out of 5 strokes are ischemic—and that’s the kind of stroke which can, with current interventions, be most successfully treated IF TREATMENT IS BEGUN WITHIN ABOUT 3 HOURS OF THE FIRST SIGNS OF A STROKE—including:
Sudden numbness or weakness of 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.
What causes a plugged up artery (ischemia) to the brain, or one to the heart, for that matter? Well, high blood pressure, diabetes, and high cholesterol all stiffen and damage our arteries and can lead to the most common cause of stroke, atherosclerosis, (the accumulation, like scale in a pipe, of “atheromas” or fatty plaques, within our arteries). Once damaged, the arteries accumulate plaques which narrow the vessels. Sometimes the greasy plaques act like an irritant and the body calcifies them like little pieces of eggshell, which can flake off. Sometimes they stay cheesy and, like an aged cheddar cheese, can flake off little pieces under stress, like high blood pressure or a sudden spurt of exercise. If a piece of the plaque breaks off, it is called an embolus and the blood flow pushes it downstream until it plugs up a smaller vessel, causing a heart attack if the plugged vessel is in the heart, or a stroke if it is in the brain. If nothing flakes off, the plaque may just crack and leak some of its greasy contents. That causes a blood clot, called a thrombus, to form in the vessel—right where it’s already narrowed by the plaque. It can plug up the vessel right there and cause a heart attack or stroke.
So, an ischemic stroke (about 80% of all strokes) is caused by a plugged up an artery to the brain or within the brain, whether the plug came from somewhere upstream (an embolus) or was formed right where it plugged up the artery (a thrombus).
Back to why it’s important to recognize stroke symptoms as fast as possible. For a limited number of hours, a therapeutic window is open during which those plugs within the blood vessel to the brain can be treated by giving a clot busting medicine—usually an enzyme which activates the body’s own clot dissolver. After just a few hours, the window closes and giving the same clot buster, or thrombolytic agent, loses its effectiveness.
The other type of stroke, a hemorrhagic stroke, is caused by a broken or leaking blood vessel in the brain. It is also important to seek expert care rapidly for this kind of stroke, not because a thrombolytic drug can be used—it is contraindicated here because it might worsen the bleeding—but because bleeding into the brain causes increased pressure and that may need a different type of rapid treatment to keep more brain tissue from being lost.
You can check with www.giveme5forstroke.org/ for more good information about stroke that has been put together by the American Academy of Neurology, the American College of Emergency Physicians, and the American Heart Association/American Stroke Association. Another excellent source of information is available through the University of Mississippi Medical Center at http://www.umhc.com/Health/Content.asp?PageID=P00863 Both will help you recognize the first signs of a stroke and get help fast.
Remember, if you have signs or symptoms of a stroke or see someone who does, call 911!
Tune in to Super Health Mississippi each Tuesday from 9 to 10 AM on the Super Talk Network. You can reach me on air at 888-808-8637 or by email to drbob@superhealthms.com.
Let’s Talk About Stroke
Posted by drbob2 on Jul 6, 2008
In a recent Super Health Mississippi program, Dr. Hartmut Uschmann, a leader in stroke prevention and treatment at the University of Mississippi Medical Center, shared his passion about stroke with me and our audience. Dr. Uschmann is a Neurologist who is Vice Chair of Neurology at UMC and has been very active in spreading the word about stroke here in Mississippi where, deep in America’s Stroke Belt, about 5000 of us have strokes each year.
As with so many health problems, a stroke prevention program is the place to start. Most all of us will benefit from healthier diets (2000 or so calories, 60 grams or less of fats) and regular exercise (walk for 30 minutes 5 times each week). Those of us with high blood pressure need to take our meds and get our pressure to 140/85-90 or less and persons with diabetes are aiming to keep their HbA1c (long term blood glucose) at the target advised by their doctor. For most of us, especially if we are smokers, have high blood pressure, or have diabetes, if our total cholesterol remains over 200 mg/dl (milligrams of cholesterol per one tenth of a liter of blood—about 3 ½ fluid ounces) after we have been faithful to diet and exercise regiment, one of the statin drugs may help get our “bad” LDL-cholesterol down and our “good” HDL-cholesterol up—and lower our risk of ischemic stroke (caused by blockage of an artery to our brain) by about 20%. Since many strokes are at least partially disabling and about 1 stroke in three is fatal, every bit of risk reduction helps.
Now, suppose you suddenly feel or act strangely or someone near you does. Below is a helpful message taken from the website of the National Stroke Association: www.stroke.org –one of several fine organizations dedicated to improving the prevention and treatment of stroke
Stroke Symptoms
If you think someone may be having a stroke, act F.A.S.T. and do this simple test:
ACT F.A.S.T. (for FACE, ARMS, SPEECH, and TIME)
FACE: ASK THE PERSON TO SMILE.—-DOES ONE SIDE OF THE FACE DROOP?
ARMS: ASK THE PERSON TO RAISE BOTH ARMS.—-DOES ONE ARM DRIFT DOWNWARD?
SPEECH: ASK THE PERSON TO REPEAT A SIMPLE SENTENCE.—-ARE THE WORDS SLURRED? CAN HE/SHE REPEAT THE SENTENCE CORRECTLY?
TIME: IF THE PERSON SHOWS ANY OF THESE SYMPTOMS, TIME IS IMPORTANT. —-CALL 911 OR GET TO THE HOSPITAL FAST. BRAIN CELLS ARE DYING.
Stroke Symptoms include:
Sudden numbness or weakness of 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.
If, at any time, even if you wake up with ANY of these symptoms, PLEASE DO NOT TRY TO EXPLAIN THEM AWAY. ACT FAST AND CALL 911. If you are having a stroke, there are interventions that, in some cases, can be done to treat stroke—but they must be done promptly in order to have their best chance of success.
Remember, stroke prevention is the key. If, however you or someone in your family, especially anyone with a diagnosis of high blood pressure, diabetes, coronary (heart) artery or carotid (neck) artery or peripheral (usually leg) arterial disease, or if your cholesterol is high, it why not make a plan with your doctor right now, during business hours, about what to do if you develop one of these symptoms, even if it seems mild to you at first, possibly in the middle of the night. Then you will be less likely to waste time on the phone—you will just call 911 and make every effort to go where your doctor told you that you can be treated promptly for stroke.
Tune in to Super Health Mississippi each Tuesday from 9 to 10 AM on the Super Talk Network. You can reach me on air at 888-808-8637 or by email to drbob@superhealthms.com.