Stroke Education

What is a stroke?

Your brain is the control center for your whole body. It lets you see, hear, taste, smell, feel, think and move around. Each area has special tasks to do, and some areas work together to get their jobs done. When your heart beats, it sends blood through arteries and veins to every part of your body. Blood carries oxygen to brain cells through arteries in and around the brain. Oxygen keeps the brain cells alive and working well.

Brain cells die when the brain’s blood flow stops or leaks into the wrong place. This is called a stroke. Brain cells that die will not recover (permanent brain damage). Other brain cells are in shock, and will start working again after a while. No one can tell just how long it will take for these cells to begin working again. Most healing happens in the first year, but people may improve their skills for much longer. Also, people may learn new skills to replace the ones they have lost.

Download our Stroke Education booklet

The Stroke Center at Prisma Health aims to reduce the effects of a stroke with quick identification, assessment, treatment and recovery.

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Warning signs of stroke

Any of the following can be a sign of stroke—and they do not all have to happen at once: • Sudden weakness or numbness of the face, arm or leg, mainly on one side of the body • Sudden confusion, trouble speaking or understanding what is said • Sudden trouble seeing in one or both eyes • Sudden trouble walking, dizziness, loss of balance or coordination • Sudden severe headache with unknown cause

If you see any of these signs, BE FAST:
  • B – Balance off /dizziness - Ask the person if they are experiencing sudden loss of balance or coordination.
  • E – Eyes - Ask the person if they have experienced sudden blurred vision, double vision or sudden, persistent vision trouble.
  • F – Face drooping – Ask the person to smile. If the face droops on one side, that is a sign of a stroke.
  • A – Arm weakness – Ask the person to raise both arms. If they cannot hold one arm up, that is a sign of a stroke.
  • S – Speech difficulty – Ask the person to say a few easy words. If they talk like they are drunk (slurred speech) or you cannot understand what they are trying to say, that is a sign of a stroke.
  • T – Time to call 911 – Time is very important. The sooner you get to the hospital, the better your chances are for improving or getting better. If you wait too long, you may get worse or may not get better.

A sudden, terrible headache – the worst ever had – may be a sign of a bleed in the brain and is very dangerous.

If any of these signs happen, call 911 as soon as possible. The ambulance team will call the hospital and tell them your signs. The stroke team will be ready to care for you when you arrive.

Types of stroke

Ischemic (iss-KEE-mik) stroke is caused when a blood clot blocks the blood vessel and prevents blood fl ow to the brain. The brain cells in that area die because they do not get the oxygen and food the cells need. As cells die, things such as speech, the ability to move and memory maybe damaged or even lost. This is the most common type of stroke, with 87 percent of brain attacks being caused by a clot in the brain. It can sometimes be treated with clot-busting drugs.

Hemorrhagic (hem-uh-RAA-jik) stroke is caused when a blood vessel bursts and bleeds into the brain tissue. Bleeding in the brain causes 13 percent of brain attacks. The degree to which a stroke survivor may recover any lost skills depends on the type and what part of the brain was damaged by the stroke. Some people who have had a stroke may get better, while others may have serious problems that never get better.

TIA is a “mini stroke” and occurs when a blood clot blocks a blood vessel for a short time. TIAs usually last only a few minutes. Although symptoms may go away soon, a TIA is a strong sign that a stroke may happen at some point. TIAs are dangerous and should be treated right away. Most people think if the symptoms go away they will be okay, but if left untreated, 25 percent of TIAs result in a stroke within 90 days.

Ask your doctor – What type of stroke did I have?

Stroke diagnosis

It is important to know when a stroke is happening because the treatment of a stroke depends on the cause and location of the stroke. As soon as you get to the hospital, doctors will run different types of tests to discover the cause of the stroke. From these tests, doctors will learn where and how much damage has happened from the stroke. Some of the tests include:

CT Scan (Computerized Tomography) is a test that uses radiation to create a picture of the brain. It is usually the fi rst test ordered for diagnosing a possible stroke.

MRI Scan (Magnetic Resonance Imaging) is a special X-ray machine that uses a large magnetic fi eld to produce a picture of the brain. The picture is sharper and gives more detail than a CT Scan and is often used to show the damaged areas of the brain.

EKG (Electrocardiogram) is a test that measures and records the electrical activity of the heart.

ECHO (Echocardiogram) is a test to fi nd out if an opening in the heart allowed a blood clot to pass through to the brain. It is a type of ultrasound test on the front of the chest that uses sounds waves to give the doctor a picture of your heart.

TEE (Transesophageal Echocardiogram) is a type of ultrasound test inserted in the esophagus (throat). The esophagus sits behind the heart, so the doctor gets a better view of the back of the heart and the left lower chamber of the heart. These areas are harder to see with a standard ECHO.

Carotid Ultrasound uses sound waves to create a picture of the inside of the arteries in your neck to see if there is any blockage located there.

Labs will be drawn on arrival and throughout your hospital stay to guide the treatment plan. These labs will test for many diff erent things, such as your blood sugar levels and blood cholesterol levels.

Treatment of acute stroke

Timing is everything and will affect what treatments are used. Treatment choices can include medications to dissolve the blood clot or surgery to repair blood vessels or remove extra blood or fluid.

Ischemic stroke

Medication – Alteplase, a clot-busting drug, may be given to dissolve the blood clot (This drug MUST be given within three hours of when stroke signs START for you to get the most benefit!)

Surgery – Clot removal devices, such as Solitaire® and Penumbra,® are used to open some clogged vessels (These must be done within eight hours of stroke signs STARTING for them to work.)

Hemorrhagic stroke

Medication – Blood pressure management and/or stop using blood thinners

Surgery – Removal of the blood clot from the brain

Who is at risk?

Risk factors are diff erent for each person. Check the risk factors below that apply to you. Remember that some of your risk factors cannot be changed, but others can be managed or controlled better when working with your health care team.

Risk factors you CANNOT change

Age – Stroke affects all ages, but the older you are the greater your risk of stroke.

Race and ethnicity – African Americans have a higher risk of death and disability from a stroke because they have a higher rate of having high blood pressure. Hispanic Americans also are at a greater risk for stroke due to problems caused by diabetes.

Gender – While more men have strokes each year, more than half of stroke deaths occur in women.

Family history – The risk of a stroke is greater in people whose close blood relatives have had a stroke.

Prior stroke or TIA – Someone who has had a stroke or TIA in the past is at higher risk of having another stroke.

Risk factors you CAN control (personal risk factors)
  • Smoking
  • Diet and exercise
  • High blood pressure
  • High blood cholesterol
  • High blood sugar (diabetes)
  • Atrial fibrillation (irregular heartbeat that can cause clots to form)

Your nurse or doctor will give you information to help you manage your risk factors.

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