7 facts about stroke you probably didn’t know
A stroke is a brain emergency, so if a stroke is suspected, call 911 immediately to summon medical help. About one-fifth of strokes happen when a blood vessel bursts. The rest happen when an artery is blocked. The treatment for each type is different, so doctors must quickly determine which type of stroke is happening.
Are you aware of the following facts about stroke?
People having strokes usually are able to hear and comprehend what‘s happening around them. That‘s because the parts of the brain responsible for hearing and comprehension are rarely affected by stroke, explains Upstate stroke neurologist Hesham Masoud, MD. The exam he conducts on patients reveals how much the stroke is affecting comprehension and their ability to express themselves, and he talks to the patients as he conducts the exam, since he knows they can probably hear him.
If doctors believe you are having a stroke, an imaging scan is essential. About 20 percent of strokes happen when a blood vessel bursts. About 80 percent happen because of a blockage to an artery. The treatment for each is very different, so doctors must determine which type of stroke is happening, and fast.
Up to a third of the people who appear to be having strokes turn out to have other medical problems that mimic strokes. Plenty of medical conditions (including seizures or urinary tract infections) cause a person to behave in an unusual way, to have an altered mental status or trouble talking. “Any neurologic deficit that is new is a stroke until proven otherwise,” Masoud says. He implores people to seek emergency care promptly.
A short-term stroke whose symptoms resolve is a harbinger of a larger, more damaging stroke. They may be labeled TIA, transient ischemic attack; RIND, reversible ischemic neurologic deficit; or mini stroke. Regardless, “Any stroke is brain damage, and any stroke needs to be treated,” says Masoud. “If you have a neurologic symptom that is sudden in onset, whether it improves or not is irrelevant to me. I want you to come to the emergency department immediately, and I want you to be worked up for it. If it‘s something minor, you may get your workup as an outpatient in the clinic. You may not need to be admitted. But the first step is not to make that assumption.”
Many people have medical conditions that increase their risk for stroke – but don‘t realize they have these conditions. Two of the biggest are uncontrolled high blood pressure and an irregular heart rhythm. These conditions are sometimes discovered after a person has a stroke, and their treatment becomes important in prevention of additional strokes.
About a quarter of stroke patients may not learn why their stroke happened. The cause may not be readily apparent in 20 percent to 30 percent of patients. Doctors may be able to pinpoint a reason as they care for a patient, but sometimes, especially in younger patients, the cause remains a mystery.
Rehabilitation can make a huge difference in a patient‘s recovery. Masoud often shares brain scans with patients and loved ones to facilitate discussions about the extent of damage. He explains that the length and quality of rehabilitation, and the patient‘s level of engagement, influence how much functional recovery he or she will have. That‘s why early on, he declines to make recovery predictions for individual patients.
While waiting for an ambulance to arrive, be sure the patient keeps breathing and make a list of his or her medications for the medical personnel.
3 ways to help while you wait for the ambulance
If you call 911 because you suspect someone is having a stroke, here‘s what you can do before the paramedics arrive:
Make sure the person continues breathing, and if his or her condition changes, make another call to 911.
Take note of the time the person was last seen behaving normally. Doctors need this information to help determine treatment options.
Assemble a list of the medications the person takes, or collect the medication containers to bring to the hospital.
Source: Nurse Josh Onyan, stroke program manager at Upstate
This article appears in the fall 2018 issue of Upstate Health magazine. For a "HealthLink on Air" interview about stroke with stroke neurologist Hesham Masoud, MD, and stroke program coordinator and nurse Josh Onyan, click here. For an interview about ways to lessen your stroke risk, with stroke nurse Michelle Vallelunga and registered dietitian nutritionist Rebecca Hausserman, click here.