Stroke, also called brain attack, occurs when bloodflow to the brain is disrupted. Disruption in blood flow is caused when either a blood clot or piece of plaque blocks one of the vital blood vessels in the brain (ischemic stroke), or when a blood vessel in the brain bursts, spilling blood into surrounding tissues (hemorrhagic stroke).
Stroke is the No. 3 cause of death, ranking behind diseases of the heart and all forms of cancer. Every year, more than 275,000 Americans die from strokes.
What are the most common symptoms of stroke?
The following are the most common symptoms of stroke. However, each individual may experience symptoms differently. If any of these symptoms are present, call 911 (or your local ambulance service) immediately. Treatment is most effective when started immediately.
Symptoms may be sudden and could include:
• Weakness or numbness of the face, arm, or leg, especially on one side of the body
• Confusion or difficulty speaking or understanding
• Problems with vision such as dimness or loss of vision in one or both eyes
• Dizziness or problems with balance or coordination
• Problems with movement or walking
• Severe headaches with no other known cause
•Sudden nausea, vomiting, or fever not caused by a viral illness
• Brief loss or change of consciousness such as fainting, confusion, seizures, or coma
Transient ischemic attack (TIA), or “mini-stroke”
All of the above warning signs may not occur with each stroke. Do not ignore any of the warning signs; even if they go away, take action immediately. The symptoms of stroke may resemble other medical conditions or problems. Always consult your physician for a diagnosis.
What are the risk factors for stroke?
There are several risk factors for stroke, some of which can be changed, treated or managed medically.
Risk factors that can be changed:
High blood pressure – this is the most important, controllable risk factor for brain attack.
Diabetes mellitus – Diabetes is treatable, but having it increases the risk for stroke.
Heart disease – Heart disease is the second most important risk factor for stroke, and the major cause of death among survivors of stroke.
History of Transient Ischemic Attacks (TIAs) – A person who has had one (or more) TIA is almost 10 times more likely to have a stroke than someone of the same age and sex who has not had a TIA.
High red blood cell count – A moderate increase in the number of red blood cells thickens the blood and makes clots more likely, thus increasing the risk for stroke.
High blood cholesterol and lipids
Lack of exercise, physical inactivity
Excessive alcohol use
Drug abuse (certain kinds) – Intravenous drug abuse carries a high risk of stroke from cerebral embolisms (blood clots). Cocaine use has been closely related to strokes, heart attacks, and a variety of other cardiovascular complications.
Abnormal heart rhythm – Various cardiac diseases have been shown to increase the risk of stroke. Atrial fibrillation is the most powerful and treatable cardiac precursor of stroke.
Cardiac structural abnormalities – New evidence shows that cardiac structure abnormalities including patent foramen ovale and atrial septal defect increase risk for embolic stroke.
Risk factors that cannot be changed:
Age – for each decade of life after age 55, the chance of having a stroke more than doubles.
Race – African-Americans have a much higher risk of death and disability from a stroke than Caucasians, in part because the African-American population has a greater incidence of high blood pressure.
Diabetes – Diabetes is strongly linked with high blood pressure and, although diabetes is a treatable condition, increases a person’s risk for stroke.
History of prior stroke – The risk of stroke for someone who has already had one is many times that of a person who has not had a stroke.
Heredity/genetics – The chance of stroke is greater in people who have a family history of stroke.
The good news is that you can prevent most strokes by controlling your risks; the biggest one being high blood pressure. Talk to your doctor about your personal risk factors and learn how to reduce them through lifestyle changes.
About the writer: Jude Verzosa, MD is an American Board of Internal Medicine certified internist and a hospital medicine physician. He serves as the vice president for the Enumclaw Regional Hospital’s medical staff. He works at Enumclaw Medical Center, part of the Franciscan Medical Group.