Every 40 seconds, someone, somewhere in the United States, suffers a stroke. According to the American Heart Association (AHA) and American Stroke Association (ASA), stroke is the fifth leading cause of death and the leading cause of adult disability in the U.S., with nearly 800,000 people suffering a new or recurrent stroke each year. It remains the third leading cause of death in Hawai‘i, with more people dying from strokes than from accidents each year.
May is National Stroke Awareness Month, which emphasizes stroke education so people know the risk factors, signs and symptoms. In addition, an update by two major health organizations earlier this year to the guidelines that determine when a patient receives treatment following a stroke could mean more lives saved.
Stroke is a disease that affects the arteries leading to and within the brain. A stroke occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot or bursts (or ruptures). When that happens, part of the brain cannot get the blood (and oxygen) it needs, so it and brain cells die. Stroke can be caused either by a clot obstructing the flow of blood to the brain (called an ischemic stroke) or by a blood vessel rupturing and preventing blood flow to the brain (called a hemorrhagic stroke). A TIA (transient ischemic attack), or “mini stroke”, is caused by a temporary clot. The brain is an extremely complex organ that controls various body functions. If a stroke occurs and blood flow can't reach the region that controls a particular body function, that part of the body won't work as it should.
When a stroke occurs, about 1.9 million brain cells die in just one minute. Recognizing the symptoms of stroke can be potentially lifesaving. Getting medical attention as fast as possible for a stroke can have a huge impact on the outcome and recovery. We always tell people to Act FAST if they believe they are having a stroke.
The word “FAST” is used as an acronym for recognizing stroke symptoms:
F = Face. Does one side of the face droop or is it numb?
A = Arm. Is one arm weak or numb?
S = Speech. Is the speech slurred, unable to talk, or hard to understand?
T = Time. Time to call 911.
Some risk factors for stroke can’t be changed, such as your age, race, sex and family history. However, there are many precursors for stroke within your control. The most common risk factors for stroke are high blood pressure, diabetes, high cholesterol and smoking. These are all controllable with lifestyle changes. However, it’s important to know the signs of a stroke because even if you lead a healthy lifestyle, stroke still can happen to anyone at any time.
When it comes to treatment for stroke, the right care right away can save lives and determine the quality of life for a stroke survivor. Tissue plasminogen activator (tPA) is an FDA-approved clot-busting treatment for ischemic stroke. It needs to be used within three hours of having a stroke or up to 4.5 hours in certain eligible patients. Many people miss this key brain-saving treatment because they don’t arrive at the hospital in time for it, which is why it’s so important to identify a stroke and seek treatment immediately for the best possible chance at a full recovery. Physical removal of the blood clot that causes ischemic stroke, known as a thrombectomy, is another strongly recommended option for treatment. Earlier this year, the American Heart Association (AHA) and American Stroke Association recommended broader access to tPA and that the window for treating acute ischemic stroke via thrombectomy be expanded from six to up to 24 hours in certain patients with clots in large vessels.
Since the new guidelines went into effect in January 2018, we have been able to treat six patients at Pali Momi who, prior to the change, would have had very limited options. Now, we’re seeing patients being discharged within three days almost symptom free, fully independent, walking and returning back to work.
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