An in-depth report on the causes, diagnosis, treatment, and prevention of stroke.
Signs of Stroke
The American Stroke Association advises everyone to learn to recognize these signs of stroke:
- Sudden numbness or weakness of the 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
The acronym F.A.S.T. is an easy way to remember signs of stroke and what to do if you think a stroke has occurred. (The most important is to immediately call 9-1-1 for emergency assistance.) F.A.S.T. stands for:
- FACE. Ask the person to smile. Check to see if one side of the face droops.
- ARMS. Ask the person to raise both arms. See if one arm drifts downward.
- SPEECH. Ask the person to repeat a simple sentence. Check to see if words are slurred and if the sentence is repeated correctly.
- TIME. If a person shows any of these symptoms, time is essential. It is important to get to the hospital as quickly as possible. Call 9-1-1. Act F.A.S.T.
Treatment of Acute Stroke
It is critical for patients with stroke symptoms to get to a hospital as quickly as possible. Patients who are suffering an ischemic stroke may be able to receive a clot-busting drug called tissue plasminogen activator (tPA) to dissolve the clot if they reach a hospital within 3 to 4.5 hours of symptom onset. Ideally, patients should receive the clot-busting drug within 60 minutes of arriving at the hospital. But this treatment window can be extended to 4.5 hours for patients who:
- Are younger than age 80 years
- Are not having a severe stroke
- Do not have a history of stroke and diabetes
- Do not take oral anticoagulant ("blood-thinner") drugs
Recently, so called 'stent retrievers' have been introduced in patients with acute embolic stroke. These devices can be threaded into the blocked artery for removal of the clot or thrombus.
Stroke Prevention for Women
In 2014, the American Heart Association and the American Stroke Association released the first guidelines to specifically address stroke prevention in women. Some of the unique risks that doctors need to consider in women include:
- Migraine with aura, which occurs more frequently in women than men.
- Preeclampsia, a pregnancy-related condition marked by dangerously high blood pressure.
- Oral contraceptive (birth control pill) use, which becomes even riskier for women who smoke, have high blood pressure, or are older.