Stroke

A stroke is a medical emergency. Prompt treatment is crucial. Early action can minimize brain damage and potential complications.

The good news is that strokes can be treated and prevented, and many fewer Americans die of stroke now than in the past.

This interruption of blood flow is usually caused by two things: a blockage or by bleeding in the brain.

It is critical that proper blood flow and oxygen be restored to the brain as soon as possible. Without oxygen and important nutrients, the affected brain cells can either be damaged or die within a few minutes. If brain cells die, the patient could experience cognitive and mental disabilities.

The good news is that strokes can be treated and prevented, and many fewer Americans die of stroke now than in the past.

Watch for these signs and symptoms if you think you or someone else may be having a stroke. Pay attention to when the signs and symptoms begin. The length of time they have been present can affect your treatment options:

• Trouble speaking and understanding
• Confusion
• Slurred words or speech that is difficult to understand
• Paralysis or numbness of the face, arm or leg
  • This often happens just on one side of your body. Try to raise both your arms over your head at the same time. If one arm begins to fall, you may be having a stroke.
• Also, one side of your mouth may droop when you try to smile.
• Sudden blurred vision, double vision or trouble seeing in one or both eye
• Sudden severe headache
  • May be accompanied by vomiting, dizziness or altered consciousness
• Stumbling or trouble walking
• Sudden dizziness, loss of balance or loss of coordination

Seek immediate medical attention if you notice any signs or symptoms of a stroke, even if they seem to fluctuate or disappear.

Think "FAST" and do the following:

• Face: Ask the person to smile. Does one side of the face droop?
• Arms: Ask the person to raise both arms. Does one arm drift downward? Or is one arm unable to rise up?
• Speech: Ask the person to repeat a simple phrase. Is his or her speech slurred or strange?
• Time: If you observe any of these signs, call 911 immediately.

Call 911 or your local emergency number right away. Don't wait to see if symptoms stop. Every minute counts. The longer a stroke goes untreated, the greater the potential for brain damage and disability.

If you're with someone you suspect is having a stroke, watch the person carefully while waiting for emergency assistance.

The specialists at Semmes Murphey provide coverage for the majority of hospitals and emergency rooms in the Mid-south region. But the Semmes Murphey Clinic offers an array of state-of-the-art rehabilitation and diagnostic services.

At Semmes Murphey, patients will have a team of stroke specialists to assist in rehabilitation.

First, rapid and accurate diagnosis by a neurologist of the kind of stroke and the exact location of its damage is critical to successful treatment. A neurologist can help with treatment and/or steps to prevent strokes.

Other stroke specialists, including physical therapists, speech pathologists, nutritionists, and occupational therapists, will guide and assist patients through every area or phase of rehabilitation.

Semmes Murphey professionals also employ technical advances, such as digital imaging, microcatheters, microsurgery and minimally invasive surgery to treat stroke problems that were inoperable a few years ago.

The physicians and health care professionals at Semmes Murphey have a number of state-of-the-art technology and treatment advances that benefit patients.

• Neurointerventional procedures for cerebral aneurysm share the advantages of no incision made in the skull and an anesthesia time that is often dramatically shorter than for craniotomy and microsurgical clipping.
• Endovascular microcoil embolization: a needle is placed into a specific leg artery, and a small catheter is inserted. Utilizing x-ray guidance, the catheter is advanced through the body’s arteries to one of the four blood vessels that feed the brain. A smaller microcatheter is fed into the aneurysm, and once properly positioned, a thin wire filament or "coil" is advanced into the aneurysm. The flexible, platinum coil is designed to conform to the shape of the aneurysm. Additional coils are advanced into the aneurysm to close the aneurysm from the inside. This prevents the flow of blood into the aneurysm by causing a clot to form on the inside.

Rehabilitation

Perhaps the most important parts of stroke treatment are recovery and rehabilitation. Most strokes require some variation of each. In some cases, other undamaged areas of the brain may be able to take over functions that were lost when the stroke occurred.

Rehabilitation includes physical therapy, speech therapy, and occupational therapy. This type of recovery can be both long- and short-term and is measured in months to years.

• Physical therapy involves using exercise and other physical means (e.g., massage, heat) to help patients regain the use of their arms and legs and prevent muscle stiffness in patients with permanent paralysis.
• Speech therapy may help patients regain the ability to speak or learn other ways to communicate.
• Occupational therapy may help patients regain independent function and relearn basic skills (e.g., getting dressed, preparing a meal, and bathing).

The Semmes Murphey neurology and rehabilitation team is continually investigating and learning new treatment protocols for the betterment of patient outcomes.

Knowing your stroke risk factors, following your doctor's recommendations and adopting a healthy lifestyle are the best steps you can take to prevent a stroke.

If you've had a stroke or a transient ischemic attack (TIA), these measures might help prevent another stroke. The follow-up care you receive is very important.

Many stroke prevention strategies are the same as strategies to prevent heart disease. In general, healthy lifestyle recommendations include:

• Controlling high blood pressure (hypertension) is one of the most important things you can do to reduce your stroke risk. If you've had a stroke, lowering your blood pressure can help prevent a subsequent TIA or stroke.

Exercising, managing stress, maintaining a healthy weight and limiting the amount of sodium you eat and alcohol you drink can all help to keep high blood pressure in check. In addition to recommending lifestyle changes, your doctor may prescribe medications to treat high blood pressure.

• Lowering the amount of cholesterol and saturated fat in your diet: Eating less cholesterol and fat, especially saturated fat and trans fats, may reduce the plaque in your arteries. If you can't control your cholesterol through dietary changes alone, your doctor may prescribe a cholesterol-lowering medication.
• Quitting tobacco use: reduces your risk of stroke. Smoking raises the risk of stroke for smokers and nonsmokers exposed to secondhand smoke.
• Controlling diabetes. You can manage diabetes with diet, exercise, weight control and medication.
• Maintaining a healthy weight: Being overweight contributes to other stroke risk factors, such as high blood pressure, cardiovascular disease, and diabetes. Losing as little as 10 pounds may lower your blood pressure and improve your cholesterol levels.
• Eating a diet rich in fruits and vegetables: A diet containing five or more daily servings of fruits or vegetables may reduce your risk of stroke. Following the Mediterranean diet, which emphasizes olive oil, fruit, nuts, vegetables, and whole grains, may be helpful.
• Exercising regularly: Aerobic or "cardio" exercise reduces your risk of stroke in many ways. Exercise can lower your blood pressure, increase your level of high-density lipoprotein cholesterol, and improve the overall health of your blood vessels and heart. It also helps you lose weight, control diabetes and reduce stress. Gradually work up to 30 minutes of activity — such as walking, jogging, swimming or bicycling — on most, if not all, days of the week.
• Drinking alcohol in moderation:. Alcohol can be both a risk factor and a protective measure for stroke. Heavy alcohol consumption increases your risk of high blood pressure, ischemic strokes and hemorrhagic strokes. However, drinking small to moderate amounts of alcohol, such as one drink a day, may help prevent ischemic stroke and decrease your blood's clotting tendency. Alcohol may also interact with other drugs you're taking. Talk to your doctor about what's appropriate for you.
• Treating obstructive sleep apnea (OSA): Your doctor may recommend an overnight oxygen assessment to screen for OSA — a sleep disorder in which the oxygen level intermittently drops during the night. Treatment for OSA includes oxygen at night or wearing a small device in your mouth to help you breathe.
• Avoiding illegal drugs: Certain street drugs, such as cocaine and methamphetamines, are established risk factors for a TIA or a stroke. Cocaine reduces blood flow and can narrow the arteries.

This information was provided by the neurology and rehabilitation specialists at Semmes Murphey Clinic. Readers are encouraged to research trustworthy organizations for information. Please talk with your physician for websites and sources that will enhance your knowledge and understanding of this issue and its treatment.