When a stroke happens, every moment counts. That's why it's crucial to recognize the signs, and act quickly.
Every 40 seconds, someone in the United States has a stroke, the Centers for Disease Control and Prevention reports, and stroke is the leading cause of disability. But at comprehensive stroke centers like Novant Health New Hanover Regional Medical Center, advanced treatment is at the ready for all varieties of stroke, from the mildest to the most severe forms.
In this episode of Meaningful Medicine, neurologist Dr. James McKinney discusses how to spot the signs of stroke, what makes the South the "stroke belt," and how Novant Health is delivering comprehensive stroke care to its communities.
Award-winning stroke care.
Maggie McKay (Host): Meaningful Medicine is a Novant Health podcast, bringing you access to leading doctors who answer questions they wish you would ask. From routine care to rare conditions, our physicians offer tips to navigate medical decisions and build a healthier future. I'm your host, Maggie McKay. It's so good to have you here. Welcome, Dr. McKinney.
McKinney: It's great to be here. Thank you for having me.
Host: So today we are going to talk about strokes and before we get started, I'd love to know how neurology became a passion of yours and what made you become a brain specialist?
McKinney: I went to medical school thinking I wanted to be a pediatrician and take care of kids. And then my first semester of medical school, we had a neuroscience class and I didn't have any neurosciences in my undergraduate courses. It was just really intuitive and fascinating to me.
The guy that was our neuroscience professor was Scottish and spoke with this really nice brogue and a lot of my costudents fell asleep during his classes, but I was enthralled. And so from there on, I wanted to be a neurologist.
Host: And did he know that you took that path? Did you ever let him know?
McKinney: No, no, once, uh, we kind of moved on to the clinical rotations, we lost touch.
Host: Mm hmm. And then what made you go on to becoming a brain specialist?
McKinney: So, the two kind of choices are really, when I got down to it, toward the end of medical school, I was thinking either neurology, which it's kind of the medical part of neurosciences and taking care of people with brain, spinal cord, and nerve disorders, or cardiology, which is a heart doctor, and I really liked cardiovascular physiology, so I kind of, you merged the two, and so I'm a vascular neurologist by training, can take care of people that have had strokes and have vascular diseases of the brain.
Host: So let's start with the basics. What is a stroke?
McKinney: There's two big types of strokes. The more common type of stroke, which is about 80% of people, have a blocked blood vessel from plaque buildup or a clot that limits blood flow and oxygen delivery to the brain. And the brain needs oxygen, it needs glucose and sugar to survive.
And so, without that, those brain cells die pretty quickly. And then about 20% of people that have strokes actually have bleeding into the brain from a ruptured blood vessel or ruptured aneurysm.
Host: And the southeast United States is sometimes referred to as the stroke belt? Why is that?
McKinney: If you look at just incidents and mortality of strokes, the southeast part of the United States has the highest incidents in penetration of stroke. There's a lot more people that smoke in the southeast part of the United States, and so that's a big modifiable risk factor.
And then, African American and Black people have higher incidences of stroke and stroke at a younger age. And so there's, we have a lot more African Americans in the southeast U.S. than maybe in some other populations. And so some of those things contribute to having a higher disease burden in our part of the country.
Host: And how can somebody identify a stroke?
McKinney: We teach people BE FAST. B stands for balance. So all of this, any sudden onset of neurological symptoms. So balance difficulty, E stands for eyes. So sudden onset of vision loss in one or both eyes. F stands for face, so a facial droop, ask people to smile and if it's asymmetric. A stands for arms, so you have them hold their arms out and if one side is weak or drifts or they can't lift it at all. And S is for speech, so inability to speak or slurred speech. And then T is time, so we want people to call 911, if they suspect that they have any stroke symptoms.
Host: And why is it so important to not second guess yourself, but instead seek help immediately?
McKinney: All of our treatment options are based on how fast you seek medical attention. So the longer you delay, the more brain cells can die. And the more brain cells die, the more disability that you may have. So the quicker you get medical attention, the more likely you are to save vital tissue in your brain.
Host: So better safe than sorry, right? If you're wrong, whatever, but if you're right, it could save your life.
McKinney: Yeah, absolutely. Our EMS systems do a good job of screening people for strokes and they notify the hospitals that they're inbound with stroke patients so the stroke teams, emergency medicine physicians, can rapidly assess people and determine whether they're having a stroke or not.
Host: The Novant Health New Hanover Regional Medical Center is a comprehensive stroke center. What are the advanced treatments that you offer patients there?