A stroke happens when a blockage or abnormality in an artery causes a lack of blood flow to the brain. When it comes to treating stroke, minutes matter.
“There really is no rhyme or reason to when a stroke can happen,” said Dr. Carlene Kingston, stroke medical director at Novant Health Presbyterian Medical Center in Charlotte, North Carolina. “It’s critical to recognize the signs and symptoms and seek treatment as soon as possible, because for every minute a stroke is left untreated, up to 2 million brain cells die.”
Recognize the signs
Kingston said that any neurological symptom can be a sign of a stroke, but the most common stroke symptoms are easy to remember if you just think F.A.S.T.
- F acial droop: One side of the face droops or feels numb.
- A rm weakness: Weakness or numbness on one side of the body.
- S peech difficulty: You have trouble expressing or understanding speech.
- T ime to call 911: If you experience any of the symptoms above, call emergency services.
“If your body was working one second, and then the next second something’s not working – you can’t get your arm or leg to move, you can’t think straight, you can’t recall simple things – that might be because of a stroke,” Kingston said.
She noted that most strokes are not associated with pain, which often leads people to believe they’re fine, and they wait for the symptoms they’re experiencing to pass. However, with each passing minute, brain cells are dying that will never be recovered.
“The most frustrating thing for me as a stroke specialist is that folks will stay home with their symptoms,” Kingston said. “They’ll notice that one part of their body isn’t working, and their first call is to their primary care doctor or their spouse. That is never the answer. The answer is to call 911.”
In treatment, time matters
When treating a suspected stroke, hospitals coordinate with emergency responders to ensure that patients get care as quickly as possible, even before you arrive to the hospital.
“The EMTs (emergency medical technicians) on the ambulance alert the emergency room that the stroke patient is coming and a whole care team is mobilized. The emergency room staff, pharmacy, lab technicians, radiology and a neurologist will be waiting to confirm the diagnosis and administer the appropriate treatment as quickly as possible after the patient arrives,” Kingston said.
There are two kinds of stroke: ischemic (caused by blood clots) and hemorrhagic (caused by brain bleeding). Treatment varies according to which kind of stroke you have, but time is of the essence with both types. According to the American Stroke Association, patients treated within three hours of a stroke have improved chances of recovery.
The national standard for treating ischemic strokes is to administer what is called a tissue plasminogen activator, or tPA, a clot-busting medication that can potentially reverse the symptoms of stroke, within 60 minutes of a patent’s arrival at the ER. According to Kingston, the drug is given within 45 minutes, 50 percent of the time, at Novant Health Presbyterian Medical Center.
“The faster the medication is administered, the better the outcomes for our patients,” Kingston said. “Your job is to get here. If you get here when your symptoms start, the likelihood of you surviving and not having any disability is high.”
Endovascular procedures to remove the clot can also be used in the case of ischemic strokes, but only after tPA has been administered successfully.
Hemorrhagic stroke is typically treated using minimally invasive endovascular procedures or surgery to stop bleeding in the brain.
Recognize your risk
Although 80 percent of strokes are preventable, according to the American Stroke Association, Kingston says that it’s not accidental that stroke is the fifth-leading cause of death in the United States. Many Americans have multiple risk factors that increase their risk of having a stroke in their lifetime.
The following conditions all contribute to your stroke risk:
- High blood pressure
- Cigarette smoking
- Heart disease
- Peripheral artery disease
- High cholesterol
- Poor diet
If you have one or several of these conditions, talk to your doctor about how to lower your risk.
Some patients may experience transient ischemic attacks (TIAs), or “warning strokes," that produce stroke-like symptoms but no lasting damage. A person who's had one or more TIAs is almost 10 times more likely to have a stroke than someone of the same age and sex who hasn't.
“You never know if your next stroke is going to be a major event, so a TIA should be considered a medical emergency and followed up immediately with a health care professional,” Kingston said.
Age may not matter
“Traditionally, stroke has been thought only to happen to older folks,” Kingston said. “It all depends on your risk factors. Strokes are affecting people as young as in their teens, and it’s not uncommon for me to have a patient who’s in their 20s who comes to the hospital with a stroke.”
This was true for Chris Lyons, a 29-year-old patient who was rushed to the hospital one Thursday morning in April when his girlfriend recognized that something wasn’t quite right.
“I noticed my arm didn’t really feel like my arm anymore,” Lyons said. “I tried to push myself up onto the couch, but my leg wasn’t really working, either.” Although he felt no pain, his speech was slurred, and his limbs were numb. His girlfriend knew this behavior was not normal, so she dialed 911.
According to Kingston, since the person having the stroke often does not feel pain, strokes are often found when a spouse, friend or family member notices that something is different about their loved one, such as slurred speech or a face that is drooping.
An ambulance arrived to take Lyons to the ER where Kingston and her team began to treat his stroke. He received tPA and acute endovascular intervention, meaning a small catheter was used to remove the blood clot.
“Thankfully, he got to us early enough that there were no long-lasting effects from his stroke,” Kingston said. “Had he arrived later or not come at all, it could have been much worse.”
Lyons said he is thankful to be alive today, with the only reminder of his stroke being poor vision in his right eye. “I never thought it would happen to me, being 29,” he said. “I feel like I definitely got a second chance.”
To learn more about treating stroke, click here.
Watch as Chris Lyons shares his story.