Can there be good news about stroke?  

Stroke—an interruption of the blood flow in the brain—has dropped from the fourth leading cause of death in the U.S. to the fifth. It’s still a serious and frequent emergency—one occurs in the U.S. every 40 seconds – but medical advances mean that more and more people are saved, and the faster the treatment, the better the chances.

The first line of defense is up to you. Knowing what to do when stroke is suspected can literally mean the difference between life and death. Getting help quickly could not only be life saving, it could mean you or your loved one won’t have to spend months in a rehab facility re-learning how to walk and talk.

More good news as of 2018: the ”window” of time to get a treatment that busts the clot (the cause of most strokes) has been extended, according to the newest guidelines from the American Heart Association/American Stroke Association. Plus, a medication that dissolves clots may help more people than doctors previously thought.

If a stroke is even suspected, “get to the hospital as quickly as possible,”  says Doojin Kim, MD, associate professor of neurology at the David Geffen School of Medicine, UCLA and medical director of the Stroke Program, Santa Monica-UCLA Medical Center. Once there, the health care team can consider which treatment is best.

• Mechanical clot removal, first recommended in 2015, can now be considered up to 24 hours after the stroke begins, Dr. Kim says. The previous window was 6 hours. Called a mechanical thrombectomy, the procedure involves threading a catheter through an artery in the groin up to the brain where the clot is. A wire cage device or stent opens inside the blood vessel and grabs the clot. The stent and clot are both removed. It can be lifesaving, but ”these devices can only be used in certain size vessels,” Dr. Kim says. The stent may not fit in a smaller vessel, he says.
• An IV medication, alteplase, has been around since 1996. It is FDA approved to dissolve clots. It’s also called tPA, for tissue plasminogen activator.  In the latest guidelines, doctors are encouraged to consider more patients than in the past for this treatment. For instance, it may be considered now for milder strokes. The time window for its use is now within 3 to 4 ½ hours after the stroke begins.
• Hemorrhagic strokes occur when a blood vessel ruptures and blood spills out. Usually high blood pressure is the cause, but sometimes hemorrhagic strokes occur when the vessels swell and bulge or when blood vessels in the brain tangle up. For these strokes, a doctor may be able to  guide a catheter up into the brain and use a coil to stop the bleeding or do surgery on the blood vessel.

Recognizing a Stroke

The biggest mistake patients and loved ones make, Dr. Kim says, is thinking positive, that the symptoms will go away or that they are due to something else. Thinking FAST is crucial, and that is the American Stroke Association’s easy way to recognize stroke and get help.

• Face drooping
• Arm weakness
• Speech difficulty
• Time to all 9-1-1.alth

Dizziness can be another symptom, Dr. Kim says, and it’s often brushed off as something minor. Other symptoms include a severe headache, vision problems, balance issues and confusion. Be suspect of anything that is not normal for that person, he says, and always err on the side of caution.

Reducing Your Risk

You can lower your risk of becoming a stroke statistic by:

• Keeping blood pressure and cholesterol at healthy levels
• Being screened for diabetes
• Keeping blood sugar under control if you have diabetes
• Not smoking

Getting Stroke Smart

Ten minutes of reading and viewing can make you stroke smart.

• Medicare has posted this video with more info on stroke awareness.
• Additional symptoms are listed here.

Could pizza be part of your stroke prevention plan?  Could be, according to this story from the archives.

Share Your Stoke recovery story

Have you or a loved one recovered from a stroke? Please share your story in our comments section below. Tell us how you persevered and what helped you succeed so you can inspire others.