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What if you are having a stroke?

Snider lgBy Robb Snider, MD, neurologist at the stroke program at Atrium Medical Center.

Q. What should you do if you think you’re having a stroke? How does a mini-stroke differ from a stroke?

A. May is Stroke Awareness Month, so it is an excellent time to learn more about this condition that affects nearly 800,000 Americans every year. Be on the lookout for these signs of stroke:

  • Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
  • Sudden trouble speaking or understanding. The person may have slurred speech or words may not make sense.
  • Sudden difficulty seeing in one or both eyes
  • Sudden loss of coordination or balance, including dizziness
  • Sudden onset of severe headache with no known cause

Sudden is the key to all of these signs. If a person is going about daily activities and notices the sudden, acute changes above, there’s a good chance that stroke is the cause. It’s even possible that the person may not realize that something is wrong because of how stroke can affect the brain. That’s when it’s critical for others to take action.

If you or someone near you is experiencing any of these signs of stroke, CALL 911 IMMEDIATELY. Don’t spend precious time trying to contact your family doctor or a neurologist, don’t ignore the symptoms and don’t let the patient go to bed because there’s no pain. Instead, call for the ambulance to take the patient to the nearest hospital emergency department. The EMS squad will alert the hospital that they’re transporting a possible stroke patient so the emergency physician is ready to treat the patient upon arrival. The emergency physician will contact an experienced neurologist and your family doctor for you.

Time is of the essence for successful stroke treatment. From the time a stroke starts until the patient receives the clot-busting medication called tPA (tissue plasminogen activator), no more than three hours can pass. There’s a lot to be done in those three hours: getting to the hospital, evaluation, blood work and a CT scan. The CT scan lets physicians know whether the stroke’s cause is a blocked artery to the brain (called an ischemic stroke, the most common type) or a burst artery deep in the brain (hemorrhagic stroke). Only ischemic strokes can be treated with tPA to reduce adverse effects and to minimize the chance of permanent disability — but tPA must be given within three hours of the stroke’s onset.

If possible, go to a hospital that’s certified as a Primary Stroke Center by the Joint Commission, the nation’s oldest and largest standards-setting and accrediting body in health care. Primary Stroke Centers are skilled in rapidly evaluating and treating stroke patients and in using tPA appropriately.

A mini-stroke is officially called a TIA, or transient ischemic attack. In a TIA, the symptoms of a stroke come and go within 24 hours. Typically they last a few minutes to a few hours. The TIA is caused by temporary impaired blood flow to the brain that improves, allowing the brain to function normally again. We sometimes refer to this impaired blood flow as the brain “holding its breath.” If the brain “holds its breath” too long, brain tissue dies and a stroke results.

Why does the blood flow return? The body may break up a blood clot on its own, or the body may rush more blood to the brain to overcome low blood flow. Or, if an artery to the brain is blocked, other arteries may work harder to supply the blood the brain needs.

It’s critical to get to the hospital fast when a person experiences any of the signs of a stroke. Only a medical evaluation can determine if the person is having a TIA or a stroke. And only a CT scan can determine whether a stroke can safely be treated with the clot-busting drug tPA. Remember, quick action and quick, effective treatment can reduce or possibly prevent disability.

This information is for educational purposes only. It is not intended to replace guidance from your physician on your specific health needs. Please talk to your physician for advice in all matters related to your health.

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