Stroke

John and Edith were eating dinner one night when John asked Edith a question. She began to answer, but couldn’t speak. John knew something was very wrong. Could Edith have had a stroke? Without waiting, he called 911. The ambulance took Edith to the hospital right away. Emergency room doctors confirmed John’s fear…it was a stroke. But because of John’s quick action in calling for help, Edith got the medical care she needed without delay. She got well quickly, her speech came back, and she’s once again having long talks with John at dinner.

Edith was lucky. Stroke is the third leading cause of death in the United States after heart disease and cancer. It is a major cause of physical and mental disabilities in older adults. And every year, more and more people are affected when they or someone they know has a stroke.

What Is a Stroke?

A stroke happens when blood can’t flow to a part of the brain. When the brain doesn’t get the oxygen and nutrients it needs from the blood, its cells are damaged or begin to die. If brain cells are only hurt, they sometimes can be repaired. But brain cells that have died can’t be brought back to life. This means that the brain may stop sending signals to other parts of the body that control things like speaking, thinking, and walking.

There are two major types of strokes. The most common kind (ischemic) is caused by blood clots or the narrowing of a blood vessel (artery) leading to the brain. The clot keeps blood from flowing into other regions of the brain and prevents needed oxygen and
nutrients from reaching brain cells in these regions. The second major kind of stroke (hemorrhagic) happens when a broken blood vessel (artery) causes bleeding in the
brain. This break also stops oxygen and nutrients from reaching brain cells.

Stroke Is an Emergency. Call 911.

Never ignore the warning signs of stroke.

Call 911 RIGHT AWAY if you see or have any of these warning signs:

• Sudden numbness or weakness in the face, arm, or leg—especially on one side of the body
• Sudden confusion, trouble speaking or understanding
• Sudden problems seeing in one eye or both eyes
• Sudden dizziness, loss of balance or coordination, or trouble walking
• Sudden severe headache with no known cause

DON’T IGNORE THE SIGNS!

The warning signs of a stroke may last only a few minutes and then go away. When this happens, it could be a mini-stroke, which is called a TIA (transient ischemic attack).  This is also a medical emergency that requires attention right away. An unrecognized and untreated TIA can be followed within hours by a major disabling stroke. Always pay attention to any stroke symptoms, even if they are fleeting.

What if it is a Stroke?

Recovery from a stroke is most successful if treatment begins within the first 3 hours after symptoms appear. The clot-busting drug t-PA can greatly lower the damage caused by a stroke, but it must be given within the 3 hour time frame. Getting to the hospital as soon as possible allows time for a CT scan of the brain. This scan will show whether t-PA is the right treatment. Only patients with ischemic stroke, caused by a clot, are candidates for this treatment. The doctor will diagnose stroke based on the patient’s symptoms, medical history, and medical tests that let doctors look closely at the brain to see the type
and location of the stroke.

There are many different ways to help people recover from a stroke. Drugs and physical therapy work to improve balance, coordination, and other deficits from the stroke such
as speech and language problems. Occupational therapy can make it easier to do things like bathing and cooking. Many therapies start in the hospital and continue at home.

A family doctor can provide follow-up care. Progress is different for each person. Some people recover fully soon after a stroke. Others take months or even years. Sometimes the damage is so serious that therapy cannot help at all.

Lower Your Risk of Stroke

Talk to your doctor about what you can do to lower your risk of stroke. Even if you’re in perfect health, follow these important suggestions:

• Control your blood pressure. Have your blood pressure checked often. If it is high, follow your doctor’s advice to lower it. Treating high blood pressure lowers the risk of both stroke and heart disease.
   
• Stop smoking. Smoking is linked to increased risk for stroke. Quitting smoking at any age lowers the risk for stroke as well as for a lot of other serious diseases.
   
• Exercise regularly. Activities such as brisk walking, riding a bicycle, swimming, and yard work lower the risk of both stroke and heart disease. Researchers think that exercise may make the heart stronger and improve blood flow. Before you start a vigorous exercise program, be sure to check with your doctor.
   
• Eat healthy foods. Eat foods that are low in fats, cholesterol, and saturated fatty acids. Include a variety of fruits and vegetables in your daily diet.
   
• Control your diabetes. If you have diabetes, work with your doctor to get it under control. Untreated diabetes can damage blood vessels and lead to a build up of fatty deposits in the arteries (atherosclerosis). This narrows arteries and blocks normal blood flow. A blocked artery will lead to a stroke.

For More Information

The National Institute of Neurological Disorders and Stroke (NINDS), part of the National Institutes of Health (NIH), has a wide range of information.

• National Institute of Neurological Disorders and Stroke
  Information Office
  P.O. Box 5801
  Bethesda, MD 20824-5801
  1-800-352-9424
  www.ninds.nih.gov
   
• National High Blood Pressure Education Program
  NHLBI Health Information Center
  P.O. Box 30105
  Bethesda, MD 20824-0105
  301-592-8573
  www.nhlbi.nih.gov
   
• National Stroke Association
  9707 East Easter Lane
  Englewood, CO 80112-3747
  303-649-9299
  1-800-STROKES (1-800-787-6537)
  www.stroke.org
   
• American Stroke Association
  7272 Greenville Avenue
  Dallas, TX 75231
  1-888-478-7653
  www.strokeassociation.org

For more information about health and aging, contact:

• National Institute on Aging Information Center
  P.O. Box 8057
  Gaithersburg, MD 20898-8057
  1-800-222-2225
  1-800-222-4225 (TTY)
   
• To order publications online: www.niapublications.org
   
• Visit the National Institute on Aging website at www.nia.nih.gov
   
• Visit NIHSeniorHealth.gov ( www.seniorhealth.gov ), a senior-friendly website from the National Institute on Aging and the National Library of Medicine. This website features popular health topics for older adults. It is simple to use, has large type, and a 'talking' functions that reads text out loud.

National Institute on Aging
U. S. Department of Health and Human Services
Public Health Service
National Institutes