Central PA Medicine - Spring 2017 - 17

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First let's discuss stroke. Stroke is relatively
sudden vascular (blood vessel related) damage to the brain. The most common type
of stroke is when there is blockage within a
blood vessel during which oxygen and other
nutrients are unable to reach downstream
brain tissue. A less common type of stroke
is when blood leaks outside of a blood vessel
and causes damage to brain tissue.
According to the American Stroke Association, someone in the U.S. has a stroke
about once every 40 seconds and strokes kill
people in the U.S. about every 4 minutes
(accounting for 1 out of every 20 deaths).
Although this is a very concerning statistic,
modern treatments have resulted in a 30%
decrease in the stroke/death rate. 80% of
people will survive a stroke.
The American Stroke Association advises
everyone to learn to recognize these signs
of stroke:

»
»
»

Sudden numbness or
weakness of the face, arm
or leg, especially on one
side of the body
Sudden confusion, trouble
speaking or understanding
Sudden trouble seeing in
one or both eyes

»

Sudden trouble walking,
dizziness, loss of balance
or coordination

»

Sudden, severe headache
with no known cause

Back to the dinner table: what should you
do for your family member? Call 911. This is
an emergency. In the emergency department,
they will gather information about what
happened and assess any potential stroke
risk factors. They will perform a physical
examination. Based on this information they
will decide whether you have to undergo
a picture of your brain (CT or MRI) and
blood work. After testing, they will share
with you treatment options. Remember, this

The acronym F.A.S.T.
is an easy way to
remember signs
of stroke and what
to do if you think a
stroke has occurred.
F.A.S.T. stands for:

FACE
Ask the person to
smile. Check to see
if one side of the
face droops.

ARMS
Ask the person to
raise both arms.
See if one arm
drifts downward.

SPEECH
Ask the person to
repeat a simple
sentence. Check
to see if words are
slurred and if the
sentence is repeated
correctly.

TIME

If a person shows any
of these symptoms,
time is essential. It is
important to get to the
hospital as quickly as
possible. Call 9-1-1.

is an emergency. Time is brain. The longer
you wait to get treatment, the more brain
tissue you lose.
Three major treatments have led to fewer
people dying from stroke and more people
surviving with less disability: "clot buster"
medicine, surgery to open blood vessels, and
improved hospital care of stroke victims.
Individuals with stroke due to blocked
blood vessels are potential candidates for a
"clot buster" medicine that is given intravenously. This medicine potentially dissolves
the clot blocking the artery, thus allowing
return of blood flow and oxygen to damaged
brain tissue. Some people are candidates
for new surgical procedures during which
a catheter is inserted into a blood vessel,
advanced to the area of blockage, and then
used to actually remove the blockage. These
treatments are only available within hours
of when the symptoms of stroke begin.
Time is brain.
Hospital care for the stroke victim has
advanced significantly as well. These treatments focus on two major themes-doing
everything possible to maximize oxygen and
nutrients getting to the brain, and reducing
potential natural complications of stroke.
This involves a combination of maximizing
things that impact brain function (blood
pressure, oxygen, hydration, sugar, electrolytes, and heart function) as well as use of
medication. There is close monitoring of the
individual in the first days after a stroke as
this is the time when there is best chance
of restoring function and the highest risk
of stroke complications.
As soon as possible, therapy is begun for
the individual in an effort to restore lost
function, and when that is not possible, to
teach the person how to compensate for
lost function.
Of the nearly 7 million stroke survivors
in the U.S., about half will deal with some
component of weakness on one side of the
body. About a third of survivors will have
Continued on page 18
Central PA Medicine Spring 2017 17
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