Around 800,000 Americans suffer with a stroke every year and it results in approximately 130,000 deaths. A stroke is the fourth most common cause of death in the United States. Even in cases which are not deadly, a large proportion of people who suffer with a stroke become physically disabled permanently. Contrary to popular belief, a stroke is not a disease that only affects the elderly. About one-third of people who suffer with a stroke are younger than 65 years of age.
Who is at risk of a stroke?
As with any condition, prevention is the best cure. By understanding what may cause or contribute to a stroke, it is possible to make dietary and lifestyle changes that can prevent a stroke. It is known that a stroke is more likely to occur in a person with one or more of the following risk factors:
- Being overweight or obese.
- High blood pressure
- High blood cholestrol
- Family history of stroke.
- Previous stroke.
- Being male.
- Age 65 years and older.
It is therefore important that any person with one or more of these risk factor be cautious and monitor for early signs of a stroke. However, a person may still have a stroke without any prior warning signs and even without any of these risk factors. Sometimes the only way to know that a stroke may occur soon is to undergo diagnostic investigation that can identify problems like a narrowing of the neck arteries or weakening of the brain arteries.
Major Stroke vs Mini Stroke
A stroke is where a portion of the brain tissue dies due to an interruption of the blood supply to the brain. The disrupted blood supply means that insufficient oxygen reaches the brain to sustain the needs of the brain tissue culminating in tissue death. This is irreversible. Sometimes a stroke is also referred to as a major stroke or massive stroke when it is severe. In these cases the effects of the stroke extremely debilitating and even deadly.
Read more on brain stroke.
Another phenomenon is a transient ischemia attack (TIA). This is also referred to as a mini-stroke which can be misleading. In a TIA the blood supply to the brain is interrupted by only for a short period of time. The signs and symptoms are largely the same as a stroke but it is usually not permanent and a person returns to normal within minutes to hours. A TIA should rather be considered as a warning stroke.
A drooping face is considered to be a characteristic sign of a brain stroke. This is a result of damage to the area of the brain that sends signals through the facial nerve to the muscles of the face. It occurs on one side of the face when it arises due to a stroke.
The drooping may not always be obvious as there may not be complete paralysis of the muscles. A person is asked to smile and if one side of the face does not ‘lift’ upwards as the other side then this confirms facial palsy. It is important to exclude other causes of facial palsy that may not be linked to astroke in any way.
Read more on Bell’s palsy vs stroke.
Arm weakness is another characteristic sign of a stroke and it is also on one side. This type of weakness of one limb is known as monoparesis. In fact this one sided weakness can affect the muscles on any part of the body in which case it is referred to as hemiparesis.
In rare cases there may be weakness of all four limbs (arms and legs) which is known as quadriparesis. The arm weakness may have to be assessed by testing grip strength between the two hands. Another test is to lift both arms above the head and see if one arm drifts downwards.
There are a number of speech problems that arise with a stroke. Slurred speech is one of the most easily identifiable signs. It is similar to the slurring seen with a person who is heavily inebriated as is the case with alcohol intoxication. This is due to problems with controlling the muscles responsible for speech and is known as dysarthria.
The areas of the brain responsible for language may also be affected. A person may find difficulty in expressing themselves which often correlates with confusion. There may be incorrect use of words or difficulty in completing sentences. This is known broadly as aphasia.
There are a number of different visual disturbances that can arise with a stroke. Sometimes this is the earliest sign of a stroke. This can range from dimming of the vision, blurred vision and double vision to tunnel vision and complete loss of vision. It can occur in one eye only or affect both eyes.
Sometimes a person with a stroke may be confused and cannot accurately identify the visual disturbance. There may be difficulty in recognizing faces, seeing objects or differentiating colors but it may not be the visual disturbance alone that is the cause. A person’s ability to recall memories or express themselves may also be responsible.
Confusion and Consciousness
Another common sign of a stroke is confusion that arises suddenly. As discussed above, a person may experience difficulty with a host of different mental faculties from forming complete sentences, identifying people and recalling memories to the inability to express their name, current location or the date.
There is often a change of conciousness and with severe stroke there may be a total loss of consciousness (blackout). This change in consciousness can be very sudden particularly with a hemorrhagic stroke. In fact an alteration in the level of consciousness with no other signs may occur in a stroke.
FAST of Stroke
Always remember the F.A.S.T. of a stroke:
- Face drooping.
- Arm weakness.
- Speech difficulty.
- Time to call emergency medical services.
Another important and useful TIME component is to record the time when the signs were first noticed. It can help doctors decide on treatment options. As with any condition, the sooner medical treatment is sought and commenced, the better the outcome. Never attempt to “sleep off” the symptoms as it can worsen the prognosis and even lead to death which could have been avoided.