A stroke is a serious, often life-threatening condition that occurs when the blood supply to the brain is interrupted. In 2019, strokes killed about 150,000 Americans - one person every 3.5 minutes. They're not limited to middle-aged or older adults. Statistics show about 10% of strokes occur in people under 50. Hailey Bieber, a 25-year-old model, and wife to pop star Justin Bieber, experienced a mini-stroke. Similarly, Sharon Stone had a stroke when she was 43 in 2001. Even before Hailey Bieber made headlines, medical professionals warned young people about the risks and urged them to be aware of the signs.
What is a Stroke?
A stroke, also known as a cerebrovascular accident (CVA), is a serious, often life-threatening medical condition that occurs when the blood supply to the brain is interrupted. A stroke can be caused by a blocked or ruptured blood vessel in the brain, a blood clot elsewhere in the body that travels to the brain, an abnormal heart rhythm that leads to blood clots that then travel to the brain.
Different Types of Strokes
There are three main types of strokes: ischemic, hemorrhagic, and transient ischemic attack (TIA).
These account for most strokes and occur when a blood vessel that supplies blood to the brain becomes blocked by a blood clot. An ischemic stroke can also occur when a clot forms in another body part and travels to the brain.
A hemorrhagic happens when a blood vessel in the brain ruptures and spills blood into the surrounding tissue.
A transient ischemic attack (TIA) is often called a mini-stroke, but it's a warning sign that a stroke could happen soon. A TIA occurs when a blood clot temporarily blocks blood flow to the brain. TIAs last a short time and don't cause permanent damage. But you should take it seriously because about one-third of people with TIA will have a stroke.
What Causes a Stroke?
High blood pressure is the leading cause of stroke and the most important controllable risk factor. Other controllable risk factors include:
- High cholesterol
- Heart disease
- Blood disorders that increase clotting
- Illegal drug use, especially cocaine
- Excessive alcohol consumption
- Poor diet
- Atherosclerosis (hardening of the arteries)
- Sedentary lifestyle
- Family history of stroke
- Previous stroke or TIA
Also, age, gender, and race/ethnicity play a role. African Americans have a much higher risk of stroke than whites, and the risk increases with age. Men are also at a higher risk than women, although this gender gap has been closing in recent years.
What Are the Signs of a Stroke?
The symptoms of a stroke depend on the area of the brain that's affected. They can appear suddenly and may include:
- Numbness or paralysis (can't move part of the body)
- Confusion or trouble speaking or understanding others
- Trouble seeing in one or both eyes
- Difficulty walking, dizziness, or loss of balance or coordination
- Severe headache with no known cause
If you experience any of these symptoms, you must get medical help immediately. When calling 911, describe the signs and ask to be taken to a hospital equipped to handle strokes. The faster a person receives treatment for a stroke, the less damage is likely to occur. Julie Chin, a lucky news anchor in Tulsa, is fine today because of the quick action taken by colleagues when she suffered a stroke on air.
How is a Stroke Diagnosed?
If you or someone else has symptoms of a stroke, call 911 immediately and go to the nearest emergency room. Doctors will ask about your medical history, do a physical exam, and order tests to diagnose a stroke.
Tests used to diagnose a stroke and find out what's causing it may include:
- An angiogram to see if there are blockages in the arteries leading to the brain
- A Doppler ultrasound to check for blockages in the major arteries
- A blood test to check for clotting problems or bleeding disorders
These tests can help doctors determine which type of stroke you've had and what treatment will be most effective.
How is a Stroke Treated?
Treatment for a stroke depends on your type of stroke and its severity.
If you have an ischemic stroke, the most common treatment is an oral anticoagulant. Also, you may receive a "clot-busting" drug called tissue plasminogen activator (tPA). If given within three hours of the start of symptoms, tPA can dissolve the clot and improve blood flow to the brain. It may also reduce the long-term effects of the stroke.
Another potential treatment is a procedure called endovascular thrombectomy. This involves threading a small tube through an artery in the leg up to the blockage in the brain. A device is then used to remove the clot. This procedure must be done within six hours of the start of symptoms for it to be effective.
If you have a hemorrhagic stroke, you may need surgery to remove the fresh blood and relieve the pressure on your brain. You may also need medication to control bleeding or lower your blood pressure.
Transient Ischemic Attack (TIA)
The mini-stroke treatment is similar to ischemic stroke treatment with an oral anticoagulation medication. You will also need to prevent future strokes.
Preventing a Second Stroke
If you've had a stroke, you're at a higher risk of having another one. Up to one-third of people with the first stroke will have another within five years. But there are things you can do to reduce your risk:
Control your blood pressure
High blood pressure is the leading cause of stroke, so it's essential to keep it under control. Your doctor can prescribe medication and make lifestyle recommendations to help you lower your blood pressure.
Manage your cholesterol
High cholesterol contributes to atherosclerosis, the buildup of plaque in your arteries. This can lead to a stroke. Your doctor may prescribe medication to help control your cholesterol.
Eat a healthy diet
Eating plenty of fruits, vegetables, and whole grains can help reduce your risk of stroke. You should also limit salt, sugar, saturated and trans fats, and red meat.
Getting regular exercise can help lower your blood pressure and cholesterol. It can also help you maintain a healthy weight.
Other lifestyle changes that can help reduce your risk of stroke include managing stress, getting enough sleep, and controlling diabetes.
What are The Long-Term Effects of a Stroke?
The long-term effects of a stroke depend on the part of the brain that was affected. Some people recover completely, but others may have permanent disabilities.
Common long-term effects of a stroke include:
Paralysis or loss of muscle movement:
This is often the most disabling effect of a stroke. It can occur on one or both sides of the body and range from mild weakness to complete paralysis.
Problems with vision:
Strokes can cause vision problems, such as blurred vision, double vision, or complete blindness.
Problems with speech and language:
Strokes can cause difficulty speaking or understanding others. You may also have trouble reading or writing.
Strokes can cause memory problems, such as forgetting recent events or the names of people you know.
Regular primary care is one of the best ways to prevent a stroke. This means visiting your clinician yearly for a check-up, even if you feel healthy. Annual screenings can help catch health problems early on when they're often easier and less expensive to treat. If you don't have health insurance, there are other options. You can see a clinician without insurance through Antidote Health.