What You Should Know About Strokes

According to The Canadian Heart & Stroke Foundation stroke is the 4th leading cause of death in Canada and is the leading cause of adult neurological disability. Sixty per cent of stroke victims will be left with a disability and a stroke survivor has a 20% chance of having a recurrent event within two years. One-third of stroke victims are under age 65. After age 55, the risk of stroke doubles every 10 years. The average hospital stay for stroke is 37 days versus 11 days for heart attack and the cost to the Canadian economy is $2.5 billion annually.

Strokes come in different flavours, may be slight or severe and can affect different areas of the brain with differing degrees of disability.


What Is A Stroke?

A stroke is a "brain attack". This term originated and was first applied to strokes by Vladimir C. Hachinski, M.D., and John Norris, M.D., world-renowned Canadian neurologists. Brain attack more aptly expresses the need for urgency in seeking immediate medical help when any signs are detected. A stroke is an emergency!

The term "stroke" goes back to the earliest recorded history of the condition when it was considered "a stroke of fate" or "a stroke of God's hand" and was viewed as unpreventable and untreatable according to the U.S. National Stroke Association. This is no longer the case. Modern research into cause and effect has identified preventable risk factors and sparked development of medications to treat the condition. But the success of these medications are directly related, in most case, to the speed with which the brain attack is treated.

In everyday life, blood clotting is beneficial. When you are bleeding from a wound, blood clots work to slow, and eventually stop, the bleeding. But blood clots are dangerous when they block arteries and cut off blood flow. A stroke, or brain attack, occurs when a blood vessel breaks or when a blood clot blocks blood flow to an area of the brain. When this happens it kills brain cells in the immediate area within minutes to a few hours after the stroke starts. The dead cells then release chemicals that set off a chain reaction endangering brain cells in the surrounding area of the brain. Without prompt medical treatment, within about six hours, this larger area of brain cells will also die.

When brain cells die, abilities which that area of the brain once controlled are lost or affected. This includes functions such as speech, movement, and memory. The specifics depend on where in the brain the attack occurs and on the extent of brain cell death. For example, someone who has a small stroke may experience only minor effects such as weakness of an arm or leg. On the other hand, someone who has a larger stroke may be left paralyzed on one side or lose the ability to express and process language. Some people recover completely from less serious strokes, while others die from very severe strokes.

Treating stroke as a brain attack and seeking emergency treatment is crucial. Each minute's delay in seeking medical help adds to the damage and limits the extent of recovery. Too many brain attack victims wait a day or more after the first symptoms appear to assure themselves that something is wrong before seeking help.. By then it may be too late for new treatments to be effective. Acting upon the first warning signs of brain attack provides the greatest opportunity for maximum recovery.

The sudden onset of any of the following symptoms may be a signal that you are having a brain attack. Seek emergency treatment immediately.

  • Numbness or weakness of arm or leg, especially on one side of the body

  • Numbness of the face

  • Confusion or problems speaking or understanding

  • Loss of vision, particularly in one eye

  • Dizziness, loss of coordination

  • Severe headache with no apparent cause


Stroke Prevention

There are some risk factors over which we have no control, but there are also many risk factors associated with lifestyle over which we do have control Most of the steps that we can take to reduce the risk of a stroke (brain attack) relate to cardiovascular fitness. Because stroke is a form of cardiovascular disease, it makes sense that keeping the heart and blood vessels as healthy as possible will influence the odds in our favour. Risk factors such as heart disease, high blood pressure, and elevated blood cholesterol and lipids, must be monitored by a physician on a regular basis. These are factors that can be changed or, at minimum, controlled, by proper medical treatment and appropriate diet and lifestyle modifications.

High blood pressure (hypertension) is the single most important risk factor for stroke. The silent killer, hypertension often has no obvious symptoms. Even mild hypertension, if not adequately treated, increases stroke risk by putting abnormal pressure on blood vessel walls. This may cause a rupture at a weak spot. A physician can prescribe medication which, in conjunction with a healthy diet, helps control hypertension.


What Else Can We Do To Reduce The Risk Factors?

Stop Smoking - Studies confirm that smokers have a higher risk of stroke, regardless of other factors such as age, high blood pressure, or heart disease. The risk declines dramatically within a few years of stopping smoking.

Treat Heart Disease - A variety of heart conditions, including irregular heart rhythms (atrial fibrillation), heart attacks and heart valve disorders, can cause stroke. Treatment of these disorders can reduce stroke risk.

Improve Diet - Consumption of foods high in fat, cholesterol and salt increases the risk for stroke.

Limit Alcohol Intake - Individuals who drink alcoholic beverages (more than two drinks per day) have an increased risk of stroke. Maintain a Healthy Weight - Being overweight strains the heart and blood vessels and is associated with high blood pressure.

Exercise Regularly - There appears to be an inverse relationship between exercise and atherosclerosis, i.e., more exercise is linked to lower levels of atherosclerosis.


Factors Beyond Our Control

Age - The chance of having a stroke increases with age. Two-thirds of strokes occur in persons over the age of 65.

Gender - For reasons that are not yet clear, stroke is 25 percent more common in men than in women.

Race - The incidence of stroke varies among races for reasons that are probably related to genetic factors.

Family or Individual Historyy - A history of cerebrovascular disease in a family appears to be a contributing factor to stroke.


Early Warning Signs

Though many brain attacks occur seemingly without warning, as many as one in every three are preceded by temporary interruptions of the blood flow to the brain called transient ischemic attacks (TIA) They are, in fact, mini strokes with the same symptoms as described earlier. The symptoms are normally present for brief periods of a few minutes to a few hours and may recur over a period of several months or even longer.

TIA is a warning of the potential for a brain attack. Yet, by virtue of the fact that the symptoms are the same as, or similar to, a stroke and disappear in a relatively short time it may breed a false sense of security, contributing to a delay in seeking emergency treatment for a full-fledged stroke.

Any occurrence of the symptoms, however brief requires medical attention. Seek help promptly.


Changing the Perception of Stroke

Myth

  • Stroke is unpreventable

  • Stroke cannot be treated

  • Stroke only strikes the elderly

  • Stroke happens to the heart

  • Stroke recovery continues throughout life

Reality

  • Stroke is largely preventable

  • Stroke requires emergency treatment

  • Stroke can happen to anyone

  • Stroke is a "Brain Attack"

  • Chargeable Customized Managed Care Services