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Getting familiar with the signs of stroke could save your life

May 10, 2021
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How many times have you heard the phrase, “If it hurts, get it checked.”

The same can’t be said about a stroke which is called “the silent killer.”

“Stroke is called ‘the silent killer’ because high blood pressure, which may show no symptoms, puts you 4 to 6 times more likely to have a stroke,” said Dr. Rajiv Padmanabhan of the Department of Neurology at Baystate Medical Center.

Other risk factors for stroke include heart disease and atrial fibrillation which can double your risk, smoking, diabetes, high cholesterol, sickle cell disease, and a family history of stroke.

Leading cause of death and disability

May is National Stroke Awareness Month and stroke is a leading cause of death for Americans and a leading cause of serious long-term disability.

The numbers speak for themselves. On average, someone in the United States has a stroke every 40 seconds. There are about 795,000 new or recurrent strokes each year. On average, someone dies of a stoke every 3 minutes and 33 seconds in the country. There are about 405 deaths from stroke each day.

“During National Stroke Awareness Month and throughout the year it is vitally important to be familiar with the warnings signs and symptoms of stroke, as well as to learn how you can minimize your risk of stroke by controlling risk factors,” said Dr. Padmanabhan.

About 87% of all strokes are classified as ischemic strokes, when part of the brain suddenly has a disruption in its blood supply. Without blood flow, that part of the brain does not receive the necessary oxygen and nutrients. Brain tissue dies as a result. Most strokes happen because a blood clot blocks an artery, or a blood vessel breaks in the brain or neck in case of bleeding stroke.

Time is crucial

“Time is crucial and the longer you wait to get care, the more damage occurs to your brain cells,” said Dr. Padmanabhan, who serves as medical director of the hospital’s Stroke Program.

Close to two million brain cells die every minute during a stroke – which occurs when blood vessels carrying oxygen to the brain are either blocked by a blood clot or rupture – increasing your risk of permanent brain damage, disability or death. In case of a clotting stroke, a clot-busting medication is administered within the first few hours of the initial stroke. The sooner this is given, the better the outcome and disability.

Better stroke outcomes begin with stroke recognition and calling 9-1-1 immediately can make a difference. Yet, calling 9-1-1 within 1 hour of symptoms is done in fewer than 50% of stroke cases and only 53% of stroke patients used emergency medical services in the nation.

Dr. Padmanabhan noted amazing teamwork at Baystate Medical Center resulted recently in a record for door to CT scan time of 1 minute. And with a recent stroke patient, a door to t-PA (clot-busting drug) of 19 minutes was achieved. National guidelines call for door-to-imaging time (CT scan) within 25 minutes for suspected acute stroke patients and door to clot-busting therapy should be 60 minutes or less, preferably less than 45 minutes.

Know the warning signs of stroke

“Knowing the warning signs of stroke are key to survival and preventing any long-term disability,” said Dr. Padmanabhan.

Major warning signs of a stroke are:

  • Numbness or weakness on one side of the body – a drooping face or arm that falls when you lift it up. These feelings can also apply to the spine, legs and feet.
  • Sudden severe headache.
  • Blurry vision, loss of peripheral vision, or total loss of vision in one or both eyes.
  • Feeling abnormally confused.
  • Problems communicating, which could include slurred speech or the inability to understand what someone is saying to you.
  • Sudden trouble walking, dizziness, loss of balance, or lack of coordination.

While women and men share a common set of stroke symptoms, women may also experience nausea or vomiting, genera weakness and fainting spells, shortness of breath, sudden non-stop hiccups, and extreme tiredness.

Stroke doesn’t discriminate

Strokes happen to all kinds of people. About 10%-15% of all strokes occur in adults age 50 or under. Stroke is among the top five causes of death in women and kills more women than men. Black adults have nearly twice the stroke risk as white adults and the highest risk of dying from stroke. Hispanics have seen an increase in death rates from stroke over the years and have the greatest number of risk factors.

“It’s also important to note that as risk factors for older adults are increasingly being seen in young adults such as obesity and its resulting health problems, there are signs that stroke may be increasing in that population. These risk factors in the younger population must be addressed early on by primary care  doctors,” said Dr. Padmanabhan.

In addition to clot-busting drugs, advances in technology have made it possible for doctors to reduce one’s risk of permanent damage or death. A newer tool in the battle against ischemic stroke is an advanced procedure called thrombectomy, and in western Massachusetts, this procedure is performed exclusively at Baystate Medical Center’s state-of-the-art neurointerventional laboratory. Thrombectomy involves anesthetizing the patient, then inserting a thin metallic stent-like device into an artery in the leg. The surgeon then threads the device up to the blockage in the brain, where it opens to immediately restore blood circulation, eventually grabbing onto the clot and pulling it out. A similar procedure is also used to secure a ruptured brain aneurysm.

Remember the acronym BEFAST

The good news is that most strokes – some 80 percent - can be prevented by lifestyle changes  and treating your risk factors such as lowering your blood pressure and cholesterol levels, losing weight if you are obese, eating a heart-heathy diet, and getting off the couch and exercising more, noted Dr. Padmanabhan.

“It is very important to identify your risk factors and manage these conditions with assistance from your primary care physician,” he added.

“Please remember, if you or someone you know may be having a stroke, it’s important to recognize the signs by remembering the acronym B. E. F.A.S.T.: B stands for balance (abnormal or loss), E stands for eye-vision loss/double vision, F stands for face drooping, A stands for arm weakness, S stands for speech difficulty and T stands for time to call 911,” said Dr. Padmanabhan.

The acute stroke team at Baystate Medical Center provides care for more than 1,600 stroke patients each year, more than any other hospital in western Massachusetts. Services feature inpatient stroke care, stroke emergency services, telestroke services, rehabilitation services after stroke, and stroke support.

Learn More About Comprehensive Stroke Care at Baystate Health

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Advancements in Emergency Stroke Care

Dr. E. Jesus Duffis talks about advancements in emergency stroke care.

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