Seconds count when talking about stroke
There are many times in life when it is important to act fast. Our sports coaches tell us to run fast and think quickly. When we play board games we want to think ahead and act fast. However, it is also important to be fast in health emergencies, especially when it comes to stroke.
May is Stroke Awareness Month. Dr. John Clark, a neurologist with Lawrence Neurology Specialists, said the most important thing to know about stroke is prevention.
“I tell my patients the best treatment for stroke is no stroke,” he said. “What that means is to identify and then reduce or eliminate risk factors. The top three risk factors are smoking, diabetes and high blood pressure. Following those top three would be high cholesterol and family history.”
Dr. Clark said something that significantly increases the risk of stroke is a warning stroke, also known as transient ischemic attack (TIA). This warning stroke has similar effects as a stroke, but only lasts minutes to hours and leaves no permanent damage. Often, those who experience a TIA are more likely to have a stroke in the future. The occurrence of a TIA should be a wakeup call to stop smoking or aggressively treat diabetes or blood pressure, he said.
For the symptoms of a stroke, remember the acronym BE FAST – Balance, Eyes, Arms, Speech and Time.
“Call 911 right away if you experience any of these symptoms,” Dr. Clark said. “Strokes are treated most effectively by seeking medical attention fast – within three hours. If people who are having a stroke are fast, they are a candidate to receive the clot busting drug tPA, which can significantly improve recovery. LMH Health’s stroke center can provide this treatment and is a primary stroke center accredited by The Joint Commission.”
Stroke Prevention Healthy Living Series
Our next Healthy Living Series on May 11 will be with Jodi Morgan, PT with LMH Health Therapy & Wellness as she presents on Stroke Prevention and what you need to know. This presentation will be geared towards children and their loved ones.
A link to the live Zoom session will be emailed to registered participants the day of the event. To learn more and register, visit the link below.
One of the best ways to identify stroke, he said, is simply by your health history and physical examination. However, supporting tests such as an MRI or CT imaging of the brain can help identify risks.
“There is often a misconception that strokes always have a devastating ending,” Dr. Clark said. “This is not the case. It depends on the size of the stroke and location. If a small stroke affects an area of the brain not controlling functions like speech, strength or sensation, there may be minimal or no symptoms at all. Other patients may have more severe symptoms at the start of the stroke but will recover some of those previous functions with time.”
Dr. Clark shared that our brains have plasticity, meaning other portions that are not damaged can take over some of the functions of the stroke region. Additionally, there are options that can improve an outcome even more.
“There is a clot retraction technique that can be done in conjunction with tPa that is given here through the vein,” he said. “This combination can improve an outcome significantly. LMH Health has a great collaboration with St. Luke’s Hospital and KU Medical Center in Kansas City providing what we call a ‘drip and ship’ treatment. If someone comes into our ER with a stroke, we begin treatment at LMH Health immediately. If we identify a large clot, we promptly send the patient via ambulance or helicopter to a radiologist at KU Medical Center or St. Luke’s who is specialized to extract the clot causing the stroke.”
Though there are treatment option for stroke, it is important not to delay care. You must BE FAST in order to have the best outcomes.
“Something patients should know is that having a stroke does not mean you are going to be in pain,” Dr. Clark said. “Most strokes are ischemic, meaning that a blood vessel becomes blocked with a clot which stops blood flow to the area of the brain downstream. Think of the brain arterial supply as a tree with a large trunk going up to large branches and then smaller branches. If a large artery becomes blocked, that results in a large area territorial stroke. Conversely, if a small artery becomes blocked, this results in a smaller territorial stroke.”
Dr. Clark said most strokes are actually not associated with pain. Sometimes strokes involving the arterial branches to the brainstem, a deeper brain region, can involve pain. But this is not too common. He commented that because there is often a lack of pain, this can cause delays in seeking emergency treatment.
“Unlike heart attacks which are commonly associated with chest pain, stroke doesn’t always have pain as a warning sign,” Dr. Clark said. “This is why it is even more important to recognize the symptoms of stroke and to always remember to BE FAST.”
Dr. Sanjeev Kumar, a neurologist who also works at Lawrence Neurology Specialists, said that in the United States alone there are around 800,000 strokes a year, 77% of which are first event that could likely have been preventable.
“Of these hundreds of thousands of strokes, around 90% of them could have been prevented through risk factor modification,” he said. “This includes hypertension, diabetes, atrial fibrillation, dyslipidemia, cigarette smoking, kidney disease, sleep apnea and alcohol intake.”
Dr. Kumar said these health concerns can all be addressed by specialists. If you suffer from sleep apnea or heavy snoring, a sleep specialist may be able to help. The sooner you stop smoking, your likelihood of stroke can decrease. He said no matter who you are or how old you are, stroke has no boundaries.
“Strokes can affect anybody, even the young,” Dr. Kumar said. “In fact, strokes in those less than 50 to 55 years of age are increasing. There is an ethnic, racial and geographic disparity as well with mortality reaching 30% higher in the stroke belt region of the country, defined as Alabama, Arkansas, Georgia, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee and Virginia. Stroke deaths are also higher in non-Hispanic Blacks. We have seen strokes in all age groups, but also in the young due to COVID-19.”
Strokes can cause permanent damage. Dr. Kumar said half of all stroke survivors will have a moderate to severe disability. He said our community should be vigilant about stroke risk, stroke identification and getting to the emergency department as soon as possible.
“You lose two million neurons per minute due to stroke,” Dr. Kumar said. “One drop of brain loss is equal to one week of life lost, and one second saved to treatment saves 2.2 hours of life.”
Dr. Kumar reemphasized that TIA is no small concern. He said this is a ticking time clock on a bomb just waiting to go off. Often times, TIA is a warning sign to seek attention immediately, intervene early and prevent a stroke in the future.
“LMH Health is equipped to take care of your stroke needs,” Dr. Kumar said. “We have been recertified again this year as a primary stroke center and have three board-certified neurologists who are prepared and ready to care for you. We love our patients, all of our patients. Your health will always be our number one priority. As a not-for-profit hospital, our commitment remains the same, to provide for you no matter your circumstance. You are important, and never delay your care.”