Resources at Hebrew SeniorLife

Stroke

Stroke is the third leading cause of death and the number one cause of adult disability in the U.S. Nearly 700,000 Americans suffer a stroke each year, resulting in more than 160,000 deaths.

Farzaneh Sorond, M.D., a consulting cerebrovascular neurologist at Hebrew SeniorLife, says the most important aspect of stroke to remember is that 80 percent of all strokes are preventable by treating risk factors. Once someone does have a stroke, the key to successful outcomes is early recognition of signs and symptoms and prompt medical treatment. Early treatment minimizes damage to the brain and potential disability. Some people, she adds, can recover completely from a stroke if treated early; however, nearly two-thirds of stroke patients have some type of disability.

Definition

A stroke or "brain attack" is a disease of the blood vessels to and within the brain that prevents needed blood and oxygen from reaching the brain cells, resulting in brain damage.

Types

  • An ischemic stroke is caused by an obstruction (such as a blood clot) in a blood vessel leading to the brain
  • A hemorrhagic stroke occurs when a weakened vessel ruptures and bleeds into the surrounding brain

Symptoms

  • Sudden numbness, weakness or paralysis of the face, arm or leg, usually on one side
  • Loss of speech or difficulty speaking
  • Sudden blurred or double vision
  • Sudden, severe headache
  • Confusion and memory problems

If you think someone may be having a stroke, act F.A.S.T. and do this simple test recommended by the National Stroke Association:

Act F.A.S.T.
FACE: Ask the person to smile. Does one side of the face droop?
ARMS: Ask the person to raise both arms. Does one arm drift downward?
SPEECH: Ask the person to repeat a simple sentence. Are the words slurred?  Can he/she repeat the sentence correctly?
TIME: If the person shows any of these symptoms, time is important. Call 911 or get to the hospital fast. Brain cells are dying.

Risk Factors 

  • Family history of stroke 
  • Age (risk increases as you get older)
  • Atrial fibrillation
  • Race (African-Americans are at higher risk)
  • High blood pressure
  • High cholesterol
  • Cigarette smoking
  • Diabetes
  • Obesity
  • Cardiovascular disease
  • Carotid artery disease
  • Previous stroke or transient ischemic attack
  • Elevated homocysteine level

Diagnosis

  • Physical examination
  • Brain imaging by computerized tomography scan (CT scan) or magnetic resonance imaging (MRI)
  • Vascular studies such as carotid ultrasonography, vascular imaging (CT angiogram or magnetic resonance angiogram) or transcranial Doppler ultrasound 
  • Echocardiography
  • Blood test to exclude a clotting disorder

Treatment

  • Tissue plasminogen activator (t-PA)
  • Angioplasty and stenting
  • Catheter embolectomy

Glossary

Atrial fibrillation - abnormal irregular heart rhythm with chaotic generation of electrical signals in the two small, upper chambers of the heart.

Cardiovascular disease - diseases of the heart and blood vessels.

Carotid angioplasty and stenting - the insertion of a stent (a wire-mesh scaffold) into the carotid artery in the neck via a catheter (a thin, hollow tube) to keep the artery open.

Carotid artery disease - a disease that occurs when the major arteries in the neck become narrowed or blocked.

Carotid endarterectomy - a procedure in which a surgeon removes the inner lining of the carotid artery if it has become thickened or damaged by plaques that restrict blood flow. This is to prevent future stroke.

Carotid ultrasonography - a test that uses high-frequency sound waves to determine if there is narrowing of or plaque formation in the carotid artery.

Catheter embolectomy - a procedure in which a tiny, narrow tube (a catheter) is threaded through blood vessels until it reaches an area in the brain where it can remove a blood clot or administer clot-busting medications.

Cholesterol - a waxy, fat-like substance in every cell in the body and in many foods.

Computerized tomography (CT) scan - a noninvasive diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce cross-sectional images of the body, showing detailed images of bone, muscle, fat and organs.

Diabetes - a chronic medical disorder in which blood glucose (sugar) levels are abnormally high because the body does not release or use insulin adequately to remove sugar from the blood stream.

Echocardiography - an ultrasound of the heart that provides an accurate assessment of the heart's overall health and can diagnose abnormalities which may lead to clot formation.

High blood pressure - a medical condition in which blood pressure (the force applied to the walls of arteries as the heart pumps blood throughout the body) is consistently higher than 120/80.

High cholesterol - elevated levels of cholesterol, a fatty substance found in the circulating blood of humans; high levels of LDL (bad cholesterol) are associated with coronary heart disease.

Homocysteine - an amino acid (a building block of protein) in the blood, high amounts of which can damage the lining of arteries and promote blood clot formation.

Magnetic resonance imaging (MRI) - a diagnostic procedure that uses a combination of large magnets, radiofrequencies and computers to produce detailed images of organs and structures in the body.

Tissue plasminogen activator - a clot-busting drug used to dissolve blood clots, which are the primary cause of heart attacks and strokes.

Transcranial Doppler ultrasound (TCD) - a test that uses high-frequency sound waves to determine if there is narrowing of or plaque formation in the blood vessels of the brain.

Transient ischemic attack - a minor or warning stroke in which a blood vessel obstruction occurs for a short time and tends to resolve itself through normal mechanisms.

Links

American Stroke Association - www.strokeassociation.org
National Stroke Association - www.stroke.org
National Institute of Neurological Disorders and Stroke - www.ninds.nih.gov

Disclaimer
The information contained on this Web site is intended for general consumer understanding and education. The information is provided as a resource only and is not a substitute for professional diagnosis and treatment. Access to the information on this site is voluntary. We advise users to consult their physician or other qualified health-care professional if they have questions regarding personal health and medical conditions. Hebrew SeniorLife expressly disclaims responsibility, and shall have no liability, for any damages, loss, injury or liability whatsoever suffered as a result of your reliance on the information contained on this site.

By visiting this site, you agree to the foregoing terms and conditions, which may from time to time be changed or supplemented by Hebrew SeniorLife. 

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