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What is a stroke?

Similar to a heart attack that cuts off the blood flow to the heart, stroke is a brain attack that cuts off blood flow to the brain, the body's most vital organ. When an artery in, or leading to, the brain becomes clogged or ruptured, blood cannot reach brain cells. Deprived of the blood's essential oxygen and nutrients, these cells die. As a result, functions that were normally controlled by these cells become impaired, causing, for example, paralysis or loss of speech or vision. Stroke is the third leading cause of death in the United States (second for women) and the number one cause of adult disability. About 80% of strokes are caused by blood clots that obstruct circulation. A thrombotic stroke occurs when blood flow is blocked by a clot formed in an artery in the head. An embolic stroke occurs when a small clot forms elsewhere in the body (e.g., the heart) and gets stuck in an artery leading to the brain. The other 20% of strokes are hemorrhagic strokes that occur when an artery in the brain ruptures. This cuts off blood to some cells and damages others from the pressure of the bleeding. These types of strokes are more lethal, with a death rate of about 50%.

A medical emergency

During stroke, brain cells in the infarct, the immediate area where stroke occurs, die quickly. When this happens, a chain reaction endangers cells in the surrounding area of tissues in the penumbra. Every minute following stroke affects the ability of damaged brain cells to recover. Proper diagnosis and prompt medical attention improve the chances for survival and successful recovery. Additionally, strokes may lead to other medical complications, like cardiac arrhythmias, that need to be treated quickly. Therefore, recognition of stroke symptoms - by the patient and emergency medical personnel - is critical.

Risk factors

Everyone is at risk for stroke. However, certain conditions increase the risk, such as:

• Previous stroke or family history of stroke
  
• Previous transient ischemic attack (TIA), a brief stroke that has most symptoms of a full stroke but lasts about 5 minutes)
  
• High blood pressure
  
• Heart disease
  
• Carotid artery disease
  
• High cholesterol
• Smoking
  
• Diabetes
• Obesity

Symptoms

Generally, people recognize the symptoms of a heart attack and obtain immediate medical assistance. Stroke symptoms, however, are more subtle and often overlooked. Recognizing these symptoms is very important to getting the quick diagnosis and treatment that can save lives.

The most common symptoms are:

• Numbness, pain, weakness or paralysis of face, arm or leg, especially on one side of the body
• Sudden blurred or decreased vision
• Sudden headaches with no apparent cause
• Difficulty speaking or understanding speech or writing
  
• Dizziness, loss of balance or coordination

Depression after a stroke

It is normal for a stroke victim to feel sad over the problems caused by a stroke. Some people, however, experience severe depression, which should be treated as soon as possible. If a stroke survivor has symptoms of depression, professional help is needed immediately. Symptoms include:

• Feeling sad or blue
  
• Feeling worthless or guilty
• Increase or decrease in appetite or weight
  
• Problems concentrating, thinking, remembering or making decisions
  
• Loss of energy or feeling tired
  
• Being anxious or worried
  
• Headaches and other aches
• Loss of interest in things that the person used to enjoy
  
• Feeling pessimistic or hopeless
  
• Thoughts of death or suicide

Be aware of the symptoms that may accompany a stroke and if symptoms occur, seek professional care. If you or a family member has had a stroke, work with your healthcare professional to maximize recovery.

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