Your Guide to Stroke Safety
May 2009
by Molly M. Ginty Diana Fite knew she was at risk.
Even so, this 56-year-old Houston resident neglected to take the medication she needed for high blood pressure, the leading cause of stroke.
Though she was a medical doctor, Fite ignored the possibility that she could have a stroke (a blood vessel blockage or rupture that injures or kills brain cells)—until the day three years ago when she was driving and suddenly lost control of her right side.
“My car was swerving back and forth, but I somehow managed to steer off the road, use my left foot to kick my right foot off the gas pedal, and use my cell phone to call 911,” says Fite. “In a garbled voice, with half my face paralyzed, I told the operator that I’d had a stroke, and was rushed to the nearest stroke specialty center.”
Every year, 700,000 Americans suffer strokes. But unlike Fite, who got successful treatment quickly, half of these patients experience permanent paralysis or other health complications. Stroke claims 150,000 lives annually and is the third leading cause of death in the United States, reports the American Stroke Association. Especially endangered are women, who suffer 60 percent of strokes and who take birth control pills and hormone therapy that can boost their risk.
In May, American Stroke Month, what you can you do to protect yourself from this leading cause of disability?
The best way to guard against a stroke, say experts, is to prevent one in the first place. Smoking, diabetes, obesity, and high cholesterol all boost your risk. So does atrial fibrillation, an irregular heartbeat that can cause blood to pool in the heart and form clots. The worst culprit? High blood pressure, which can cause tiny blood vessels in the brain to become rigid and blocked. Researchers say half of strokes could be prevented if people with high blood pressure kept their condition under control.
In addition to addressing these health issues, adults over age 20 should have a blood pressure screening every five years. People with atrial fibrillation can take anti-clotting drugs such as warfarin. Those at high risk can take an aspirin daily to prevent blood platelets from forming clots—or have preventive surgery to prop open an artery, remove a blockage, or seal off an aneurysm (a weak spot in the blood vessel wall).
These steps can help you ward off an ordeal that is nothing short of terrifying. During a stroke, the brain is deprived of oxygen and nutrients, and 1.9 million nerve and brain cells die per minute. As a result, sufferers can suddenly lose muscle control (usually on one side); be unable to speak or understand speech (aphasia); and experience searing headaches, double vision, and altered consciousness.
After a massive stroke, survivors may never be able to speak coherently—or breathe without a ventilator—again. The damage can be equally devastating from an ischemic stroke (the most common form, in which a blood clot blocks an artery to the brain) or a hemorrhagic one (in which a blood vessel in the brain bursts or ruptures).
The most common strokes are transient ischemic “mini-strokes,” with temporary symptoms such as the loss of vision for half an hour. For every full-scale stroke that receives medical attention, five to 10 of these smaller or silentones go unattended, setting the stage for larger strokes—and big health trouble—in the future.
Twenty percent of patients who have mini-strokes suffer full-blown ones with in three months—the reason you must see a doctor immediately if you have temporary numbness, weakness, dizziness, or severe headache. According to a 2007 British study, patients who receive stroke treatment within 24 hours reduce their risk of a second incident by 80 percent compared with those who wait three days or more.
If you do experience the symptoms of stroke, call for medical help right away. “It takes the average American 12 to 24 hours to get to the hospital after stroke symptoms,” says Jim Baranski, director of the National Stroke Association. “But faster action is crucial for saving lives.”
Make sure that your doctor gives you an accurate diagnosis, done with X-rays, sound waves, or a diffusion MRI (a scan that shows fluid moving in the brain—and slowing dramatically as dying brain cells swell).
To treat stroke, doctors may remove obstructions with surgery such as carotid endarterectomy (done on the major artery in the neck) or angioplasty (which widens arteries leading to the brain). They may administer blood-thinning drugs, or, in the case of ischemic stroke, dispense clot-busting tPA (tissue plasminogen activator, given within three hours of a stroke to reduce the chances of injury by 30 to 65 percent).
To treat her stroke three years ago, Dr. Fite took tPA, which helped her immobilized right side come back to life—and spared her from long-term damage. Today, Fite takes the daily medication she neglected in the past: three blood pressure pills and a cholesterol-lowering drug. “I’m also taking a drug to prevent blood clots,” she says. “That last drug never would have been necessary if I had snapped out of denial and paid attention to my health.”
Molly M. Ginty lives in New York. Her work has appeared in Ms., Marie Claire, Redbook, and Women’s eNews.
For more information
American Stroke Association
National Stroke Association
The Stroke Collaborative