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Published on May 10, 2019

What You Should Know About Strokes: Acting Fast and Reducing Risks

What You Should Know About Stroke CareIn this Fox 8 House Call series, Cone Health specialists explore stroke care, including:

Strokes: Who’s at Risk and How to Reduce Your Risks

A stroke happens when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot or ruptures. When that happens, part of the brain cannot get the blood and oxygen it needs, so brain cells die. Stroke is the fifth leading cause of death and a leading cause of disability in the United States.

There are several risk factors for stroke that you can change or treat, including:

  • High blood pressure: The single most important risk factor and leading cause of stroke. If it is greater than 140/90, it is important to get it controlled.
  • Diabetes: More than doubles your risk.
  • Smoking: Damages blood vessels, which lead to blockages that cause a stroke.
  • High cholesterol: Increases the risk of blocked arteries. Blocked arteries in the brain can result in a stroke.
  • Physical inactivity and obesity: Being inactive, obese or both can increase your risk of heart disease and stroke.
  • Excessive alcohol intake: Drinking an average of more than 1 drink per day for women or more than 2 drinks per day for men can raise blood pressure. Binge drinking can lead to a stroke.
  • Transient Ischemic Attacks: Produce stroke-like symptoms but most have no lasting effects. Know the warning signs of TIAs and seek help immediately. They include weakness, numbness or paralysis in your face, arm or leg, typically on one side of your body, along with slurred or garbled speech, or difficulty understanding others.

Risk factors you can’t control include increasing age, gender, heredity and race, and prior stroke.

Since many of the risk factors for stroke are modifiable, it is important to discuss any risk factors and ways you can decrease your risk with your health care provider. Nearly all of these risk factors can be screened for during a primary care visit.

Ashish Arora, MD, is a neurohospitalist and vascular neurologist at The Moses H. Cone Memorial Hospital and a member of Cone Health Medical Group. He completed medical school at Kasturba Medical College, Mangalore; research fellowship in neuroimaging at Brigham & Women’s Hospital, Harvard Medical School Boston; residency in neurology at University at Buffalo; and clinical fellowship in stroke neurology at The University of Texas at Houston.

Strokes: Know the Warning Signs and Act Fast

Every 40 seconds, someone in the United States has a stroke, and being able to recognize the signs and symptoms can help you or a loved one get the quick medical attention they need. Stroke symptoms include:

  • Weakness on one side of the body.
  • Change in vision, often blurriness or blindness in one of your vision fields.
  • Sudden onset of dizziness or extreme headache.
  • Staggering gate/difficulty balancing.
  • Slurred speech/speech difficulty.
  • Facial droop.

The word FAST can help you remember the signs of a stroke:

  • Face: Does the face look uneven?
  • Arm: Does one arm drift down?
  • Speech: Does their speech sound strange?
  • Time: Every second, brain cells die. Call 911 at any sign of stroke.

Symptoms can include a combination of those in the face, arm and speech categories, and sometimes in just one.

When a person experiences a stroke, the brain tissue stops receiving blood flow to this particular area and then starts dying after 6 to 20 minutes. Acting quickly is of utmost importance because the longer that blood flow is blocked, the more damage the brain experiences. The quicker a stroke patient receives care, the better the outcome. In most cases, patients have the best chance of recovery if they are treated within 6 to 8 hours.

Cone Health has a dedicated stroke team. When a stroke patient reaches the hospital, the Stroke Center team evaluates the nature of the stroke to determine the best course of treatment. We often administer a clot-busting medication, which must be given within 4 and a half hours of having a stroke. We also perform a procedure that removes the clot, if necessary, and allows blood to flow back into the brain. The sooner this procedure is done, the better the outcome, as 80 to 85% of procedures successfully remove the blockage and restore blood flow to the brain.

Hannah Steele is a registered nurse with The Stroke Center at The Moses H. Cone Memorial Hospital. She received her Bachelor of Science in registered nursing from Gardner-Webb University.

Strokes: Steps to Prevent Recurrent Strokes

After a stroke, it’s important to remember that your body has just experienced a major trauma. The greatest improvements in recovery happen within the first 3 months, so patience and positivity are key! The earlier a patient begins rehabilitation, the better the outcome. Because the brain controls everything, it now has to recreate pathways and compensate for that damaged area. It is common to feel more fatigued during this time, but this is something that will get better with time.

A common question we hear from patients after they’ve had a stroke is “will this happen again?” Unfortunately, we cannot do a test that tells us whether you are about to have another stroke. After having 1 stroke, you are at a lifetime risk of having a recurrent stroke, and this risk is especially higher within the first 3 months. The good news is that if you manage your risk factors, take prescribed medications, eat healthy and exercise regularly, you greatly reduce your risk of having another stroke.

How to reduce your risk:

  • Maintain wellness through a good diet and nutrition.
  • Exercise for 30 continuous minutes a day.
  • Manage blood pressure – typically we like this less than 130/90 – and monitor it at home
  • Keep cholesterol in check – we look at your bad cholesterol, or your LDL, and we want this less than 70.
  • If you have diabetes, keep your A1c less than 6.5.
  • Stop smoking.

You will also team up with your primary care provider for continuous monitoring and management of your cholesterol, blood pressure and diabetes.

Jessica VanSchaick, MSN, AGNP, is a board-certified adult-gerontology nurse practitioner at Guilford Neurologic Associates and a member of Cone Health Medical Group. VanSchaick specializes in neurology and stroke care. She received both her Bachelor of Science in nursing and Master of Science in nursing from the University of Rochester School of Nursing.

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