After experiencing some abnormal dizziness the other night, I followed my usual routine of spending hours researching the most rare brain diseases ever (not out of hypochondriases, but rather out of my odd desire to learn about this things). In the midst of this research, I came across strokes. Luckily, I was pretty sure that I had not had one. But, I was surprised to learn that it is the third leading cause of death in Americans, the #1 cause of disability in Americans, and 80% preventable. This prompted me to learn more.
A stroke in most basic terms is when a blood vessel in the brain either becomes blocked (ischemic stroke) or ruptures (hemorrhagic stroke), preventing an adequate supply of oxygen to the surrounding brain tissue. Without the oxygen, cell death can occur quite rapidly…typically within minutes.
Symptoms: The “FAST” pneumonic device is my personal favorite for remembering the symptoms of stroke:
Treatment: There are various treatments depending on the scope and type of stroke.
For ischemic stroke, the doctor will try to use any measure possible to remove the blockage to the brain. This can include a clot-busting (thrombolytic) drug, which while effective has a very limited time window and a narrow scope of those it can help. There are also various surgical procedures, most often done within the cartoid artery, that can reduce the plaques and blocks to the brain.
Should you have an ischemic stroke and survive, the doctor will likely prescribe anti-coagulant (clotting) and anti-platelet drugs to try and prevent a recurring stroke.
For hemorrhagic stroke, the most common effective treatment are several types of surgery which tries to either remove, clamp, or repair the aneurysm.
Recovery: Recovery depends greatly on the severity of the stroke. Some survivors may require minimal rehabilitation, while some may require a host of support. Severe strokes can lead to loss of speech, motor functioning, breathing, etc. The doctor, family, and social worker should all work together to develop the best rehabilitation plan for the patient should the patient be unable to make these decisions on his own.
Morbidity (# of deaths): Over 160,000 in America die from stroke
Mortality (# affected by the condition): About 700,000 strokes happen each year, 500,000 as the first stroke and 200,000 as a repeated stroke.
Epidemiology: Although strokes happen all over the country, the highest incidences are in southeastern states. There is no clear data as to explain why.
Prevention: As is the case with many conditions and diseases I have written about, the most important thing to do is BE HEALTHY. Most of the things on the following list follow common sense:
- Don’t smoke
- Keep your blood pressure under control
- Keep your cholesterol within a normal range
- Eat a well balanced diet with foods high in fiber and low in saturated (animal) fats, as well as a lot of fruits and vegetables
- Maintain a healthy weight
- Do not drink more than in moderation if you choose to drink
- Exercise regularly
- Don’t do illegal drugs
- Keep stress levels under control
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