By: Tashfin Huq, MD, Board Certified and Fellowship Trained Neurologist,
Thibodaux Regional Health System
Stroke is a treatable neurological emergency that is currently the fifth
leading cause of death in the United States and the #1 cause for disability
in adults. On average, one person suffers from stroke every 40 seconds
in this country. According to our latest studies, each year around 800,000
patients suffer from strokes. During a stroke, brain cells die due to
lack of oxygen and nutrients secondary to interruption of blood flow to
areas of the brain.
Stroke can be subdivided into two main categories: Ischemic and hemorrhagic.
Ischemic stroke occurs when there is a decrease or lack of blood flow to brain cells due
to narrowing or blockage of one or more arteries that are responsible
for providing blood supply to that region. This blockage can happen due
to myriad reasons. One of the primary reasons is fatty deposits of plaque
in the arteries, known as atherosclerosis, which in turn results from
longstanding hypertension, diabetes mellitus, and abnormal cholesterol
levels. In addition, other factors such as arrhythmias, particularly atrial
fibrillation, heart failure, narrowing or blockage of carotid arteries,
tear or rupture of arteries leading to dissection, can also contribute
to ischemic strokes. A subset of ischemic stroke is known as TIA or "mini
stroke". This usually occurs when interruption in blood flow leads
to reversible oxygen deficiency to a portion of the brain. Once blood
flow is restored, patient’s symptoms resolve. However, a person
suffering from TIAs are at a higher risk of suffering from subsequent strokes.
Hemorrhagic stroke occurs when a leak or rupture of intracranial arteries causes blood to
come in direct contact with the brain cells, resulting in mass-effect
and reduction of blood supply to that area of the brain. The most common
type of hemorrhagic stroke is intracerebral hemorrhage. Uncontrolled hypertension
and intracranial aneurysms are major risk factors for intracerebral hemorrhage.
In addition, subarachnoid hemorrhage is another kind of hemorrhagic stroke,
which can cause significant disability and carries a higher risk of fatality
compared to intracerebral hemorrhage.
Currently, we are able to treat majority of strokes successfully, and thus,
reduce the risk of disability and death. However, treatment of stroke
is time sensitive. Stroke is considered a neurological emergency. On average,
2 million brain cells die per minute when a patient is suffering from
stroke. For ischemic strokes, we are able to treat the patient with a
"clot buster", known as tissue plasminogen activator, or TPA.
For certain ischemic strokes, we are also able to provide patient with
endovascular therapy and remove clots from the arteries.
Although each kind of stroke can have its unique set of potential causes,
in general both ischemic and hemorrhagic strokes can likely affect individuals
with uncontrolled hypertension, unmanaged diabetes, abnormal cholesterol
levels, carotid artery disease, heart failure, atrial fibrillation and
obesity. In addition, sedentary lifestyle, increased alcohol consumption,
smoking cigarettes, and use of illicit drugs such as cocaine, heroin,
and amphetamines also increase the risk of stroke.
It is important to identify symptoms of stroke due to the time sensitivity
of the available treatment options. Many of us are aware that sudden onset
weakness, numbness, or inability to move one or more limbs increases the
suspicion for stroke. However, other subtler symptoms, such as slurred
speech, word finding difficulty, confusion, difficulty walking, dizziness
or vertigo, headaches and change in mental status can also be symptoms
of stroke. It is good to remember the acronym BEFAST, which stands for
balance, eyes, face, arm, speech and time.
If you suspect that either you or your loved ones may be suffering from
one or more symptoms of stroke call 911 immediately. At Thibodaux Regional
Health System we are able to provide care for stroke patients by board-certified,
fellowship trained neurologists. However, the success of treatment begins
with you identifying the symptoms as early as possible.
For more information contact Thibodaux Regional Neurology Clinic, 985.493.3090.