The devastating effect of stroke on the health of our nation is significantly underestimated. It’s the fifth leading cause of death in the U.S., and the No. 1 leading cause of disability. Due to increasing risk factors in our population, more strokes are occurring at younger ages, causing massive impact to individuals who are often in the prime of their lives.
Stroke is a sudden-onset neurological event due to problems with blood vessels of the brain. There are two major types: 80 to 85% are ischemic, which means a blood vessel is blocked and starves the brain of blood, and 15 to 20% are hemorrhagic, where a blood vessel bursts and causes bleeding either in or around the brain. Both can have deleterious consequences.
Fortunately, there is great hope as treatments have emerged to treat this once “untreatable” condition. For the ischemic (blood clot type) strokes, we have a clot-busting medication called tissue plasminogen activator (or tPA for short) and technological advancement with devices that can be moved through the blood vessels and remove clots to restore blood flow to the brain. For hemorrhagic (bleeding type) strokes, there is also significant advancement with devices to treat brain aneurysms and other causes of bleeding. These, along with new treatment paradigms in neurosurgery and neurocritical care, have led to much better, life-saving outcomes.
Stroke is one of the most time-sensitive conditions in all of medicine. It’s estimated that a person suffering a stroke loses 2 million brain cells a minute, making it a condition where every second counts. Unfortunately, the treatments available can only be offered in a short time window after the start of a stroke (within the first few hours up to 24 hours) so it’s of the utmost importance that people know the symptoms of a stroke so they can seek immediate medical attention. We like to use an acronym called BE FAST:
B – Balance difficulty
E- Eyes (visual loss or double vision)
F – Face weakness
A – Arm (or leg) weakness
S – Speech difficulties
T – Time to call 911
Another symptom that should not be ignored and requires medical attention is the sudden onset of a severe headache, as this could be related to the breaking of an aneurysm and bleeding around the brain.
It is critical to call 911 and get medical attention right away, as this can mean the difference between life and death, disability and no disability. EMS has great skill in identifying stroke, and responders will be well-versed in the protocols needed to rapidly get stroke patients to a hospital so they can receive the timely care they need. In many areas of the country, EMS will also make assessments and get more severe stroke patients to the hospital with the most advanced capabilities (such as comprehensive stroke centers) so we can get the patient to the right hospital the first time.
With all of the advanced techniques and further innovation in the field, there is great hope to limit and cure this devastating condition.