1. Nothing on 100% recovery statistics.
2. Nothing on 30-day deaths compared to other hospitals.
3. Nothing on the efficacy of stroke rehab protocols.
4. Nothing on tPA full efficacy.
5. Nothing on misdiagnosis percentage of strokes, especially young strokes.
http://health.usnews.com/health-care/for-better/articles/2017-05-17/what-you-need-to-know-about-stroke
By
Lisa Edelstein, Contributor | May 17, 2017, at 6:00 a.m.
If you're worried someone is having a stroke, ask him or her to raise both arms. Look for one arm lagging behind.
The statistics are sobering: Every 40 seconds,
someone in the United States experiences a stroke. As the No. 5 cause of
death in the U.S., strokes are fatal to almost 130,000 people a year.
Equally devastating, stroke is the leading cause of long-term adult
disability in the U.S., creating mobility challenges and difficulties
performing everyday tasks and activities.
But there is some good news: Studies show that
up to 80 percent of strokes may be preventable. May is Stroke Awareness
Month, where the American Heart Association, American Stroke Association
and National Stroke Association dedicate time to public awareness and
education about stroke and how to recognize stroke symptoms, identify risk factors and help reduce the incidence of stroke.
So what is a stroke, exactly? The brain is the
body's "command central," which controls all aspects of how we function –
how we move, how we think, how we talk and understand, how we swallow,
how we see, how we behave. A stroke is a "brain attack" and occurs when
blood flow to an area of the brain is interrupted. This can be due to a
clot blocking a blood vessel in the brain, or a ruptured blood vessel
within the brain, which causes bleeding. When blood flow to a part of
the brain is interrupted, the area of the brain that does not get oxygen
can die, and that part of the brain, and the functions it controls, are
compromised. The part of the body controlled by the damaged brain does
not work as it should.
Stroke Warning Signs
Similar to knowing the signs of a heart attack,
you should also know the signs of a stroke. The acronym FAST has been
developed to raise awareness about stroke symptoms and how to recognize a stroke as a medical emergency, requiring immediate medical attention and a call to 911.
F is for face – ask the person to smile. Look for an uneven smile, with one side of the mouth drooping.
A is for arm – ask the patient to raise both arms. Look for one arm lagging behind or unable to lift easily.
S is for speech – ask the person to say a simple sentence. Listen for slurred speech or the inability to talk at all.
T is for time – time to call 911 at the first sign.
Stroke symptoms include:
- Sudden weakness or numbness in the arms, legs or the face, especially on one side of the body.
- Sudden balance problems, with difficulty standing, walking or with coordination.
- Sudden confusion, with difficulty speaking or understanding.
- Sudden difficulty seeing in one or both eyes.
- There may be a sudden, severe headache, plus nausea and vomiting.
Studies have shown that most Americans can't
identify the signs of a stroke, and many people are not aware of the
need for immediate medical attention. Advances in medical care have made
prompt calls to 911 even more important, since there are drugs and
procedures to break up or remove clots in the brain or to help control
bleeding in the brain. Many of these treatments are time-sensitive and
can only be given within specific time frames from the onset of
symptoms. Calling 911 at the first signs of stroke can help lessen its
disabling effects. It's important to remember that "time is brain," and
to get help as soon as possible.
Stroke Prevention
Many strokes can be prevented, so it's important
to know which risk factors you can change and manage to help reduce
your risk. Treatable stroke risk factors include:
- Managing high blood pressure
- Not smoking
- Controlling high cholesterol
- Weight management
- Getting physical activity
- Managing diabetes to control blood sugar levels
- Managing carotid artery disease
- Treating atrial fibrillation or other heart arrhythmias
There are some risk factors for stroke that
can't be controlled. These include our age, sex, race, hereditary
factors and having had a prior stroke. It's important to talk with your
doctor or health care professional to best manage your personal risk
factors so you can do all you can to reduce your chance of having a
stroke.
Advances in Stroke Rehabilitation
There are almost 7 million stroke survivors in the U.S. While every stroke affects the brain in a unique way,
some type of disability and physical limitation are common effects of a
stroke. There can be physical challenges, with limb weakness or
paralysis, problems with balance, swallowing difficulties and visual
changes. There may be challenges with speaking or understanding words
and sentences. Writing, reading and math skills may be affected, and
there may be changes in thinking skills, in emotions and with behavior
since the brain controls all these functions. A stroke survivor may be
irritable, forgetful, impulsive, anxious or depressed, and may have
difficulty with memory, planning and organizing.
Rehabilitation after a stroke can help with relearning new and safe ways of doing daily activities, as well as recovery of as much independence, mobility, safety and quality of life as possible.
Research has shown that the adult brain has the
quality of plasticity – the ability to change and develop new pathways
after injury. While much of the work of stroke rehabilitation does focus
on improving abilities to do daily activities, technology has taken on a
new role in helping the brain to rewire itself. Robotic devices can
move a weak limb with hundreds of repetitions – many more than can be
provided by one therapist in a treatment session.
Telerehab, with the use of web cameras, can help
those who cannot come to a therapy clinic and still allow input from
health practitioners. Computer programs can provide voice output with a
few keystrokes to help with speech production. Readily available apps
assist with memory, math skills and reading. Many technologies,
including devices that stimulate weak or paralyzed muscles, have
widespread use in stroke rehabilitation. Ongoing research will continue
to show which techniques, devices and technologies are most effective in
helping the brain heal after a stroke.
Lisa Edelstein, OT, is director of the Stroke Program at Burke Rehabilitation Hospital in White Plains, New York.
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