What Can We Do to Reduce Stroke Numbers?

Totally the wrong question! Just by asking that you're going down the route of  prevention topics.     LEAVING MILLIONS EACH YEAR DISABLED!!! Do the hard work of stopping the 5 causes of the neuronal cascade of death in the first week thus saving millions to billions of neurons. LEADERS would solve the real problem, not just spout prevention crapola. We have NO LEADERS IN STROKE!!!

What Can We Do to Reduce Stroke Numbers?

(In this article, Brent E. Masel, M.D, Executive Vice-President for Medical Affairs for CNS and a Clinical Professor of Neurology at the University of Texas Medical Branch in Galveston, discusses how we might decrease the severity of strokes or even mitigate them completely).

Stroke is the 4th leading cause of death in the US, where there are approximately 800,000 strokes yearly. A stroke occurs every 40 seconds, and one person dies every four minutes from a stroke. Globally, one person in four people over age 25 will have a stroke in their lifetime.  Interestingly, 60% of individuals who have a stroke are female. (There are lots of theories about this, but no one knows for sure).  An individual surviving a stroke has a 5.5-year reduction in their life span.

Aside from prevention, what can we, as healthcare providers, do to reduce these numbers? People will still have strokes, but we can do something to decrease the severity of the stroke or even mitigate it completely.

 We need to recognize the symptoms of a stroke so the individual may receive an intervention that may change the course of the event. The key is the acronym FAST:  Face, Arms, Speech, Time.

1. Facial weakness:  Can the person smile?  Has their mouth or eye drooped?
2. Arm weakness:  Can the person raise both arms?
3. Speech problems: Can the person speak clearly and understand what you say? 
4. Time to call 911 if you see any of the signs.

There are indeed other signs that should be considered and taken seriously, including sudden weakness or numbness on one side of the body, difficulty finding words or speaking in clear sentences, sudden blurred vision or loss of sight in one eye, sudden memory loss or confusion as well as dizziness or sudden fall.

“Time is brain.” 1.9 million brain cells die for every minute the brain is deprived of blood. If we see these signs, the individual must immediately go to a hospital emergency room – by ambulance if possible.  But what happens next, and what can be done?

Upon arrival, a “stroke team” will be activated. This team consists of specially trained doctors, nurses, and technicians who have a protocol to work as quickly as possible to find the best intervention for that patient. The patient will be evaluated and stabilized. Blood studies and a CT scan of the head will be done.  If the patient can receive treatment approximately 4.5 hours after the onset of symptoms, they may be appropriate for IV medication, TPA, that can break up the clot. It is believed that after approximately 4.5 hours, the chances of reversing the stroke and not causing further damage with the clot busters are markedly reduced. Studies have shown that individuals receiving TPA at the appropriate time are 30% more likely to have little or no symptoms at 3 months than those who received a placebo.

Another treatment possibility is removing the clot mechanically. This isn’t easy and requires highly trained interventionalists. A wire must be threaded up the artery to the clot and then the clot is “grabbed” and removed. Unfortunately, only 10% of stroke patients are eligible for this procedure, as the clot must be in a large artery close to the neck. The ideal timing is six hours after the event occurred, but the procedure can be done up to 24 hours later. Studies have shown recanalization, opening of the artery, in 60-75% of cases.