(L to R) Dr. Atif Zafar, Valerie McWhinnie and Kapilan Kulasingham.

(L to R) Dr. Atif Zafar, Valerie McWhinnie and Kapilan Kulasingham.

Stroke care at Unity Health Toronto spans all three of our sites and includes hundreds of staff and physicians working in the emergency departments, ICUs, inpatient stroke units and specialized follow-up clinics at St. Joseph’s and St. Michael’s, as well as rehabilitation units at Providence Healthcare.

Providing excellent, wraparound stroke care is important for the health of our communities: Stroke is the third leading cause of death in Canada and the leading cause of adult disability. A stroke event leads to a hospitalization or emergency department visit every five minutes in Canada, research shows. 

For Stroke Awareness Month, we reached out on social media to ask people to send in their stroke-related questions. Here are the answers, provided by Dr. Atif Zafar, medical director of the stroke program at St. Michael’s, and Providence Healthcare Physiotherapist Valerie McWhinnie and Occupational Therapist Kapilan Kulasingham.

Q: I heard that stroke is increasing in young adults. Why is this happening?

Zafar: The number of strokes in younger people is on the rise. We believe this increase is due to rising incidence of diabetes, high blood pressure, sleep problems, alcohol, and drug use in younger individuals.

Q: How is rehab different for young adults who’ve had a stroke compared to older adults?

McWhinnie and Kulasingham: Rehabilitation is generally the same for younger and older stroke survivors. Stroke survivors here at Providence are treated by a specialized interdisciplinary team in our inpatient and outpatient settings. We listen to their concerns and make goals together focusing on maximizing their recovery.

Younger stroke survivors often have many questions: Why did I have a stroke? Am I at risk for another stroke? Will I return to work? How can I care for my children? How will I pay my bills? We support and help the survivors find the answers to their individualized questions.

Younger stroke survivors will likely have to live longer with a disability. It is important that they learn strategies for heathy living. In our outpatient Stroke Clinic, we offer a Living with Stroke program that focuses on self-management skills. Ongoing exercise is encouraged through our partnership with Variety Village (accessible community fitness facility).

Q: Are there differences between men and women in the signs of stroke?

Zafar: Sometimes there can be slight differences. Recent studies did not find significant differences in stroke signs between genders, but past research has shown that women may experience more headaches and non-specific symptoms during a stroke.

Q: I’ve read that women who have strokes fare worse than men. Why is that?

Zafar: Interestingly, women tend to have better survival rates than men after a stroke. However, when it comes to disability, women may experience more challenges. The exact reasons for this are not fully understood, but it could be related to the control of risk factors and access to rehabilitation services after a stroke.

Q: Why does pregnancy increase the risk of stroke?

Zafar: The hormonal changes during pregnancy contribute to an increased risk of stroke. The risk is particularly high during the last trimester and the first weeks after labor. Pregnant individuals with high blood pressure and diabetes should have closer monitoring by their doctors to reduce their risk.

Q: What is a mini-stroke and what should you do if you think you’re having/have had one?

Zafar: A mini-stroke, also known as a TIA (transient ischemic attack), is a temporary set of stroke-like symptoms. These symptoms may include temporary paralysis or difficulty speaking. Even though the symptoms resolve within minutes to an hour, a TIA should be taken seriously. Seek immediate evaluation in the emergency room if the symptoms are ongoing or visit an urgent care clinic or stroke clinic if the symptoms have resolved. Treating the underlying cause is crucial to prevent a more serious stroke in the future.

Q: Do migraines with aura increase my risk of stroke?

Zafar: Migraines with aura are associated with a higher likelihood of having an ischemic stroke. It’s important to have your migraines with aura properly managed and discussed with your doctor. Unlike regular migraines, migraines with auras should be taken seriously due to their connection to stroke risk. Auras can involve visual disturbances like zig-zag lines or temporary loss of vision, followed by a headache and other symptoms.

Q: How do sleep habits impact the risk of stroke?

Zafar: Obstructive sleep apnea (OSA) is a risk factor for stroke. If you snore at night and feel tired during the day, it’s important to discuss these symptoms with your doctor to explore the possibility of OSA treatment.

Q: Is it true that smelling burnt toast when there is none is a sign of a stroke? Why is this associated with stroke symptoms?

Zafar: Contrary to popular belief, smelling burnt toast when there is none is not a proven sign of a stroke. However, this misconception may stem from the association between stroke and changes in sensory perceptions. If you experience any unusual symptoms or suspect a stroke, it’s important to seek medical attention immediately.

By: Marlene Leung