Stroke Awareness: Early Signs & Emergency Care

A stroke occurs when the blood supply to the brain is  reduced or interrupted. This deprives brain tissue of essential oxygen and nutrients, causing brain cells to begin to die within minutes.

Immediate treatment is critical. Early action can reduce brain damage and prevent potential long-term disability or death.

The Main Types of Stroke

• Ischemic Stroke: It happens when a blood vessel supplying the brain becomes blocked or plugged, often by a blood clot. These clots can form in arteries damaged by fatty deposits (atherosclerosis) or travel from other parts of the body, such as the heart.
• Hemorrhagic Stroke: This type occurs when a blood vessel within or on the surface of the brain leaks or ruptures (bursts). This causes bleeding into the brain tissue or the surrounding spaces, which puts excessive pressure on brain cells and damages them. Causes include uncontrolled high blood pressure, aneurysms (bulges in a vessel wall), or arteriovenous malformations (AVMs), which are irregular tangles of blood vessels.

A Transient Ischemic Attack (TIA), or "mini-stroke," is a related condition. It involves a temporary period of stroke-like symptoms caused by a brief decrease in blood supply to the brain. While a TIA doesn't typically cause permanent damage, it serves as a serious warning sign that a major stroke may be imminent.

Recognizing the Symptoms: Act F.A.S.T.

Stroke symptoms appear suddenly. Recognizing them is the first step to getting life-saving help. The F.A.S.T. acronym is a simple way to remember the key signs:

• F - Face: Ask the individual to smile. Check if one side of their mouth or face sags or appears uneven.
• A - Arms: Instruct the person to lift both arms in front of them. Observe if one arm lowers involuntarily or is incapable of being raised fully.
• S - Speech: Ask them to repeat a very basic sentence. Listen for speech that sounds thick, slurred, or odd. Also, note if they have trouble comprehending instructions.
• T - Time:  If you observe any single one of these warning signs, treat it as a medical emergency.

Other sudden symptoms to watch for include:

• Unexplained weakness or numbness in the limbs or face, particularly when these symptoms manifest only on one half of the body.
• Confusion.
• Trouble seeing in one or both eyes, such as sudden blurred or blackened vision.
• Dizziness, or a loss of balance & coordination.
• A severe headache with no known cause, which may be accompanied by vomiting or dizziness.

Understanding the Causes and Risk Factors

While the direct causes are a clot (ischemic) or bleeding (hemorrhagic), numerous risk factors increase the likelihood of a stroke. These factors are categorized as controllable or uncontrollable.

Controllable (Modifiable) Risk Factors: These are factors you can manage with lifestyle changes or medical treatment.

• Medical Conditions:
• High Blood Pressure (Hypertension): This is the single most significant risk factor for stroke.
• High Cholesterol: Can lead to the buildup of plaque in arteries.
• Diabetes: Poorly controlled diabetes damages blood vessels over time.
• Heart Conditions: Atrial fibrillation (an irregular heartbeat), heart defects, and other heart diseases can create clots.
• Obstructive Sleep Apnea: A sleep disorder that can raise blood pressure.
• Lifestyle Factors:
• Tobacco Use: Smoking or chewing tobacco damages blood vessels and raises blood pressure.
• Physical Inactivity: Lack of exercise contributes to obesity, high blood pressure, and high cholesterol.
• Unhealthy Diet: Diets high in saturated fats, trans fats, and sodium can raise cholesterol and blood pressure.
• Heavy Alcohol Use: Can increase blood pressure.
• Use of Illegal Drugs: Drugs like cocaine can narrow arteries.

Uncontrollable Risk Factors:

• Age: The risk of stroke increases as you get older.
• Family History: A personal or family history of stroke, heart attack, or TIA increases your risk.
• Race and Ethnicity: Some groups, such as African Americans, have a higher risk of stroke.
• Sex: Men have a slightly higher risk of stroke than women, though women are often older when they have strokes and are more likely to die from them.
• Hormones: The use of estrogen-containing birth control pills or hormone therapies can increase risk.

How a Stroke is Diagnosed

In an emergency setting, a medical team will work quickly to determine the type of stroke. This involves:

• Physical and Neurological Exam: Checking mental alertness, coordination, balance, vision, speech, and for weakness or numbness.
• Brain Imaging: A Computerized Tomography (CT) scan is often done first. It can quickly show bleeding in the brain (hemorrhagic stroke) or damage from an ischemic stroke. A Magnetic Resonance Imaging (MRI) scan provides a more detailed image of brain tissue and can detect damage earlier than a CT.
• Other Tests: A carotid ultrasound uses sound waves to check for plaque buildup in the neck arteries. An echocardiogram can create images of the heart to find a source of clots. Blood tests are also performed.

Treatment

The treatment for a stroke depends entirely on its type.

For an Ischemic Stroke: The goal is to restore blood flow to the brain as quickly as possible.

• IV Medicines: An injection of recombinant tissue plasminogen activator (tPA) is the gold standard. This clot-busting drug must be given within 3 to 4.5 hours of when symptoms started.
• Endovascular Procedures: These are performed directly inside the blocked vessel. A mechanical thrombectomy involves a surgeon threading a catheter to the clot and using a device (a stent retriever) to pull it out. This can be effective up to 24 hours after symptom onset in certain cases.

For a Hemorrhagic Stroke: The goal is to control the bleeding and reduce pressure on the brain.

• Medication: Drugs are given to lower blood pressure, counteract blood thinners, and prevent seizures or blood vessel spasms.
• Surgery: If the bleeding is severe, surgery may be needed to remove the blood and relieve pressure. If the stroke was caused by a ruptured aneurysm, a surgeon may perform:
• Surgical Clipping: A tiny clamp is placed at the base of the aneurysm.
• Coiling (Endovascular Embolization): Tiny coils are placed inside the aneurysm via a catheter to block blood flow and cause clotting.

Recovery and Prevention

Recovery from a stroke, known as rehabilitation, is a critical part of the process and often begins in the hospital. The goal is to regain skills and independence. This may involve:

• Physical Therapy to regain strength, balance, and movement.
• Occupational Therapy to relearn daily activities like eating, dressing, and writing.
• Speech Therapy to help with language, speaking, and swallowing.

The best way to manage stroke is to prevent one. Controlling your modifiable risk factors is the most effective strategy. This includes managing high blood pressure, quitting smoking, eating a healthy diet, exercising regularly, & managing conditions like diabetes and atrial fibrillation.

​A Complete Spectrum of Emergency Medical Services

Sterling Hospital delivers rapid, specialized emergency care through a well-structured response system designed to meet critical medical needs. The emergency department is equipped to manage severe trauma from accidents and injuries, deploying experienced medical teams for immediate intervention in complex cases.

The hospital excels in treating acute cardiovascular events such as myocardial infarctions and cardiac rhythm disturbances, using advanced diagnostic tools and evidence-based treatment protocols to ensure timely care.

Neurological emergencies are addressed with prompt evaluation and targeted treatment strategies aimed at minimizing long-term damage. The emergency team is also trained to manage a wide range of urgent medical conditions with swift stabilization and appropriate clinical management.

Enhancing this care pathway are Sterling’s specialized critical care units, which are staffed around the clock by intensivists and physicians certified in critical care medicine. These units combine expert supervision with state-of-the-art life support systems and continuous monitoring to create the best possible outcomes for patients in life-threatening conditions.