
Strokes are a life-threatening medical emergency that occurs when there is an issue with blood flow to the brain. While there is no exact answer to how many strokes a person can have and survive, each stroke injures the brain and increases the risk of lasting damage or death. Immediate medical attention is critical to improving the chances of survival and minimising the risk of permanent disability. In the United States, about 795,000 people suffer a stroke each year, with nearly one-quarter of these being repeat strokes.
Characteristics | Values |
---|---|
Number of people who have a stroke each year in the US | 795,000 |
Number of first strokes each year in the US | 610,000 |
Number of strokes each year in the US that are not first strokes | 185,000 |
Percentage of strokes that are first strokes | 76.7% |
Number of stroke deaths each year in the US | 137,000 or 140,000 |
Percentage of stroke deaths by gender | 40% male, 60% female |
Number of strokes every year worldwide | N/A |
Number of strokes that can be survived | N/A |
What You'll Learn
Risk factors for stroke
While anyone can have a stroke at any age, certain factors can increase your chances of having one. It is important to understand your risk and take steps to control it. Here are some risk factors for stroke:
Conditions that Increase Risk
- Previous stroke or transient ischemic attack (TIA): If you have had a previous stroke or TIA ("mini-stroke"), your chances of having another stroke are higher.
- High blood pressure: High blood pressure is a leading cause of stroke. It occurs when the pressure of blood in your arteries is too high and can lead to blood vessel damage, making a stroke more likely.
- High cholesterol: Cholesterol is a waxy, fat-like substance produced by the liver. While the liver makes enough for the body's needs, additional cholesterol from food can build up in the arteries, including those in the brain, leading to narrowing and blockage.
- Heart disorders: Common heart disorders such as coronary artery disease, heart valve defects, irregular heartbeat (atrial fibrillation), and enlarged heart chambers can increase the risk of blood clots that may cause a stroke.
- Diabetes: Diabetes causes sugars to build up in the blood, preventing oxygen and nutrients from reaching the brain. It is also associated with high blood pressure, a leading cause of stroke.
- Obesity: Obesity is linked to higher levels of "bad" cholesterol and triglycerides and lower levels of "good" cholesterol. It can also lead to high blood pressure and diabetes, both risk factors for stroke.
- Sickle cell disease: This blood disorder, predominantly affecting Black children, can cause red blood cells to form an abnormal sickle shape. If these sickle cells get stuck in a blood vessel, they can block blood flow to the brain and lead to a stroke.
Behaviours that Increase Risk
- Diet: Consuming a diet high in saturated fats, trans fat, and cholesterol has been linked to stroke and related conditions such as heart disease. Excess salt (sodium) in the diet can also raise blood pressure levels.
- Physical inactivity: Lack of physical activity can lead to health conditions that raise the risk of stroke, including obesity, high blood pressure, high cholesterol, and diabetes. Regular physical activity can reduce your chances of having a stroke.
- Alcohol consumption: Drinking excessive alcohol can elevate blood pressure levels and the risk of stroke. It also increases triglyceride levels, a form of fat in the blood that can harden arteries.
- Tobacco use: Tobacco smoking can damage the heart and blood vessels, increasing the risk of stroke. Nicotine raises blood pressure, and carbon monoxide from cigarette smoke reduces the oxygen-carrying capacity of the blood.
Other Factors that Increase Risk
- Genetics and family history: Genetic factors likely play a role in high blood pressure, stroke, and related conditions. People with a family history of stroke may also share common environments and other factors that increase their risk. The combination of heredity and unhealthy lifestyle choices, such as smoking and an unhealthy diet, can further amplify the risk.
- Age: The chance of having a stroke increases with age, doubling every ten years after age 55. However, it is important to note that stroke can occur at any age, and about one in seven strokes happen in adolescents and young adults ages 15 to 49.
- Gender: Women are at a higher risk of stroke than men and are more likely to die from it. Pregnancy and the use of hormonal birth control pills pose additional stroke risks for women.
- Race/Ethnicity: In the United States, non-Hispanic Black adults and Pacific Islanders have a higher risk of dying from a stroke than other racial groups. The risk of a first stroke is nearly twice as high for Black people as for White people.
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How to recognise a stroke
Strokes are a life-threatening medical emergency and can happen to anyone, from children to adults. Immediate medical attention is critical to prevent permanent damage or death.
F.A.S.T. test
- Face: Ask the person to smile and observe if one side of their face droops or is numb.
- Arm: Check if one arm is weak or numb by asking the person to raise both arms. See if one arm drifts or droops downward.
- Speech: Listen for strange or slurred speech by asking the person to repeat a simple phrase.
- Time: If you observe any of the above signs, call the emergency services right away. Make a note of the time when the symptoms first appeared. This information is crucial for healthcare providers to determine the best course of treatment.
B.E.F.A.S.T. test
- Balance: Be watchful for a sudden loss of balance.
- Eyes: Look out for sudden loss of vision or double vision in one or both eyes.
- Face: Ask the person to smile and look for a droop on one or both sides of their face, indicating muscle weakness or paralysis.
- Arm: Check for muscle weakness on one side by asking the person to raise their arms.
- Speech: Observe if the person is having difficulty speaking or choosing the right words.
- Time: Time is critical, so don't delay in seeking medical help.
Other signs and symptoms of a stroke include:
- Severe headache with no known cause.
- Numbness or weakness, especially on one side of the body.
- Confusion, disorientation, or trouble understanding speech.
- Trouble walking, dizziness, loss of balance, or lack of coordination.
- Nausea and vomiting.
- Emotional instability and personality changes.
- Memory loss.
- Passing out or fainting.
If you or someone you know is experiencing any of these symptoms, call the emergency services immediately.
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Types of stroke
There are two main types of stroke: ischemic strokes and hemorrhagic strokes. Ischemic strokes are the most common, accounting for about 87% of all strokes, while hemorrhagic strokes make up the remaining 13%.
Ischemic Strokes
Ischemic strokes occur when a blood vessel supplying blood to the brain is blocked or clogged, usually by a blood clot or a buildup of fatty plaque. This blockage impairs blood flow to the brain, causing brain cells and tissues to die within minutes from a lack of oxygen and nutrients. Ischemic strokes can be further divided into two groups:
- Thrombotic strokes: caused by a blood clot that develops in the blood vessels inside the brain.
- Embolic strokes: caused by a blood clot or plaque debris that develops elsewhere in the body and then travels to one of the blood vessels in the brain through the bloodstream.
Hemorrhagic Strokes
Hemorrhagic strokes occur when a weakened blood vessel, often due to an aneurysm or arteriovenous malformation, ruptures and bleeds. This bleeding creates pressure and injures the surrounding brain tissue, damaging brain cells. Hemorrhagic strokes are rarer than ischemic strokes but progress more quickly and are usually more severe. They can be divided into two subtypes:
- Intraparenchymal: bleeding occurs directly in the brain tissue, often due to high blood pressure.
- Subarachnoid: bleeding occurs in the subarachnoid space, between the brain and the surrounding membrane. This is often caused by an aneurysm or arteriovenous malformation.
Transient Ischemic Attack (TIA)
Transient Ischemic Attack (TIA), also known as a "mini stroke", is a temporary blockage that resembles an ischemic stroke but only lasts a short time. It is often a warning sign of a full ischemic stroke in the future.
Cryptogenic Stroke
A cryptogenic stroke is a stroke of unknown origin, where the cause cannot be determined.
Brainstem Stroke
A brainstem stroke occurs in the brain stem and can affect both sides of the body, leaving the patient in a locked-in state, generally unable to speak or move below the neck.
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Preventing another stroke
Having a stroke puts you at a higher risk of having another one. In fact, 1 in 4 stroke survivors will have another stroke. However, many strokes can be prevented through education and lifestyle changes. Here are some ways to prevent another stroke:
Manage Your Health Conditions and Risk Factors
If you have health conditions such as obesity, abnormal heart rhythms, sleep apnea, high blood pressure, Type 2 diabetes, or high cholesterol, it is important to manage them effectively. This can include taking prescribed medications and making lifestyle changes.
Improve Your Lifestyle
Adopting a healthier lifestyle can significantly reduce the risk of having a stroke. This includes eating a healthy diet rich in fruits and vegetables, getting regular physical exercise, quitting smoking and tobacco use, and limiting alcohol consumption. It is also important to get adequate sleep, with the recommended amount being seven to eight hours.
Take Prescribed Medications
It is crucial to take your prescribed medications as directed by your doctor. Not taking medications as recommended is a significant risk factor for repeat strokes. Continue taking your medications unless advised otherwise by your doctor.
Work with Your Doctor
Create a prevention plan with your doctor that addresses your specific needs, goals, and concerns. Keep your follow-up appointments and make any recommended lifestyle changes.
Recognize the Warning Signs
It is important to recognize the warning signs of a stroke and act quickly. Remember the acronym BE FAST:
- Balance: Watch for a sudden loss of balance.
- Eyes: Look for a sudden loss of vision or double vision.
- Face: Ask the person to smile and look for a droop on one or both sides of the face.
- Arms: Ask the person to raise their arms; one arm drifting downward could indicate muscle weakness.
- Speech: Strokes often cause difficulty speaking or slurred speech.
- Time: Time is critical; call emergency services immediately if you observe any of these symptoms.
By following these steps and working closely with your doctor, you can significantly reduce the risk of having another stroke.
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Treatment for stroke
The number of strokes a person can have depends on various factors, but it is important to note that having a stroke puts you at high risk of having another one. In fact, research estimates that nearly 1 in 4 people who survive a stroke will have another within 5 years.
Now, let's discuss the treatment for strokes in detail:
Strokes are a life-threatening medical emergency, and immediate treatment is crucial to prevent permanent damage or death. The treatment depends on the type of stroke, but the overarching goal is to restore blood flow to the brain and limit any lasting damage. Here is a detailed breakdown:
Ischemic Strokes:
Ischemic strokes account for about 80%-87% of all strokes and occur when blood flow to the brain is blocked, often by a blood clot. Treatment for this type of stroke focuses on restoring circulation to the affected areas of the brain as quickly as possible.
- Thrombolytic Drugs: Also known as "clot-busting" drugs, these medications are used to dissolve blood clots and improve the chances of recovery. Tissue plasminogen activator (tPA) is the most common thrombolytic drug used. It is essential to administer these drugs within 3 to 4.5 hours of the first stroke symptoms to improve outcomes and reduce the risk of disability.
- Thrombectomy: This is a surgical procedure to remove a blood clot. It is often performed within 24 hours if there is no significant brain damage.
- Blood Thinners: Doctors may prescribe blood-thinning medications to prevent new clots from forming.
Hemorrhagic Strokes:
Hemorrhagic strokes make up about 13%-20% of all strokes and occur when a blood vessel in the brain leaks or ruptures. The focus of treatment is to stop the bleeding, reduce blood pressure, and relieve pressure on the brain.
- Endovascular Procedures: These procedures can help repair weak spots or breaks in blood vessels.
- Surgery: Surgery may be necessary to stop the bleeding and relieve pressure on the brain. For example, a metal clip may be placed to stop blood loss from a ruptured aneurysm.
- Blood Pressure Management: Lowering blood pressure is crucial in treating hemorrhagic strokes as high blood pressure is usually the underlying cause.
Stroke Rehabilitation:
Rehabilitation is a critical part of stroke treatment and can include various therapies to help patients recover or adapt to changes in their brain:
- Speech Therapy: This helps patients regain language and speaking abilities and improve their ability to control muscles related to breathing, eating, drinking, and swallowing.
- Physical Therapy: This helps improve or regain movement and coordination, particularly in the hands, arms, feet, and legs.
- Occupational Therapy: This therapy helps retrain the brain to perform daily activities, such as eating, drinking, dressing, bathing, and writing.
- Cognitive Therapy: This can address memory problems and difficulties with activities that require focus and concentration.
Preventing Future Strokes:
After a stroke, it is essential to address the underlying causes and make necessary lifestyle changes to prevent another stroke:
- Medications: Doctors may prescribe medications to lower blood pressure, reduce cholesterol, or treat conditions such as atrial fibrillation.
- Diet and Exercise: Adopting a healthy diet and adding physical activity to your routine can help lower the risk of another stroke.
- Address Risk Factors: This includes managing conditions such as obesity, high blood pressure, diabetes, and high cholesterol. Quitting smoking and reducing alcohol consumption are also important.
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Frequently asked questions
There is no exact answer to how many strokes a person can have and survive. However, the more strokes a person has, the higher the risk of damage to the brain.
In the United States, about 795,000 people suffer a stroke each year, with around 137,000 people dying annually.
A stroke lasts as long as there is a lack of blood flow to the brain. Without treatment, a stroke will continue until the brain cells in the affected areas die, causing permanent damage.
Nearly one in four people who survive a stroke will have another stroke.