Strokes Of Fate: Counting Each One And Moving Forward

Strokes are a leading cause of death and disability worldwide, with around 795,000 people in the US experiencing a stroke each year. They occur when there is an interruption to the blood supply to the brain, which causes brain cells to die due to a lack of oxygen. The longer the interruption, the greater the damage. While not all strokes are fatal, the more strokes a person has, the higher the risk of lasting damage or death.

How many strokes can a person survive?

Strokes are a life-threatening medical emergency and can cause death or disability. While there is no exact answer to how many strokes a person can survive, it is clear that the more strokes a person has, the higher the risk of damage to the brain, and the greater the likelihood of lasting damage or death.

Brain cells need a constant supply of blood and oxygen to stay alive. When something blocks the blood supply, brain cells begin to die within minutes, and the longer the interruption in blood flow, the greater the damage. This can result in disability, depending on the part of the brain affected, and the larger the area of the brain that is affected, the less likely a person is to survive. A stroke in the brainstem is also more likely to be fatal.

Immediate medical attention is critical to prevent permanent damage or death, and early treatment improves the chances of survival. If a person gets to the hospital within 3 hours of the first symptoms of a stroke, they often experience less disability after 3 months than those who receive delayed medical attention.

There are two main types of strokes: ischemic and hemorrhagic. Ischemic strokes are the most common and happen when a blood clot or the narrowing of a blood vessel reduces blood flow to the brain. Hemorrhagic strokes are marked by a burst blood vessel that causes blood to leak into or around the brain. Hemorrhagic strokes carry a greater risk of death and having another stroke than ischemic strokes.

It is worth noting that one in four stroke survivors will go on to have another stroke, and having a stroke makes it more likely that a person will have another. However, 80% of strokes are preventable, and certain lifestyle changes can lower the risk of having a stroke. These include not smoking, controlling high blood pressure and cholesterol, and eating a healthy diet rich in fruits and vegetables.

What are the different types of strokes?

Strokes are a life-threatening medical emergency that occurs when there is an issue with blood flow to the brain. They are the brain's equivalent of a heart attack. There are two main types of strokes, and within those categories, there are further subtypes.

Ischemic Strokes (Clots)

Ischemic strokes are caused by a blockage of an artery or, in rare cases, a vein, impairing blood flow to the brain. Brain cells and tissues begin to die within minutes due to a lack of oxygen and nutrients. This type of stroke accounts for 80-87% of all strokes. Ischemic strokes are 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 travels to the blood vessels in the brain through the bloodstream.

Ischemic strokes can also be classified as:

• Thrombosis: Formation of a clot in the brain.
• Embolism: A fragment of a clot that formed elsewhere in the body travels to the brain and gets stuck.
• Lacunar stroke: Small vessel blockage that can occur due to long-term, untreated high blood pressure, high cholesterol, or high blood sugar.
• Cryptogenic strokes: Strokes with an unknown cause.

Hemorrhagic Strokes (Bleeds)

Hemorrhagic strokes occur when a weakened blood vessel, usually an aneurysm or arteriovenous malformation (AVM), ruptures and bleeds. This type of stroke accounts for about 13% of all strokes. There are two types of hemorrhagic strokes:

• Intracerebral hemorrhage: Bleeding from blood vessels within the brain.
• Subarachnoid hemorrhage: Bleeding in the subarachnoid space, or the area between the brain and its outer covering.

Transient Ischemic Attack (TIA)

Transient ischemic attacks, or TIAs, are also known as "mini-strokes." These are temporary clots that serve as warning signs of a more severe stroke in the future.

What are the warning signs of a stroke?

A stroke is a life-threatening medical emergency that requires immediate attention. It occurs when there is a sudden interruption to the blood supply in the brain, causing brain cells to die within minutes. It is important to be able to recognise the warning signs of a stroke and act quickly to prevent long-term disability or death. Here are the warning signs to look out for:

Balance Problems

Be watchful of a sudden loss of balance. The person may feel dizzy or stumble while walking.

Eyesight Issues

Look out for a sudden loss of vision or double vision in one or both eyes.

Facial Drooping or Numbness

Ask the person to smile and observe if one side of their mouth droops. This is a sign of muscle weakness or paralysis.

Arm Weakness

Ask the person to raise both arms. If they have one-sided weakness, one arm will stay up while the other will sag or drop down.

Speech Difficulty

The person may have difficulty speaking clearly, slurring their words, or have trouble finding the right words.

Terrible Headache

The person may experience a sudden, severe headache, unlike any they have had before.

If someone is exhibiting one or more of these symptoms, it is crucial to act fast. Call 911 or your local emergency services immediately. Time is of the essence when it comes to treating a stroke, and early treatment can significantly improve the chances of survival and reduce the risk of long-term disability.

What to do if you suspect someone is having a stroke?

A stroke is a life-threatening medical emergency that requires immediate attention. If you suspect someone is having a stroke, here are some steps you should take:

• Call for emergency medical help – Time is critical in treating a stroke. Call 911 or your local emergency number immediately. Paramedics can provide rapid assistance and recognise if someone needs urgent medical care.
• Do not drive the person to the hospital – While it is important to act quickly, it is safer and faster to call for emergency services.
• Do not give aspirin – Aspirin can be beneficial for certain types of strokes but detrimental for others. It is best to leave such decisions to medical professionals.
• Do not give food or water – Stroke can impair muscle control, including the ability to swallow, so it is not advisable to give anything to eat or drink.
• Note the time – Knowing when the symptoms started is crucial for determining the appropriate treatment. If unsure, note the time the person was last seen in a normal state.
• Help the person lie down – Assist the person in lying on their side with their head slightly elevated to promote blood flow.
• Loosen restrictive clothing – Removing or loosening tight clothing can help the person breathe more easily. Avoid pulling or straining any weakened limbs.
• Check for breathing and pulse – If the person is unconscious, check their breathing and pulse. If there is no pulse, immediately start CPR until emergency services arrive.

Remembering the acronym BE FAST can help you recognise the warning signs of a stroke:

• B alance: Watch for a sudden loss of balance.
• E yes: Look for sudden vision loss in one or both eyes, or double vision.
• F ace: Ask the person to smile and observe for facial drooping, which indicates muscle weakness or paralysis.
• A rms: Check for one-sided weakness by asking the person to raise their arms. One arm sagging or dropping indicates muscle weakness.
• S peech: Strokes often cause difficulty in speaking, such as slurred speech or trouble finding the right words.
• T ime: Time is of the essence. Act quickly and seek medical help immediately.

Acting fast can significantly reduce the death rate and level of disability resulting from strokes. Prompt medical care improves the chances of a positive outcome.

How to prevent a stroke?

According to the Centers for Disease Control and Prevention (CDC), 8 in 10 strokes are preventable. While age and family history are stroke risk factors that you have no control over, there are several other risk factors that you can control. Here are some ways to prevent a stroke:

Lower Blood Pressure

High blood pressure is a significant contributor to the risk of stroke in both men and women. Monitoring and treating high blood pressure can be a game-changer in reducing the chances of a stroke. An ideal blood pressure range is less than 120/80, but this may vary based on individual circumstances. To achieve this, it is recommended to reduce salt intake, avoid high-cholesterol foods, adopt a diet rich in fruits and vegetables, and incorporate regular exercise into your daily routine.

Maintain a Healthy Weight

Obesity is a risk factor for stroke and is linked to complications such as high blood pressure and diabetes. Losing weight, even a small amount, can significantly lower the risk of stroke. Work with your doctor to determine a healthy weight goal and develop a personalised weight loss strategy.

Exercise Regularly

Engaging in regular physical activity is an effective way to prevent strokes. Aim for at least 150 minutes of moderate aerobic activity, such as walking or biking, each week. Additionally, include muscle-strengthening activities, such as lifting weights or doing push-ups, at least two days a week. If you're just starting, begin with smaller durations and gradually increase your activity levels over time.

Adopt a Healthy Diet

Improving your diet can considerably reduce your risk of stroke. The Mediterranean diet, which includes healthy fats (fatty fish, nuts, seeds, avocado, and extra-virgin olive oil), beans, legumes, and whole grains, is recommended for lowering stroke risk. Additionally, limit your salt and sugar intake, especially in processed, packaged, and canned foods.

Treat Underlying Health Conditions

Certain underlying health conditions can increase the risk of stroke. These include heart disease, atrial fibrillation (irregular heartbeat), high cholesterol, and diabetes. It is crucial to seek treatment for these conditions and follow your doctor's advice on managing them effectively.

Quit Smoking

Smoking is a significant risk factor for stroke. Quitting smoking is one of the best things you can do to reduce your chances of having a stroke. If you struggle with quitting, speak to your healthcare provider, who can offer guidance and resources to support your journey.

Drink Alcohol in Moderation

Excessive alcohol consumption increases the risk of stroke. To lower your risk, drink in moderation or not at all. This typically means no more than one drink per day for women and no more than two drinks per day for men.

Monitor Your Blood Sugar

High blood sugar can damage blood vessels over time, making clots more likely to form. Keeping your blood sugar levels within the normal range can help reduce the risk of stroke. Consult your doctor to determine the best ways to manage your blood sugar.

Frequently asked questions