Stroke is the fifth leading cause of death and a leading cause of disability
among adults in the United States. A stroke can be devastating to patients
and their families. Strokes can range from mild to severe and can happen
at any age. They can occur in different parts of the brain and may affect
different body functions.
What is a stroke?
A stroke, or “brain attack,” occurs when the blood supply stops
flowing to a part of the brain. Brain cells die from the lack of oxygen.
There are two main types of stroke:
Ischemic: An ischemic stroke occurs when a blood vessel that delivers blood to
the brain is blocked by a blood clot. This is the most common type of
stroke, making up about 87% of all strokes. Patients that have this type
of stroke may be administered a medication that dissolves the clot called
Tissue Plasminogen Activator (tPA) or receive a procedure called mechanical
thrombectomy (clot retrieval). Treatment for this kind of stroke is available
if the patient arrives soon after the stroke occurs which is why calling
9-1-1 with the first signs of stroke is vital.
Hemorrhagic: A hemorrhagic stroke occurs when a blood vessel in the brain breaks open
and bleeds into the brain. This causes swelling, pressure and damage to
the brain tissue. Hemorrhagic strokes are less common but are more likely
to cause death. Treatment of hemorrhagic strokes includes medications,
neurosurgery, or treatment of blood vessels using catheter based approaches
(endovascular approaches).
What are the early signs of stroke?
It is important to know the early signs of stroke.
Call 9-1-1 immediately if you or someone you are with shows signs of having a stroke. Do not
try to drive yourself to the hospital. It is important to get care quickly
because you may be eligible for treatment to reduce damage caused by a
stroke. Treatment and recovery may depend on how soon you get care.
Stroke symptoms can vary. They often come on quickly. You may wake up with
the symptoms. Act quickly and
call 911 immediately if you notice any of these symptoms: Remember to BE FAST
Stroke Symptoms:
Numbness or weakness of the face, arm or leg, especially on one side of the body
Confusion or trouble speaking or understanding, sudden incoordination
Trouble seeing in one or both eyes
Trouble walking, dizziness, or loss of balance or coordination
Severe headache
A stroke can happen with just one of these symptoms. Sometimes people have
stroke like symptoms that go away quickly (called a transient ischemic
attack or TIA.) Do not ignore these signs! Many people who have these
warning signs go on to have a stroke.
After a stroke, you will probably have many questions about what happened
and what treatments are available. If the stroke was severe, you may not
be able to ask questions for yourself.
You or your advocate should ask:
What are the effects of having this type of stroke?
What can be done to improve your chance of recovery?
Where in the brain did the stroke occur? Can the doctor draw a picture
of the affected area or show you on a scan where it occurred?
What was the cause of your stroke?
What is being done to prevent other health problems and address your risk factors?
What new medicines are recommended?
What are the benefits and side effects of the new medicines?
Will the new medicines interact with your current medicines, over the counter
medicines, or dietary or herbal supplements?
Can a medicine be changed if it costs too much or causes side effects?
Will surgery or another type of treatment be necessary?
When will rehabilitation (rehab) begin? Stroke rehab will help you achieve
the best possible recovery and quality of life. Rehab should begin while
you are in the hospital.
How long will the recovery take?
In the case of a severe stroke, your advocate can also:
Remind caregivers that you have had a stroke. The advocate can tell caregivers
what you can and cannot do.
Remind visitors that you may not be able to speak, but you can still understand things.
Ask caregivers and visitors to wash their hands to prevent the spread of
infection.
What can you expect in recovery?
Stroke recovery often takes months. Your physician may be able to guide
you as to what to expect during recovery. Everyone recovers to a different
degree, but generally the more exercises you do, the better your eventual
recovery will be. Therapists and Rehabilitation doctors will work with
you to maximize your stroke recovery.
Before leaving the hospital, you and your advocate should work with the
case manager and care team to determine how to continue your recovery.
Ask:
What is your long term outlook for work, daily activities, physical activity
and mental function?
What type of rehab will you need? Home care? Outpatient? Inpatient?
Is rehab covered by your insurance? If not, ask the case manager what services
are available in your area.
Will you need long term rehab or lifelong exercises?
How often should you see a doctor?
What kinds of tests will be done to see if treatments or medicines are helping?
What are your treatment goals? For example, what should your blood pressure be?
Are there any alternative or complementary treatments, such as massage,
that will help?
What kinds of symptoms or changes should always be reported to a doctor?
Should you join a support group?
During this time, it is important to:
Be realistic about your abilities. Identify what you can do and build on it.
Allow people to help you. If people ask, give them something specific to do.
Talk to your doctor if you are feeling blue or fatigued. Do not ignore
these symptoms. Depression and mood changes are common after a stroke.
Make sure you are evaluated and treated, if necessary.
Educate yourself. Learn about the stroke resources available in your community,
online and at your local library.
