Jessamine County Coroner

Strokes

Stroke! This one simple word is often ignored by all but those who have been stricken by it; because it seems we generally don’t hear a lot about it. The truth is, approximately 800,000 Americans each year suffer some kind of stroke.   A stroke is called by other names, such a CVA (cerebral vascular accident), or brain attack.  Like a heart attack that affects blood flow through the heart’s arteries, a stroke interrupts the flow of blood to certain areas of the brain, which in turn causes many of the brain’s cells to die.  When this happens, the functions which that part of the brain controls, such as memory and muscle strength are lost or impeded.  Depending on the severity and how fast medical treatment is received, those functions may partially return, return completely, or never return. 

Strokes vary in location, severity, and cause.  A thrombotic stroke is caused most often by atherosclerosis, or the build-up of fat and cholesterol plaques on the inside walls of the arteries of the body.  As this disease progresses the blood supply is reduced to the heart, brain, and other organs.  Sometimes, a part of this plaque can break off and block the flow of blood to the brain causing the resulting symptoms resulting from the ischemia, or decreased blood supply.

An embolic stroke is caused by a clot or thrombus that has formed in another part of the body, and migrates to the brain, causing those same symptoms.  This can originate in the heart as a result of atrial fibrillation (A fib), or a clot which develops in the deep veins of the legs, and again migrates through the circulation to the brain, and sometimes to the lungs causing a pulmonary embolism.

A hemorrhagic stroke is caused by a ruptured aneurysm or weakened vessel wall within the brain which starts to leak blood into the surrounding brain tissue causing swelling and increased pressure, resulting is cellular death of that particular area.  This is also referred to as a “brain bleed”.

A TIA (Trans Ischemic Attack) is a temporary disturbance of the flow of blood to an area of the brain which lasts anywhere from less than five minutes up to 24 hours. They are caused by the same things that cause all strokes, but resolve themselves by either breaking up or circulating further downstream where they do no harm in the brain.  Called “warning strokes” or” mini-strokes”, they often precede a more severe stroke; and even though they self-resolve, they still need medical attention. Generally because blood flow is restored so quickly, they leave no residual or long-term effects. 

Major warning signs of a stroke include: sudden numbness or drooping of one side of the face, slurring of speech or inability to talk, numbness or weakness of one leg or arm, dizziness or balance problem, visual disturbances, and sudden headache.

“Time is Brain”, is a favorite saying of doctors who treat stroke.  The sooner the patient can be evaluated and treated with tPA (a clot-busting drug), the greater the chance for recovery.  This drug needs to be administered between 3 and 4 hours after the first symptoms occur, to drastically reduce long-term disability (the most severe form being the persistent vegetative state), or death.

Risk factors for stroke include: diabetes, smoking, high blood pressure, obesity, atrial fibrillation, valvular heart disease, fatty diet, and cocaine /amphetamine abuse. 

You can help prevent blood clots from forming in your legs by not crossing them and not remaining seated for prolonged periods of time, such as when traveling, without stopping to rest and walk around for about ten minutes every two to three hours.

If you feel that you might be at risk for a stroke, please consult your health care provider.

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