What is a stroke?
A stroke occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot or bursts. When that happens, part of the brain cannot get the blood and oxygen it needs, so it and brain cells die. Stroke can be caused either by a clot obstructing the flow of blood to the brain (called an ischemic stroke) or by a blood vessel rupturing and preventing blood flow to the brain (called a hemorrhagic stroke). Hemorrhagic strokes account for 13 percent of stroke cases, and there are two types: intracerebral (within the brain), and subarachnoid hemorrhage, which is bleeding between the brain and tissue covering the brain. A TIA (transient ischemic attack), or “mini stroke” is caused by a temporary clot.
What do you need to know if someone is having a stroke?
Use the letters in “BE FAST” to spot stroke signs and know when to call 911. If someone is showing the symptoms, even if the symptoms go away, call 911 immediately. The survivability of stroke and the consequences of the ability to recover is directly dependent on how fast it gets treated. If you activate the 911 system, the ER already has a heads up on who’s coming in, and they have already coordinated with healthcare professionals. There are pathways in place so the treatment starts right away. For more information on stroke warning signs, head to www.strokeassociation.org.
Dr. Atul Gupta has a concierges practice in Hilton Head and Bluffton, called Hilton Head Concierge Physicians. Before opening his own practice, Dr. Gupta served as the Director of the Emergency Department in the Lowcountry covering five hospitals. He has worked diligently with the American Heart Association over the last two years to fight cardiovascular disease and stroke and is this year’s Vice Chair of the 21st Annual Heart Ball.
What’s the difference between heat stroke and stroke?
Heat Stroke is a rise in body temperature above 104˚F accompanied by neurologic dysfunction (e.g. confusion). Stroke is a loss of blood flow to an area of the brain due to blood vessel damage that causes neurologic dysfunction (e.g. paralysis). About 85 percent of strokes are due to arterial occlusion and 15 percent are due to arterial rupture with hemorrhage. The portion of the brain that is deprived of blood and oxygen, causing brain cells to die, determines the deficits of the stroke.
What are the causes?
The causes of heat stroke vs. stroke are quite different. Heat Stroke: Causes can be exertional (e.g. physical activity in the heat) or non-exertional (e.g. elderly, sedentary, chronically ill, very young are more susceptible to heat stroke). Stroke: Common causes/risk factors include high blood pressure, diabetes, high cholesterol, smoking, abdominal obesity and atrial fibrillation.
How do you treat it? Heat Stroke: Go to the hospital. Treatment includes rapidly cooling the body to a core temperature of 102˚F. Stroke: Go to the ER IMMEDIATELY. Clot busters (e.g. TPA) and clot retrieval devices can be used, but only in the first few hours. Control of modifiable stroke risk factors through diet, exercise and medications will lower risk.
Paul Mazzeo, MD, is a board-certified neurologist with Coastal Neurology, seeing patients in both Beaufort and Bluffton. He is on the medical staff at Beaufort Memorial Hospital and is the medical director of the hospital’s Memory Center. Beaufort 843-522-1420, Bluffton 843-836-3667.
What are the symptoms of a stroke?
An important acronym to remember when recognizing the signs and symptoms of a stroke in both men and women is BE FAST.
B—BALANCE Many people who have had strokes report dizziness as their primary symptom.
E—EYES Visual disturbances may also be caused by a stroke.
F—FACIAL DROOP When smiling, the face is asymmetrical.
A—ARM WEAKNESS in one or both sides.
S—SPEECH Whether you have difficulty speaking or understand what it being said to you.
T—TIME The most important letter! Call 911 IMMEDIATELY because time is brain!
You hear of many men having strokes or heart attacks on the golf course. Is heat a factor?
It’s important to protect your heart from the heat, especially over the age of 50, or for those who are overweight, or on medications that affect the heart. Heat can elevate the heart rate, so it’s important to stay hydrated, take frequent breaks from the heat, and recognize the signs and symptoms of heat exhaustion and heat stroke. Heat stroke occurs after the body reaches an internal temperature above 104° F. This can lead to heart attack and possibly death, if untreated.
Amy Anderson is a Stroke and Chest Pain Coordinator and Interim Director of the Emergency Department for Hilton Head Hospital. 843-681-6122
How can I prevent a stroke?
Prevention of stroke depends upon managing risk factors: controlling blood pressure, controlling diabetes, maintaining a normal cholesterol, not smoking and drinking alcohol in moderation. Exercising can help, as it helps with weight, controlling blood pressure and diabetes, as well. If you have any of the above risk factors, plus the additional risk of family history of stroke, taking a daily aspirin can help reduce your risk.
Does stress play a factor in strokes?
Stress really is not a risk unless it is causes hypertension. Hypertension is when an individual has abnormally high blood pressure. The cause of hypertension is usually caused by lifestyle or genetic factors.
Paul Zorch, M.D. is a Board-Certified Emergency Physician and Medical Director of the Emergency Department at Coastal Carolina Hospital. 843-784-8080