A primer on strokes and the warning signs to watch for
Someone suffers from a stroke every ten minutes in Canada. Here's what a doctor wants you to know.
This article was originally published December 1, 2017.
The lives of many Canadians are touched by stroke each year. According to the Ontario Stroke Network, strokes are the leading cause of adult disability in Canada and the third leading cause of death. In the course of a year, about 50 000 strokes occur all over the country, which means one stroke every ten minutes. But many of us wouldn't know what to do if we see the signs of stroke in ourselves or a loved one. Since strokes are so prevalent and often misunderstood, Dr. Sara Mitchell, a neurologist Sunnybrook Hospital, stopped by The Goods to give us a primer on strokes.
Types of stroke
A stroke is a sudden loss of brain function. There are two main types. One kind is caused by a sudden brain blood vessel blockage, called an ischemic stroke. This is when a clot goes into a blood vessel in the brain, causing the area after the clot to lose blood supply. That's the most common cause of stroke. Then there's hemorrhagic stroke. That's when there is a burst in a blood vessel and blood goes into the brain causing a loss of function.
Each area in the brain is responsible for different functions or abilities, so the after-effects of a stroke depend on the area of the brain that was affected and the size of the damaged area in the brain. The brain has pathways that "cross over:" damage in the right brain area (right hemisphere) will affect the left side of the body and damage in the left brain area (left hemisphere) will affect the right side of the body.
After suffering from a stroke, the effects could be loss of control or feeling, weakness, numbness, paralysis of one side of the body, trouble communicating, mood swings, depression and fatigue. An estimated 400,000 Canadians are living with the effects of stroke, and they're not all elderly, so stroke is something that those who are young and fit should be aware of as well. Even The Goods' Andrea Bain suffered from a stroke in 2011 while she felt that she was in good health. Since strokes can strike anyone, it's important for everyone to know the signs of stroke and the risk factors.
The Ontario Stroke Network lists the following as the factors that we cannot change:
Age – The older you get, the higher your chances of stroke, with two thirds of strokes occurring in patients over 65.
Gender – Men have a lightly higher risk of stroke than women.
Family history – If immediate family members (grandparents, parents or siblings) had a stroke before they were 65, your risk of stroke is elevated.
Prior stroke or mini-stroke – For patients who have survived a stroke, the chances of having another stroke are elevated. According to the Ontario Stroke Network, "up to a third of people who survive a first stroke or mini-stroke will have another stroke within 5 years."
The risk factors you can change
High blood pressure (hypertension), illicit drug use, smoking, blood thinners, diabetes, high blood cholesterol, atrial fibrillation, birth control pills, alcohol consumption, and being overweight have all been shown to increase the risk of stroke. The good news is that these risk factors can be managed, mitigated, or reduced, so talk to your doctor. It's more about lifelong care and maintenance; there are no quick fixes to prevent something as serious as a stroke.
Spotting the signs... FAST
It's important to recognize the signs and symptoms of stroke so you can act fast. The signs and symptoms of stroke are the same for both men and women. Neurologists have a saying that "Time is brain!" because a patient loses 2 million brain cells for every minute they are not being treated. Since every minute counts, it's important to quickly recognize the signs and act FAST, which is the acronym you need to keep in mind.
Face – Is it drooping?
Arms – Can you raise both arms? Most people have trouble with one side of their body.
Speech – Is it slurred or jumbled?
Time – As soon as you see one of these symptoms, do not hesitate. Call 911 immediately.
Usually these symptoms occur all at once, or you might just feel or observe one or two. Either way, it's better to be safe than sorry if you're unsure, and seek emergency help.
The good news
If you are assessed and treated quickly, there's the possibility that stroke can actually be reversed! Dr. Mitchell works at a hospital with a stroke center. She carries a pager when on call, and must reach the patient very quickly in order to deliver a clot-busting medicine called TPA that can actually break down the clot in the brain to restore function to that part of the brain and actually reverse the effects of the stroke. There are other treatments as well, such as endo-vascular treatment. For this treatment, doctor's put a catheter in the groin, enter the brain, and physically remove the clot out of the blood vessel. This is sometimes used in combination with other treatments.
These medical advances are very exciting. Hopefully we will soon live in a world where fewer strokes happen, but until then at least we can lean on Dr. Mitchell and other medical professionals for their very informative expertise regarding this very serious medical condition.