Starting with some definitions, a stroke is an injury to the brain resulting from lack of oxygen to part of the brain or an injury from bleeding in the brain (hemorrhage). Ischemia occurs when oxygen supply / blood supply are cut off to an area of tissue, which can occur in essentially any organ in the body. When it happens in the heart, we call it a myocardial infarction or heart attack. When it happens in the brain, we call it a cerebral infarction or ischemic stroke, often shortened to just stroke.
strokes can have a range of impact from mild temporary symptoms to permanent, severe disability and death. Sometimes, blood flow is restored on its own and symptoms resolve quickly. This is called a transient ischemic attack (TIA), and often referred to as a “ministroke.” These episodes can be a warning that a more serious stroke is going to happen. The symptoms of ischemic stroke depends on the part of the brain affected, how much of the brain is affected, and how long the blood flow is diminished. That last one is where your health care teams can potentially have a real impact. There are treatments available that can help restore blood flow to the brain by breaking up or removing clots. There are many factors to consider when utilizing these treatments with time being a very critical factor. “Time is brain” as we say in the neurology business; the longer the blood supply is cut off, the more brain cells die. In fact, in a typical large vessel stroke, more than 100 million neurons (brain cells) can die and more than 800 billion synapses (connections) can be lost per hour. There is also maximum time limit for our clot buster treatments, because at a certain point, they no longer do any good and actually become more dangerous than helpful.
course, in order to get prompt treatment, one has to first recognize the signs of stroke. A helpful acronym to remember is FAST: Facial drooping, Arm weakness, Speech difficulties and Time. Facial drooping occurs when one side of the face is weak. It may be more noticeable with a smile as one side of the mouth will not move as it should. Arm weakness can involve the entire arm or just part of it. Speech difficulties can be slurred or garbled speech or word finding difficulty. Other symptoms of stroke include clumsiness, loss of sensation, leg weakness, difficulty walking, loss of sensation, and sudden loss of vision.
It is important for all of us to recognize the signs of stroke and to seek medical attention right way when we recognize them because there are treatments that can be helpful, but the time window is narrow.
(Tessa Marburger, MD, is a neurologist and neuromuscular specialist at CHI St. Alexius Health. Dr. Marburger specializes in the diagnosis and treatment of nervous system disorders, including diseases of the brain, spinal cord, nerves and muscles.)