In the United States, stroke, or brain attack, is the leading cause of death in the elderly. “The symptoms that occur during a stroke are due to depriving a group of cells of oxygen and nutrients,” says neurologist Richard Stappenbeck, M.D. “It can ultimately result in the permanent death of those cells.” Unlike other parts of the body, the brain cannot repair itself, so the damage that occurs during a stroke is permanent.
If part of the brain is damaged, it is lost and cannot be regained. This means it is critical to seek treatment immediately if you or someone you know exhibits stroke symptoms. “Time is of the essence,” Dr. Stappenbeck says. Stroke can occur during one of three scenarios, he explains:
Blood clots that start in the heart. For example, if a patient has atrial fibrillation and his or her heart does not beat correctly, clots can form in the heart and be passed up into the brain through large vessels.
A blockage inside the brain. This is often the consequence of high blood pressure or diabetes. These clots are treated with a clot-busting intravenous drug called t-PA.
A ruptured blood vessel. This causes blood to leak, or hemorrhage, into the brain. To treat this type of stroke, a patient’s individual condition must first be considered. It can be treated with surgery, reversal of the bleeding tendency or medication.
Determining a course of treatment
Dr. Stappenbeck considers each patient’s medical history, particularly anything related to heart disease, diabetes and high blood pressure, when determining how to treat a stroke. “We check their blood pressure and blood glucose, monitor their bleeding profiles, then decide what caused the stroke and determine what we can do to reverse it,” he explains.
CAT scans play a large role in determining what caused a stroke. Stroke treatment is complicated because there is no one-size-fits-all approach. “Stroke care is a highly complicated medical endeavor because it is highly individualized,” Dr. Stappenbeck says. “It’s a process of taking care of patients day by day when they’re in the hospital.”
It is important to remember the acronym FAST if you believe you or someone you know may be having a stroke.
The following symptoms are classic indicators of a stroke:
Face - A face droop or uneven smile
Arms - Arm numbness or weakness
Speech - Slurred speech or difficulty speaking
Time - Call 911
“FAST has been recognized for at least 20 years now as a great public education tool,” he says. “For stroke care, time is of the essence, so dial 911 and get emergency help as soon as possible.” For more information, visit Piedmont’s Stroke Program.
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