Know Stroke Warning Signs and Respect the Need for Quick Treatment

"It's a classic scenario," comments Darryl Camp, M.D., neurology director at the Brain & Spine Center at Brackenridge Hospital. "People wake up in the middle of the night and feel a weird numbness or weakness on one side of their body. They know something is not quite right, but figure if they go back to sleep and it will go away. It never occurs to them they could be having a stroke . Hours later the symptoms have intensified so they have a family member drive them to the Emergency Room and still treatment is delayed because they are not sure how to explain their symptoms."

Being knowledgeable about stroke warning signs and the critical importance of rapid treatment could be the difference between a good recovery and long-term disability or death. Dr. Camp spells it out with the facts. "Strokes are the third-leading cause of death in the United States behind heart disease and cancer, killing about 275,000 people a year. It is the top cause of adult disability. More women die of stroke than breast cancer every year. Stroke is an emergency. Effective therapies are currently available for patients with acute stroke. Stroke is preventable."

The chain of events that happen when a stroke and a heart attack occur are basically the same with the point of distinction being if the blockage impacts blood flow to the heart or the brain. "A stroke occurs when a blood vessel becomes blocked causing restricted blood flow (ischemia) to a region of the brain, or when a blood vessel ruptures releasing blood contents into the brain tissue. Eighty percent of strokes are of the ischemic variety," says Dr. Camp. "This type of stroke responds very well to specific therapy that can reverse the debilitating effects of stroke or at least prevent further damage."

One specific therapy Dr. Camp refers to is t-PA (Tissue Plasminogen Activator), a powerful clot-busting medicine given intravenously that was approved for use in 1996. It revolutionized outcomes of stroke victims. However, there is a catch. T-PA can only be given by vein if not more than three hours have passed since the initial stroke took place, which has directed all emphasis and attention on how to most efficiently and quickly deliver the treatment.

Three years ago the Brain & Spine Center at Brackenridge Hospital started a Stroke Program called "Code Stroke" that like a trauma response protocol, deploys upon minutes after the patient arrives in the Emergency Room. "Our Stroke Program was the first of its kind in Texas to be certified by the JCAHO (Joint Commission on Accreditation of Healthcare Organizations)," says Dr. Camp. "By creating a program standard, we are able to continue to measure and improve our effectiveness, share our experience with other facilities and work better as an interdisciplinary team to treat patients." Seton Medical Center Austin also is a certified stroke center.

One unique and important component of the program is follow-up. "We have a Stroke Clinic (Offered through Capitol Neurology Associates) where patients go for scheduled check-ups after their first stroke event. Our objective is to review and address risk factors to help prevent secondary stroke through education, monitoring and to make sure they understand the importance of seeking emergency assistance if they think another stroke is taking place," adds Dr. Camp.

Darryl Camp, M.D.

Medical Director, Stroke Program and Neurology

Brain & Spine Center, Brackenridge Hospital

Darryl Camp, M.D., is the Medical Director Neurology at the Brain & Spine Center at Brackenridge Hospital. Dr. Camp attended medical school and completed his residency at The University of Texas Health Science Center in San Antonio.

Stroke Warning Signs

• Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
• Sudden confusion, trouble speaking or understanding
• Sudden trouble seeing in one or both eyes
• Sudden trouble walking, dizziness, loss of balance or coordination
• Sudden, severe headache with no known cause

Source: Dr. Darryl Camp, director Stroke Program, Brain and Spine Center of Brackenridge Hospital, Austin, Texas

Stroke Prevention

The following are risk factors that can be changed, treated or controlled to lower the risk or even prevent a stroke from happening:

• High blood pressure
• Cigarette smoking
• Diabetes mellitus
• Carotid or other artery disease
• Atrial fibrillation
• Other heart disease
• Sickle cell disease
• High blood cholesterol
• Poor diet
• Physical inactivity and obesity
• Alcohol abuse
• Drug abuse

Source: American Stroke Association

Health Library Interactive Tool: What Is Your Risk for a Stroke If You Have Atrial Fibrillation?From Healthwise