Teaching Students About Stroke Awareness May 18, 2012
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Local middle school students are learning about stroke--the health condition that strikes more than 790,000 people every year--in a new interactive program launched by Seton Brain & Spine Institute called Brainiac Kids.

Stroke is 80 percent preventable and starts with education. The most effective stroke treatments must be given within the first few hours after stroke symptoms start. By recognizing signs and acting fast, children can help medical professionals lessen a stroke's damage. The information students learn from this fun, interactive program may one day save their own life or the life of a loved one. "We're starting to see these diseases at a much younger age. It used to be stroke was just for grandpa or grandma. Now we're seeing patients that are 20 years old suffering a stroke," said Marci Wilson, Seton Brain & Spine Institute Outreach Coordinator.

According to the National Stroke Association- during the year following the implementation of this type of interactive program-children are saving family member lives because they are able to recognize symptoms and call 9-1-1.




Stroke Program
Diagnosis & Treatment Options

DIAGNOSIS

The treatment you receive in the first few hours can be the difference between partial and complete recovery. Symptoms of a stroke include:

  • Numbness, weakness or paralysis of the face, arm or leg, especially on one side of the body
  • Trouble seeing in one or both eyes, double or blurred vision
  • Confusion or trouble understanding
  • Slurred or garbled speech
  • Trouble walking
  • Severe headache with no known cause

If you have any of these symptoms, call 911 or other emergency services right away. See your doctor if you have symptoms that seem like a stroke, even if they go away quickly. You may have had a transient ischemic attack (TIA), sometimes called a mini-stroke. A TIA is a warning that a stroke may happen soon. Getting early treatment for a TIA can help prevent a stroke.

Types of Strokes

Ischemic

The most common type of stroke is Ischemic, with approximately 83 percent falling into this category. Ischemic strokes occur when clots block an artery. The underlying condition for this type of obstruction is the development of fatty deposits lining the vessel walls called atherosclerosis. These fatty deposits can cause two types of obstruction:

  • Cerebral thrombosis refers to a thrombus (blood clot) that develops at the clogged part of the vessel or
  • Cerebral embolism which refers generally to a blood clot that forms at another location in the circulatory system, usually in the heart and large arteries of the upper chest and neck. A portion of the blood clot breaks loose, enters the bloodstream and travels through the brain's blood vessels until it reaches vessels too small to let it pass.

A second important cause of embolism is an irregular heartbeat, known as atrial fibrillation. It creates conditions where clots can form in the heart, dislodge and travel to the brain.

Hemorrhagic

Hemorrhagic stroke is the least common, but can be fatal. Hemorrhagic strokes happen when a weakened vessel in the brain ruptures and bleeds into the surrounding brain tissue. The two types of hemorrhagic strokes are intracerebral hemorrhage and subarachnoid hemorrhage.

Two types of weakened blood vessels usually cause hemorrhagic stroke: aneurysms and arteriovenous malformations (AVMs). An aneurysm is a ballooning of a weakened region of a blood vessel. If left untreated, the aneurysm continues to weaken until it ruptures and bleeds into the brain. (American Stroke Assoc)

Transient ischemic attacks

Transient ischemic attacks (TIAs) are minor or warning strokes. In a TIA, conditions indicative of an ischemic stroke are present and the typical stroke warning signs develop. However, the obstruction (blood clot) occurs for a short time and tends to resolve itself through normal mechanisms.

Even though the symptoms disappear after a short time, TIAs are strong indicators of a possible major stroke. Steps should be taken immediately to prevent a stroke.

In other cases, a clot that has formed elsewhere in the body may travel through the bloodstream and lodge in a brain artery. There, it can block blood flow to the brain and cause an embolic stroke.

Together thrombotic and embolic strokes make up about 75% of total cases. Since interrupted blood supply can kill brain tissue, these types of strokes frequently cause temporary or permanent disability and may even be fatal.

TREATMENT

Ischemic stroke is treated by removing obstruction and restoring blood flow to the brain.

In Hemorrhagic stroke, doctors introduce an obstruction to prevent rupture and bleeding of aneurysms and arteriovenous malformations.

Prompt treatment of stroke may minimize brain damage and improve the chances of survival. Starting a rehabilitation program as soon as possible after a stroke increases your chances of recovering movement and feeling which may have been adversely affected or lost.

Initial treatment for stroke

Initial treatment for a stroke varies depending on the type of stroke hat has occurred. Before starting treatment, your doctor will use a computed tomography (CT) scan of your head and possibly magnetic resonance imaging (MRI) to diagnose the stroke type. Additional tests may be performed to locate the clot or bleeding and to assess the amount of damage. While treatment options are being determined, blood pressure, breathing ability and other vital signs will be closely monitored. Initial treatment focuses on restoring blood flow for an ischemic stroke or controlling bleeding for a hemorrhagic stroke.

Ischemic stroke

Treatment for an ischemic stroke depends on the location and cause of the clot. Measures will be taken to stabilize vital signs, including medication.

If a stroke is diagnosed within 3 hours of the start of symptoms, patients may be given a clot-dissolving medicine called tissue plasminogen activator (t-PA), which can increase chances of survival and recovery. But t-PA is not safe for everyone. If a patient has had a hemorrhagic stroke, use of t-PA would be life-threatening. Eligibility for t-PA will be quickly assessed in the emergency room.

Patients may also receive aspirin or aspirin combined with another antiplatelet medicine. But aspirin is not recommended within 24 hours of treatment with t-PA. Other medicines may be given to control blood sugar levels, fever, and seizures. In general, high blood pressure won't be treated immediately unless systolic pressure is over 220 millimeters of mercury (mm Hg) and diastolic is more than 120 mm Hg (220/120, which is also called 220 over 120).

Hemorrhagic stroke

Initial treatment for hemorrhagic stroke is difficult. Efforts are made to control bleeding, reduce pressure in the brain, and stabilize vital signs, especially blood pressure.

There are few medicines available to treat hemorrhagic stroke. In some cases, medicines may be given to control blood pressure, brain swelling, blood sugar levels, fever, and seizures. Patients are closely monitored for signs of increased pressure on the brain, such as restlessness, confusion, difficulty following commands, and headache. Other measures will be taken to keep patients from straining from excessive coughing, vomiting, or lifting, or straining to pass stool or change position.

Surgery generally is not used to control mild to moderate bleeding resulting from a hemorrhagic stroke. But if a large amount of bleeding has occurred and the person is rapidly getting worse, surgery may be needed to remove the blood that has built up inside the brain and to lower pressure inside the head.

If the bleeding is due to a ruptured brain aneurysm, surgery to repair the aneurysm may be done. Repair may include:

  • Using a metal clip to clamp off the aneurysm to prevent renewed bleeding.
  • Endovascular coil embolization, a procedure which involves inserting a small coil into the aneurysm to block it off.
  • The ability of these procedures to help depends on the location of the aneurysm the patient's condition following the stroke.
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