If you or a loved one had a stroke, would you be able to recognize the signs?
Imagine you and your best friend are sitting at lunch, chatting about your most recent round of golf. Your friend starts to explain how they hooked their shot on the ninth hole when suddenly their speech becomes garbled.
Your friend looks panicked, neither of you is unsure what to do. Within moments, your friends speech returns to normal.
So what happened? Did your friend have a stroke? Should you get them to the hospital right away or can you continue with your lunch?
Knowing the signs of stroke is not just a good idea, but can be the difference between life or death.
Stroke is a leading cause of death and disability in the U.S. and globally. It’s estimated that 800,000 people suffer from a stroke each year.4
Fortunately, death rates are declining, due to increased cardiovascular health management, awareness of symptoms, and earlier medical intervention. From 1977 to 2013, death rates due to stroke have declined 77%.4
Being diligent about stroke symptoms remains vital to continuing to save lives.
This article will discuss stroke, TIA, and the acronym BEFAST.
What is a Stroke?
A stroke in the medical world is called a cerebrovascular accident, or a “CVA”.
Although the term is rather strange, basically a stroke occurs when the blood supply is disrupted in the brain.
The brain needs ample amount of blood and oxygen to function. Lack of blood can lead to damage in the brain tissue.
Proper blood flow to the brain provides the brain with the nutrients and oxygen it needs to grow and maintain neurons,or brain cells.
The ability of that brain tissue to recover can depend on the amount of time the brain tissue is without proper blood/oxygen supply.
What Are the Different Types of Stroke?
There are two different types of stroke- ischemic and hemorrhagic.
Ischemic strokes occur more commonly. With an ischemic stroke, there is a blockage in a blood vessel in the brain, which prevents proper blood flow to part of the brain.
The blockage is due to a blood clot.
With a hemorrhagic stroke, there is a rupture of a blood vessel within the brain. This type of stroke is much more severe.
The tricky thing about blood in the brain is that it must travel within the vessels to correctly supply brain tissue. Once blood is leaking on the brain tissue it becomes almost like a poison to the brain, causing cell damage and tissue death.
How is a Blood Clot Formed?
A blood clot is formed from a buildup of blood or plaque in the arteries or veins.
This can occur within the vessels of the brain, or a blood clot can form in vessels outside the brain and travel to the brain.
When a clot breaks off the vessel it was formed in and travels in the bloodstream, it’s referred to as a thrombus.
A thrombus which ends up in a blood vessel of the brain leads to an ischemic stroke.
Is a DVT a Special Type of Clot?
A blood clot in the legs is usually referred to as a DVT or deep vein thrombosis. If you’ve ever had surgery or travelled on a long flight, you’ve likely heard about the risks of developing a DVT.
A DVT is a blood clot that forms in a vein, rather than an artery.
Arteries, which carry blood away from the heart, have their own pumping mechanism to keep blood from pooling in the body.
Veins, however, don’t have that same mechanism. Instead, veins require our muscle activation to move the blood from our limbs back to the heart.
Particularly in the legs, which tend to rest in dependent positions (i.e. gravity assists in pulling the blood downard) blood can remain stagnant, or pool, if the muscles don’t pump the blood back to the heart. This can lead to the development of a blood clot.
Medical professionals put a lot of effort into educating patients on the importance of moving their legs while lying in a hospital bed, or making sure they walk around every hour or so on a flight to avoid blood pooling in the legs.
Do DVTs Cause a Stroke?
In order to understand what causes an ischemic stroke, it’s important to know how the heart and its vessels work.
Blood from the body travels to the heart via veins. This blood has just circulated through the body and delivered oxygen to the muscles and organ systems, so it’s in need of oxygenation before it goes back out to the body.
The unoxygenated blood comes into the left side of the heart, then travels into the lungs, where it gets oxygen. Then it comes back into the right side of the heart and gets sent out of the rest of the body.
If blood that is coming from the legs has a thrombus in it, that thrombus will most likely get caught in the lungs. This causes what is called a pulmonary embolism.
A pulmonary embolism, or a “PE”, is also a serious condition which can also lead to serious adverse events, but it is not the same as a stroke.
A clot which causes a stroke is most likely to form in the arteries of the heart which travel into the brain with the blood that gets pumped out to the rest of the body. A clot in the arteries in the neck that supply blood to the brain could also cause a stroke.
This is not to say that a DVT or PE are not serious conditions, rather it is to point out that blood clots which form in the arms or legs don’t typically cause a stroke.
What is a TIA?
TIA stands for transient ischemic attack. Basically, it’s when the brain experiences a more “brief” moment of ischemia. It’s also more commonly referred to as a “mini stroke.”1
“Brief” is in quotes here because it can feel like a very long time for the person experiencing it and anyone witnessing it.
On the other hand, some people have TIAs and they don’t even realize they have occurred.
Basically, the ischemia resolves itself, but that doesn’t mean a TIA can’t still cause brain damage.
As previously mentioned, brain tissue lacking blood and oxygen is a very serious thing, and even brief episodes can lead to cell damage, although not as detrimental as that of a stroke.
So Is Time the Only Difference Between a Stroke and a TIA?
Essentially, yes.
With a TIA, symptoms usually last less than an hour, and blood flow to the brain is restored on its own.1
With a stroke, symptoms persist and medical intervention may be needed to remove the blockage.
Should I Go to the Hospital If I think I’ve Had a TIA?
Yes!
If you think that you or a loved one has experienced a TIA, call 911, and get medical attention immediately!
A TIA may be just a brief episode of ischemia, but it could also be an indication that a full-blown stroke is about to occur.
Don’t ignore any symptoms of a stroke, even if they are fleeting! Seek medical attention as quickly as possible!
How is a Stroke Treated?
When an ischemic stroke occurs it’s possible that a drug called tPA, or tissue plasminogen activator, may be used to help break up the clot and restore blood flow.2
This drug has been found to be effective if given within the first three to four and a half hours of the stroke occurring. This is one of the reasons why it is so important to get medical attention as quickly as possible following stroke/TIA symptom onset.
If medications don’t completely break up the clot, surgical removal may be possible.3
If one is experiencing a hemorrhagic stroke, a blood transfusion or surgical intervention may be needed in order to minimize damage and restore proper blood flow.3
Following a stroke, many individuals need physical, occupational, and speech therapy in order to help restore deficits in strength, balance, coordination, walking, speaking, swallowing, fine motor skills, etc.
What therapies are needed is dependent on where in the brain the stroke occurred and what deficits resulted from it.
What Are the Signs of Stroke/TIA?
It’s important to commit the following acronym to memory in order to be able to identify symptoms of a stroke within yourself or your loved ones.
Please note: you don’t need to experience all of these symptoms to be having a stroke! If you suspect a stroke or TIA, call 9-1-1 immediately!
The acronym is: BE FAST
Balance- unsteadiness or difficulty with balance
If they’re already sitting, don’t ask them to stand. If you notice they’re having difficulty with balance, have them sit down if possible.
Eyes- difficulty seeing or vision changes
Ask if they are having difficulty seeing or are experiencing double vision.
Face- facial drooping, numbness
Ask them to smile and notice if they’re unable to bring one side of their mouth upwards.
Arm- weakness in one arm
Ask them to lift both arms overhead, noticing if one lags significantly, or they can’t perform on one side.
Speech- difficulty with speech, slurred speech
Ask them to tell you their birthdate or the name of the president to identify difficulty with speech.
Time- time to call 9-1-1.
Remember “time is brain” meaning the quicker you can get medical attention the less brain damage.
**Knowing this information can truly be lifesaving! Commit this to memory and never be afraid to call 9-1-1 if you are concerned about a possible stroke or TIA.**
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Have the Strength to Live Life to the Fullest!
Sources:
- https://oregon.providence.org/forms-and-information/a/ask-an-expert-stroke-vs-tia/#:~:text=TIA%20(transient%20ischemic%20attack%2C%20also,long%20%E2%80%93%20usually%20less%20than%20hour.
- https://www.ninds.nih.gov/About-NINDS/Impact/NINDS-Contributions-Approved-Therapies/Tissue-Plasminogen-Activator-Acute
- https://www.mayoclinic.org/diseases-conditions/stroke/diagnosis-treatment/drc-20350119
- All photos created on Canva.com
