Joseph R. Anticaglia MD
Medical Advisory Board
Ron is a 67 year old man who was feeling fine one minute and the next minute was on the floor of the living room of his apartment with his head against the sofa.
His wife came out of the kitchen and said, “What are you doing on the floor? Get up.”
He looked at her, his eyes pleading for help. He did not speak nor move his body. For a moment, his wife was as motionless as the marble sculpture in the corner of the room. Petrified, not knowing what to do, she ran next door to a neighbor’s apartment, rang the bell and both were at Ron’s side in a matter of minutes
“Ron, tell me your name!” No response.
Repeat this sentence: “Today is Monday. Can you smile? Smile for me?” He could do neither of these.
Ron: “I want you to raise both arms. Give it a try.” He could barely raise his left arm. He couldn’t raise his right arm at all. We need to call 911 and get him to the hospital right away.
Stroke or CVA (Cardiovascular Accident) is the sudden death of brain tissue due to a lack of oxygen and glucose to a region of the brain. It’s caused either by a blockage of the blood flow or by a rupture of an artery to the brain. The former is called ischemic and the latter a hemorrhagic stroke.
A less severe form of a stroke is TIA (Transient Ischemic Attack) or “mini stroke”. TIAs are due to a temporary blockage of a blood flow to the brain and do not cause lasting damage to it. The stroke-like symptoms come on suddenly and most TIA’s last for an hour or two but may persist for up to 24 hours
According to the American Heart/American Stroke Association, a stroke kills someone in the U.S. about once every four minutes or about 129,000 people a year. It’s the fifth leading cause of death. It’s the leading cause of disability and is one of the leading preventable cause of disability.in the U.S. Men get more strokes than women and African-Americans are almost twice as likely to suffer a first time-ever stroke compared to white people,
The faster you get a stroke victim to the hospital, the quicker the treatment is initiated, the less likely a stroke will kill a person and the more likely there will be a faster recovery from the damage to the brain. To get a stroke victim to the hospital quickly, we need a fast way to be aware of the signs and symptoms of a stroke.
F.A.S.T.
Face Drooping — Ask the person to smile. Is it uneven? Is the face numb?
Arm Weakness — Ask the person to raise both arms. Is he unable to lift them or does the arm drift down?
Speech Difficulty — Is the speech slurred, unintelligible or absent? Ask person to repeat a simple sentence.
Time to call 911 — Immediately go to the emergency room of the hospital if the person demonstrates any of the above signs (even if they go away)..
Additional Signs/Symptoms of a Stroke
Eyesight Does the person have sudden trouble seeing in one or both eyes?
Weakness Is there one sided weakness or numbness of the body (face, arm, leg)?
Confusion Does the person experience sudden confusion, disorientation to time and place?
Dizziness Is the person having trouble with dizziness, vertigo, walking or an off-balance sensation?
Severe headache Is there an out of the ordinary, excruciating headache that comes on suddenly with no known cause?
Act in Time
Stroke is a medical emergency and every second counts. Ischemic stroke (blockage of the blood flow to the brain — the most common type of stroke) can be treated with a blood clot dissolving drug called t-PA. Here’s the rub, the drug needs to be administered to the patient within 3 hours from the time of the first symptom of the stroke. That means you need to get the patient to the hospital within 90 minutes or less so he/she can be evaluated and treated…
Do not ignore TIAs because if you have experienced one, it may be a setup for a full blown stroke the same day or within days or months. Even if the symptoms have disappeared and you feel perfectly well, follow-up with your physician. It’s a warning sign to ACT F.A.S.T. and to ACT (get to the hospital) IN TIME!
Glossary
t-PA (tissue plasminogen activator) is only recommended to be given within 3 hours of the first signs of a stroke. Therefore, remember to note the exact time when the person had the first signs/symptoms of the stroke. A fatal side effect of this drug is cerebral hemorrhage.
References
- Walter N. Kernan et al; Stroke, Guidelines for the Prevention of Stroke in Patients With Stroke and Patients with Transient Ischemic Attack; AHA/ASA; May 1,2014
- Jauch, EC; et al; Guidelines for the early management of patients with acute ischemic stroke; American Heart Association/American Stroke Association, Stroke, 2013
- American Heart Association/American Stroke Association; Warning Signs of Stroke.
This article is intended solely as a learning experience. Please consult your physician for diagnostic and treatment options…