SpartanDO Expert Take 2022-10
October 2022
World Stroke Day
Stroke expert Anmar Razak, M.D., provides insights on stroke risk factors, treatment and prevention.
As the fifth leading cause of death in the United States, strokes can happen to any person at any age, according to the American Stroke Association. In honor of World Stroke Day, which takes place each year on Oct. 29, Anmar Razak, M.D. shares life-saving insights on identifying a stroke, stroke symptoms and best treatment practices.
What is a stroke?
A stroke is a sudden loss of brain function caused either by an interruption in blood supply (called an ischemic stroke) or a rupture in the brain (called a hemorrhagic stroke). While ischemic strokes are most common and account for about 87% of all strokes, either type of stroke can manifest into mild to severe loss of brain function.
According to the American Stroke Association, strokes are the leading cause of disability in the U.S. — and can result in lifelong effects on physical, mental and emotional health, including paralysis, speech/language problems, memory loss and vision problems.
What are the symptoms?
The most common symptoms are captured in the acronym F.A.S.T., which stands for “Face drooping, Arm weakness, Speech difficulty, Time to call 9-1-1.”
While F.A.S.T. captures about 70% of stroke symptoms, it does not cover all, which is why stroke experts are working to expand the acronym to encompass more symptoms and save more lives, explained Dr. Razak. Other symptoms may be confusion, numbness, visual spatial awareness issues, trouble with balance and coordination, and severe headaches, according to the American Stroke Association.
“If you think of the brain as a world map, the effects will be different depending on which part of the brain is affected,” Dr. Razak said. “All the different parts of the brain are supplied by different blood vessels, so if the left side of the brain is affected, then the symptoms will manifest as numbness or weakness in the right arm, leg or face.”
Oftentimes, strokes do not exhibit any warning signs. Some people experience a transient ischemic attack (TIA), which is a temporary blockage of blood flow to the brain that resolves shortly after and does not cause permanent damage, said Dr. Razak.
If an individual suspects they are having stroke symptoms or a TIA, they should seek immediate medical attention. Time is a critical factor in any stroke, and quick action can determine how much brain function is lost. Strokes are painless and sudden, making them hard to detect, which is why Dr. Razak emphasizes the importance of knowing stroke symptoms and your risk factors.
What are stroke risk factors?
Most commonly, the majority of stroke victims are over the age of 65, said Dr. Razak. Due to their longer average life spans, women face higher risk of stroke. Risk factors include high blood pressure, high cholesterol, diabetes and smoking.
Modifiable risk factors — or risk factors that patients and physicians can modify or help with by changing lifestyle or medication — include obesity, sedentary lifestyle, poor diet and substance use, according to Dr. Razak. Unmodifiable risk factors, or things that cannot be changed, can include family history, genetic disorders, age and gender. Having a prior stroke, TIA or heart attack also increases risk for stroke.
Dr. Razak noted that studies have shown there is a racial disparity for stroke risk. Black and Hispanic people are at higher risk of stroke due to lack of access to health care services (from emergency stroke care to long-term rehabilitation services), socioeconomic barriers, lack of community education and language resources, and genetics.
How can I reduce my risk for stroke?
“Prevention revolves around controlling your risk factors,” Dr. Razak said.
He recommends regular check-ups with your primary care physician to ensure “you’re on top of your health,” especially if you’re monitoring conditions such as diabetes or high blood pressure. This is especially important for those who may have delayed medical care during the peak of COVID-19 shutdowns. Through regular visits, you can prevent stroke by “getting the medication you need, monitoring your health and changing your behavior, if needed.”
“Prevention revolves around controlling your risk factors."In addition, Dr. Razak urges people to know the signs and symptoms of a stroke so you can recognize it in yourself and others. The earlier the stroke is detected and treated, the fewer disabilities a patient will suffer, he said.
How is a stroke treated?
Fast action is critical with strokes — every minute counts. “Depending on how quick and successful we are, we can hopefully stop or limit the progression of these symptoms,” Dr. Razak said. “Then we can start therapy to regain some of that function back.”
For the more common ischemic strokes, some patients qualify for a clot-busting medication to dissolve the blood clot causing the blockage. For patients who do not meet certain criteria or fall outside of the timeframe for that intervention, a minimally invasive surgery to remove the clot may be warranted. These are the two rescue treatments to reestablish blood flow, but it is “highly dependent on how soon the patient seeks treatment,” Dr. Razak said.
The entire stroke process, which is called the “Chain of Survival of a Stroke” by experts, consists of the patient calling an ambulance upon exhibiting symptoms, arriving at a stroke center, receiving evaluation (such as a CT scan) and IV fluids, and stroke experts administering either surgical or medical treatment. After treatment, patients recover in the hospital where they will receive proper rehabilitation services, such as physical therapy, speech therapy and occupational therapy. Then, the prevention phase begins when the patient and their medical team take steps to prevent having another stroke, such as adjusting lifestyle habits or introducing blood-thinning medication. Finally, the patient will reenter the community where they will return home or to a long-term care center.
What can I do?
Teach your friends, relatives and community members about stroke symptoms and prevention. Helping others understand their own risk factors and educating them about the F.A.S.T. acronym may save precious minutes during a stroke.
Learn more about strokes this World Stroke Day — it may save a life. Find more information at Stroke.org.
If you suspect you’re having any symptoms of a stroke, you should seek medical attention immediately.