As a nurse and a relative, I have seen the devastating results of major strokes, medically called cerebrovascular accidents (CVA). Decades ago, there was little that could be done medically except rehab to help with the effects of a major stroke. Now we have new techniques and new hope. However, these techniques depend on the person having the stroke or the people around them recognizing the symptoms and getting immediate medical treatment.
WHAT IS A STROKE?
Strokes happen when some brain cells die due to a lack of oxygen when the blood flow to the brain is impaired by a blockage (ischemic CVA) or rupture of a blood vessel (hemorrhagic CVA). Symptoms depend on the area of the brain affected.
In 1996, the FDA approved tissue plasminogen activator (tPA), an intravenous medication that can dissolve blood clots in the 80% of strokes caused by blockage of blood flow (ischemic CVA). It cannot be used with strokes caused by bleeding and tPA must be given within a 3-4 hours following the onset of symptoms. If given promptly, the Stroke Association estimates that1 in 3 patients will see their symptoms resolve or have major improvement.
For the less common strokes caused by bleeding (hemorrhagic CVA), surgery like clipping, coils or removal may help reduce long-term damage and relieve pressure on the brain.
In 2004, the FDA approved the first medical device that could actually remove blood clots from blocked brain arteries in ischemic CVAs and the window of opportunity to treat was eventually widened to 6 hours after the onset of symptoms. After 6 hours, experts thought the affected areas of the brain were dead or irreparably damaged.
Now, a new study shows that that window may be widened to 24 hours and this would allow many more patients to benefit.
The researchers “contended that many patients have a ‘mismatch’ between the dead tissue where a stroke started and the far larger territory of brain tissue that is threatened, but still alive”. The results of the study on 206 patients with serious strokes at 32 hospitals in the U.S., Spain, France and Australia are impressive and hopefully will be proven and replicated.
My point is that medical progress is made when we don’t give up on people.
In the meantime, there is much we can do to help people with strokes.
SYMPTOMS OF STROKE
As a nurse, I made sure that all my relatives, especially the older ones, could recognize the symptoms of stroke and the importance of immediate treatment. Everyone needs to know and pass along this information from webmd.com to others:
“Sometimes a stroke develops gradually. But you’re more likely to have one or more sudden warning signs like these:
- Numbness or weakness in your face, arm, or leg, especially on one side
- Confusion or trouble understanding other people
- Trouble speaking
- Trouble seeing with one or both eyes
- Trouble walking or staying balanced or coordinated
- Severe headache that comes on for no reason
The FAST test is a quick way to check someone for symptoms.
Face: Smile! (Does one side of their face droop?)
Arms: Raise both arms. (Is one higher than the other? Do they have a hard time holding one up?)
Speech: Repeat a short, simple sentence, like “Mary had a little lamb.” (Do they slur their words? Is it hard to understand them?)
Time: If any of these are “yes,” call 911.”
Also, note the time when symptoms started. The hospital staff needs to know this.
The life and health you save may be your own!