Column: Stroke Awareness Week

[Column written by Dr W. Taylor Kimberly]

This week is Stroke Awareness Week in Bermuda and we wanted to take the opportunity to share some information about this serious illness. In 2020, King Edward VII Memorial saw 4-5 patients a week presenting with stroke symptoms and with the island’s aging population, it’s likely these numbers will only go up.

What is a stroke?

A stroke, or brain attack, happens when blood flow to your brain is stopped. It’s an emergency situation so it’s important to know the signs of a stroke and get help quickly. Call 911 if you think you or someone else might be having a stroke or stroke symptoms. Treatment is most effective when started right away.

The brain needs a constant supply of oxygen and nutrients to work well. If blood supply is stopped even for a short time, this can cause problems. Brain cells begin to die after just a few minutes without blood flow or oxygen.

When brain cells die, brain function is lost. You may not be able to do things that are controlled by that part of the brain. For example, a stroke may affect your ability to:

• Move
• Speak
• Eat, drink, and swallow
• See clearly
• Think and remember
• Solve problems
• Control your bowel and bladder
• Control your emotions
• Control other vital body functions

A stroke can happen to anyone at any time.

What causes a stroke?

A stroke is caused when blood flow to your brain is stopped or disrupted.

There are 2 kinds of stroke: ischemic and hemorrhagic.

• Ischemic stroke. This is the most common type of stroke. It happens when a blood vessel in the brain is blocked. It may be blocked by a blood clot.
• Hemorrhagic stroke. This occurs when a blood vessel in your brain bursts, spilling blood into nearby tissues. With a hemorrhagic stroke, pressure builds up in the nearby brain tissue. This causes even more damage and irritation.

Who is at risk for a stroke?
Anyone can have a stroke at any age. But your chance of having a stroke increases if you are older and have certain risk factors. Some risk factors for stroke can be changed or managed, while others can’t.

Risk factors for stroke that can be changed, treated, or medically managed:

• High blood pressure
• Heart disease
• Diabetes
• Smoking
• Birth control pills
• History of TIAs [transient ischemic attacks]
• High red blood cell count
• High blood cholesterol and lipids
• Lack of exercise
• Obesity
• Excessive alcohol use
• Illegal drugs
• Abnormal heart rhythm
• Cardiac structural abnormalities

Risk factors for stroke that can’t be changed:

• Older age – For each decade of life after age 55, your chance of having a stroke more than doubles.
• Race – African Americans have a higher risk for death and disability from a stroke than whites. This is partly because the African-American population has a greater incidence of high blood pressure.
• Gender – Stroke occurs more often in men, but more women than men die from stroke.
• History of prior stroke – You are at higher risk for having a second stroke after you have already had a stroke.
• Heredity or genetics – The chance of stroke is greater in people with a family history of stroke

What are the symptoms of a stroke?

Stroke symptoms may happen suddenly. Each person’s symptoms may vary. FAST is an easy way to remember the signs of a stroke. FAST stands for:

F – Face drooping. One side of the face is drooping or numb. When the person smiles, the smile is uneven.
A – Arm weakness. One arm is weak or numb. When the person lifts both arms at the same time, one arm may drift downward.
S – Speech difficulty. You may see slurred speech or difficulty speaking. The person can’t repeat a simple sentence correctly when asked.
T – Time to call 911. If someone shows any of these symptoms, call 911 right away. Call even if the symptom goes away. Make note of the time the symptoms first appeared.

What can I do to prevent a stroke?

Know your risk for stroke. Many stroke risk factors can be changed and some things you can do to control your risk factors are listed below – a healthy lifestyle can help reduce your risk for stroke:

• Stop smoking, if you smoke.
• Make healthy food choices. Be sure to get the recommended amounts of fruits, vegetables, and whole grains. Choose foods that are low in animal fat, trans fat, cholesterol, salt [sodium], and added sugars.
• Stay at a healthy weight.
• Be physically active on a daily basis.
• Limit alcohol use.

- Mass General Brigham Neurology, Chief of Neurocritical Care, Dr W. Taylor Kimberly

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