How to Recognize and Prevent Stroke

By Sondra Forsyth

May is Stroke Awareness Month, a good time to bring attention to the deadly issue of stroke. According to the American Stroke association, an estimated 129,000 Americans die each year from stroke. It is the fourth leading cause of death in the U.S.

Here, physicians from New York-Presbyterian/Columbia University Medical Center, in Manhattan, share their knowledge of stroke – how to recognize it and preventive measures you can take to avoid it. (The medical center treats one of the highest number of stroke and cerebrovascular disease patients in the world.)

A stroke can happen in an instant, changing a person’s life forever, according to these physicians. Eighty percent of strokes are caused by a blood clot that blocks blood flow to the brain. These events are medical emergencies that require immediate attention. The earlier a stroke is recognized and treated, the greater the chance of recovery.

The New York-Presbyterian/Columbia University Medical Center physicians say that remembering the acronym BE FAST is an easy way to learn how to recognize a stroke and what to do to minimize its long-term damaging effects.

The initials stand for:

B – Balance  Is there a sudden loss of balance?

E – Eye  Is there a loss of vision in one or both eyes?

F – Does the face look uneven?

A – Arm Is an arm hanging down?

S – Speech –Is speech slurred? Is there confusion or trouble speaking?

T – Time – Call 911 right away.

Other symptoms, the doctors say, include a sudden weakness or numbness in the face, arms or legs, specifically on one side of the body; dizziness and trouble walking; or a sudden severe headache that occurs for no apparent reason.

“When someone has a stroke, they may show either slight or extremely noticeable physical changes,” says Dr. Randolph Marshall, chief of the Stroke Division at the Medical Center. “The most effective way to prevent the permanent damage associated with stroke is to recognize the signs of an attack and to seek medical attention immediately.”

Early treatment can prevent and even reverse damage, but to do so the treatment must begin within a few hours of the symptoms appearing. One of the most common treatments is tissue plasminogen activator (t-PA), the only FDA-approved clot-dissolving drug for acute ischemic stroke. The drug is injected into an artery or vein to dissolve the clot, restoring blood flow to the brain. Another treatment is revascularization, in which microcatheters are inserted into the artery to remove the blockages and reopen the artery

Stroke Prevention Tips

Taking the time to make a few simple lifestyle adjustments can save thousands of lives each year, experts say.

“Although stroke is very common and is the leading cause of disability in adults in the U.S., most can be attributed to modifiable risk factors,” says Dr. Ji Y. Chong, director of the Stroke Center at NewYork-Presbyterian/Lower Manhattan Hospital.  “These are risk factors that can be controlled. Treatment of high blood pressure, high cholesterol, cardiac arrhythmias and diabetes can have a very high impact on lowering risk of stroke.”

Several lifestyle changes can greatly reduce the risk of having a stroke:

Reduce salt intake. High blood pressure is one of the leading causes of stroke. Cutting back on salt is one of the most significant steps to maintaining or lowering blood pressure to a healthy level of 130/80 or below. Try flavoring your food with a variety of spices that may be healthier than salt.

Improve your diet. If you are obese or overweight, you are not only more likely to develop high cholesterol, high blood pressure and diabetes, you are more likely to have a stroke. Extra weight places an added strain on your entire circulatory system, but a heart healthy diet helps to reduce stroke risk and can help in losing those extra pounds.

Stop smoking. Smoking is bad not only for your lungs, but for your brain as well. A smoker is at twice the risk of having a stroke because smoking damages blood vessels, raises blood pressure and speeds up the clogging of arteries.

Exercise. Exercise benefits everyone, so we should all aim for at least 30 minutes of moderate exercise most days to improve our overall health.

Some populations are at a higher risk of having a stroke even after making  such changes: adults 55 or older, African-Americans and Hispanics, those with a family history of stroke, and people who have already had a stroke or a transient ischemic attack (mini-stroke). In addition, women are more likely to die from a stroke than men, although attacks are more common in men.

 NewYork-Presbyterian Hospital treats one of the highest volumes of stroke and cerebrovascular disease patients in the world and the highest in New York City. The hospital has four state-designated Primary Stroke Centers and is recognized by the American Heart Association’s Honor Roll-Elite program. Stroke patients treated at high-volume centers with specialty-trained physicians have the best survival and recovery rates. For more information about stroke, visit the  American Stroke Association website, www.strokeassociation.org.