A Stroke Warning Sign?
Neurologists say “time is brain” when it comes to having a stroke. What they mean is every second counts when it comes to someone having a stroke. Delaying treatment places a person at a higher risk of coma or even death.
An ischemic stroke, also called a “brain attack,” occurs when something blocks blood flow to part of the brain and brain tissue cannot receive the oxygen and nutrients that it needs. Blood clots or plaque, which are fatty deposits that build up in blood vessels, can block blood flow and cause a stroke. Brain cells begin to die in a matter of minutes when they lack blood and oxygen.
Another type of stroke, called hemorrhagic, occurs when a weak blood vessel in the brain ruptures.
The effects of stroke outcomes vary greatly among people, according to Dr. Camilo Gomez, a stroke specialist at Loyola Medicine who also coined the phrase “time is brain” in 1993. Depending on the blood circulation pattern in the brain, one person may benefit from emergency treatment, while it may be too late for another person to be treated at the same time.
“It’s clearly evident that the effect of time on the ischemic process is relative,” Dr. Gomez wrote in an editorial for the Journal of Stroke & Cerebrovascular Diseases in August 2018.
Now, doctors can minimize stroke damage during the crucial first hours due to the rapid improvements in imaging technologies and treatments, Dr. Gomez wrote.
“It is imperative that clinicians begin to look upon stroke as a medical emergency of a magnitude similar to that of myocardial infarction (heart attack) or head trauma,” he wrote.
Dr. Brandon Giglio, the director of vascular neurology at NYU Langone Hospital—Brooklyn, says about 85 percent of strokes in the United States are ischemic strokes, while 15 percent are hemorrhagic strokes. What’s more, many people experience what’s called a “warning stroke” well in advance of a full-fledged stroke. Warning strokes, on the other hand, can come on quickly even though they last for a short time.
Symptoms Warn of Oncoming Stroke
Just because a warning stroke does not cause brain damage, the condition should still be taken seriously, Dr. Giglio said.
“It really is a harbinger in many people for someone who is going to have a stroke even within the next 48 hours and certainly within the next seven, 30, 90 days,” Dr. Giglio told HuffPost.
So what exactly is a warning stroke? Medically speaking, a warning stroke is called a transient ischemic attack (TIA) and is more commonly known as a “ministroke.” Dr. Joshua Willey, a stroke neurology expert at Columbia University’s Vagelos College of Physicians and Surgeons, calls “mini-stroke” a problematic term because it reduces the emergency nature of the condition. Dr. Willey prefers using the term “warning stroke” because it brings attention to the seriousness of the condition.
A TIA has symptoms similar to those found early in a stroke, but unlike a stroke, a TIA lasts a few minutes to up to 24 hours and does not cause permanent damage.
The signs and symptoms of a TIA include:
- • Numbness or weakness or paralysis in the face, arm, or leg, typically on one side of the body
- • Confusion or trouble speaking or understanding speech
- • Blindness in one or both eyes or double vision
- • Vertigo (dizziness) or loss of balance or coordination
- • Severe headache with no apparent cause
Although a TIA is not a major stroke, it is a medical emergency nonetheless because there is no way to know in the beginning whether the symptoms are from a TIA or a major stroke. Because of this, medical professionals say to dial 9-1-1 right away if you or someone with you experience signs or symptoms of a stroke.
A warning stroke has some of the same signs as other health conditions, which is why medical professionals stress the importance of getting checked out. According to the American Stroke Association (ASA), a TIA evaluation includes the following:
- • Assessment for symptoms and medical history
- • Imaging of the blood vessels in the head and neck
- • Other testing such as head CT, angiography, and MRI
After a determination of TIA is made, doctors will recommend a follow-up visit with a neurologist to assess the risk of a future stroke, the ASA reports.
Statistics show that more than one-third of those who have a TIA and do not get treatment to have a major stroke within one year. The U.S. Centers for Disease Control and Prevention reports that as many as 10-15 percent of people will have a major stroke within three months of a TIA. What’s more, a major stroke basically has all of the same signs and symptoms as a TIA.
Medical professionals say stroke symptoms come on quickly, and people who are having a stroke or the people who are with them must act fast. An acronym, BEFAST, is widely used to help people identify a stroke. BEFAST stands for:
- • Balance—The person experiences dizziness and loses coordination. The person has problems staying balanced and walking.
- • Eyesight —The person has a sudden change in vision and has trouble seeing due to blurriness, loss of sight, or double vision.
- • Facial droop —The person’s face droops or has an uneven smile.
- • Arm —The person suddenly feels numb, and the person has trouble raising both arms. One arm may slowly move downward due to weakness on one side of the body.
- • Speech — The person has changes in speech, like slurring words or speaking gibberish.
- • Time — It’s time to dial 9-1-1 and get to the hospital as soon as possible. Dr. Willey said the “t” can also stand for the “terrible” headache that comes on fast.
After arriving at the emergency room, Dr. Willey advises people to “escalate” their situation by telling the nurses and doctors that they believe they are having a stroke. For those who do not feel comfortable going to the emergency, Dr. Willey says to see their doctor or a cardiologist as soon as possible, preferably the same day. Keep in mind that people who experience a TIA will more than likely have a stroke within 48 hours. So, waiting for weeks for a non-emergency appointment at a doctor’s office is not recommended.
Manage Health Conditions That Lead to Strokes
Certain health conditions, such as diabetes, heart disease, and high cholesterol, can lead to a stroke. To avoid the risk of a stroke, medical professionals recommend that you:
- • Talk with your doctor about how to effectively manage health conditions that can increase the risk of stroke
- • Increase your physical activity
- • Quit smoking
- • Change your diet
- • Take medications for conditions such as high blood pressure
Most importantly, Dr. Willey warns not to ignore the signs and symptoms of a stroke.
“There’s an urgent need for the public to understand the signs and symptoms of stroke and what to do,” Dr. Willey said. Unfortunately, he added, many people wait too long to seek treatment for stroke and warning stroke.