When someone’s brought into the emergency room for acute ischemic stroke – or a blocked artery to the brain – a neurologist is called in to determine treatment. But back in 2010, Baylor Healthcare System noticed a problem at a regional center in Waxahachie: speed. The solution was a telemedicine program using laptop cameras and a robotic device to save crucial time in providing treatment. Dr. Dion Graybeal, medical director of the Baylor stroke program, talks about how it’s done in this installment of KERA’s Vital Signs.
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Definition of a Stroke
- A stroke occurs when the blood supply to part of your brain is interrupted or severely reduced, depriving brain tissue of oxygen and food. Within minutes, brain cells begin to die.
- A stroke is a medical emergency. Prompt treatment is crucial. Early action can minimize brain damage and potential complications.
- The good news is that strokes can be treated and prevented, and many fewer Americans die of stroke now than even 15 years ago.
Types of Stroke:
About 85 percent of strokes are ischemic strokes. Ischemic strokes occur when the arteries to your brain become narrowed or blocked, causing severely reduced blood flow (ischemia). The most common ischemic strokes include:
- Thrombotic stroke. A thrombotic stroke occurs when a blood clot (thrombus) forms in one of the arteries that supply blood to your brain.
- Embolic stroke. An embolic stroke occurs when a blood clot or other debris forms away from your brain – commonly in your heart – and is swept through your bloodstream to lodge in narrower brain arteries. This type of blood clot is called an embolus.
Hemorrhagic stroke occurs when a blood vessel in your brain leaks or ruptures. Brain hemorrhages can result from many conditions that affect your blood vessels, including uncontrolled high blood pressure (hypertension) and weak spots in your blood vessel walls (aneurysms). A less common cause of hemorrhage is the rupture of an arteriovenous malformation (AVM) — an abnormal tangle of thin-walled blood vessels, present at birth. The types of hemorrhagic stroke include:
- Intracerebral hemorrhage. In an intracerebral hemorrhage, a blood vessel in the brain bursts and spills into the surrounding brain tissue, damaging brain cells. Brain cells beyond the leak are deprived of blood and damaged. High blood pressure, trauma, vascular malformations, use of blood-thinning medications and other conditions may cause intracerebral hemorrhage.
- Subarachnoid hemorrhage. In a subarachnoid hemorrhage, an artery on or near the surface of your brain bursts and spills into the space between the surface of your brain and your skull. This bleeding is often signaled by a sudden, severe headache. A subarachnoid hemorrhage is commonly caused by the rupture of an aneurysm, a small sack-shaped or berry-shaped outpouching on an artery in the brain. After the hemorrhage, the blood vessels in your brain may widen and narrow erratically (vasospasm), causing brain cell damage by further limiting blood flow to parts of your brain.
Transient ischemic attack (TIA)
A transient ischemic attack (TIA) – also called a ministroke – is a brief episode of symptoms similar to those you’d have in a stroke. A transient ischemic attack is caused by a temporary decrease in blood supply to part of your brain. TIAs often last less than five minutes.
Like an ischemic stroke, a TIA occurs when a clot or debris blocks blood flow to part of your brain. A TIA doesn’t leave lasting symptoms because the blockage is temporary.
Symptoms of a Stroke:
- Sudden weakness or numbness in the face, arm, or leg on one side of the body.
- Abrupt loss of vision, strength, coordination, sensation, speech, or the ability to understand speech. These symptoms may become worse over time.
- Sudden dimness of vision, especially in one eye.
- Sudden loss of balance, possibly accompanied by vomiting, nausea, fever, hiccups, or trouble with swallowing.
- Sudden and severe headache with no other cause followed rapidly by loss of consciousness — indications of a stroke due to bleeding.
- Brief loss of consciousness.
- Unexplained dizziness or sudden falls.
Strategies to Prevent Stroke:
- Controlling high blood pressure (hypertension).
- Lowering the amount of cholesterol and saturated fat in your diet.
- Quitting tobacco use.
- Controlling diabetes.
- Maintaining a healthy weight.
- Eating a diet rich in fruits and vegetables.
- Exercising regularly.
- Drinking alcohol in moderation, if at all.
- Treating obstructive sleep apnea, if present.
- Avoiding illicit drugs.