Stroke types, signs, treatment and risk factors

Are You at Risk for a Stroke?, Valley Health System, Las Vegas, NV.Stroke statistics are reason enough to be cautious of your risk of a stroke. According to The Centers for Disease Control and Prevention, in the United States, someone has a stroke every 40 seconds. Every 3.5 minutes, someone dies from stroke. It’s crucial for people to understand stroke risk factors and the signs of stroke so they can seek help immediately.

Krystal Coffman, DNP, Director of Quality at Henderson Hospital, shares important information surrounding stroke, including types of stroke, symptoms, and what recovery involves.

Types of Stroke

There are two main types of stroke: ischemic and hemorrhagic. An ischemic stroke occurs when a blockage occurs in an artery and the brain does not receive enough blood. Hemorrhagic strokes happen when an artery breaks or leaks and blood gets into the brain tissue. People often refer to hemorrhagic strokes as "brain bleeds."

Ischemic strokes are by far the most common, comprising about 87% of all strokes.

Signs of Stroke

One aspect to keep in mind with stroke is the sudden onset of symptoms. "I might be having a conversation and then, all of a sudden, I start having trouble speaking or my face starts to droop," explains Coffman.

Additional symptoms include:

  • Weakness, numbness, or tingling on one side of the body
  • Confusion upon hearing words
  • Trouble speaking or forming coherent sentences
  • Dizziness and loss of balance/coordination
  • Extreme headache, what is often referred to as, "the worst headache of your life"

If any of the above occur to you or a loved one, it’s important to call 911 immediately.

Don’t try to drive yourself to the emergency room, because time to care is crucial with stroke and there are steps EMS professionals can take as they transport you to the hospital. They will also alert the neurology department of symptoms so physicians have the information they need to intervene as quickly as possible.

Stroke Treatment

Once a person arrives at the emergency department (ED), the first step is to perform a CT scan of the brain. This helps identify what kind of stroke has occurred. If the stroke was considered a “major” one, neurosurgeons may perform additional imaging scans.

"That would be a CT angio and a CT perfusion. Those look at the arteries to see if we see any blockages, and we look at the extent of the stroke that's developed so far," says Coffman. "While those are being read by the radiologist, you're going to get other tests. The ED doctors and nurses assess you for stroke symptoms. They're going to draw blood, check your history, check what medicines you're on, find out when the symptoms started."

All of this happens very quickly, because there is a limited window for certain treatments to be applied. For example, the "clot-busting" medication needs to be injected within approximately three to four hours from the start of the stroke. Outside of that window, it becomes useless. However, advanced technology is now providing solutions beyond just the clot-busting medication.

What Does Recovery Look Like?

If a person acts immediately, and is able to receive medication, chances are they will recover well. That doesn’t mean someone who doesn’t get the medication will have a difficult time getting back to baseline. Every person is different in their recovery process.

"Some people have very small strokes and they may never have any significant symptoms," Coffman says. "Others may have massive strokes and be permanently paralyzed or unable to speak. But, when you're talking about the early phases and getting to the hospital, it's all about time. Everything after that is really about attitude and being motivated to work with therapy and to get better."

Coffman encourages family members and friends to practice patience with someone who is recovering from a stroke. It takes time to heal, and getting frustrated just makes recovery harder. She also advises being cognizant about the potential for depression, as many stroke survivors develop it during the recovery process.

"We see depression in about a third of all stroke survivors, and that is independent of whether or not they had any indications of depression before," she says. "The chemicals and all the stuff in your brain just got messed up."

Stroke Risk Factors

Coffman wants everyone to understand that anyone can have a stroke, regardless of risk factors or age. That’s why it’s so important to be aware of stroke symptoms. However, there are some factors that contribute to risk:

  • Age (risk rises as we get older)
  • Untreated high blood pressure
  • Current smoker or a history of smoking
  • Previous stroke
  • Chronic diseases such as diabetes, kidney failure, sleep apnea

Remember, Time Is Everything

When it comes to stroke, Coffman cannot stress urgency enough. "The most important part of [treating] stroke is getting to the hospital. So, identifying you're having stroke symptoms, make sure to call 911. Don't lay down and see if it gets better. Don't think, ‘Oh, I'm overestimating' or 'I'm being dramatic.’ Come in and let us check you out."