March 10, 2006

Are you at risk of a Stroke?

The recent premature death of the baseball player from a stroke brings this issue into focus.

By Eduardo Grunvald, M.D.

You’re enjoying breakfast while reading the newspaper when suddenly the print is all fuzzy, your coffee cup crashes to the floor because your hand can’t maintain enough strength to hold the handle, the words coming out of your mouth sound like language from another planet, and when you try to stand up you collapse because your right leg has gone limp.

More than likely, you are having a stroke – think of this as a heart attack of the brain.

What should one do? CALL 911 immediately. That bears repeating…CALL 911. Fortunately, there have been some amazing advancements in treating this previously irreversible affliction. There are medications that can open up the arteries and allow the brain cells to get the vital blood before it is too late, BUT IT MUST BE GIVEN WITHIN THREE HOURS FROM THE ONSET OF SYMPTOMS

Statistics show that Hispanics suffer from strokes at a rate twice as high as non-Hispanic white Americans. The reasons are similar to those cited for an increased incidence of heart attacks: obesity, diabetes, high blood pressure, high cholesterol, and inactivity.

At this year’s American Stroke Association’s International Stroke Conference it was estimated that in 2005 over three billion dollars was spent in treating the most common form of stroke in Hispanics in the United States. These costs included acute care and hospitalization, rehabilitation and chronic care, and lost wages.

One way to reverse this unfortunate statistic is to prevent strokes before they strike, and to recognize the symptoms so that life-preserving medications can be administered before it’s too late.

The brain, like any other organ in our body, needs blood flow to function properly. Oxygen and blood sugar – the two major elements that fuel the body – are delivered in the blood via arteries. When one of these arteries become clogged, a process that can occur rapidly or gradually over many years, the cells in that part of the brain die, similar to what happens in the heart during a heart attack. This is called an ischemic stroke, the most common kind.

The other much less common type, or hemorrhagic stroke, happens when there is bleeding in the brain, usually associated with very high blood pressure or tumors.

The human brain is an incredible organ composed of countless parts each serving as individual control centers for the everyday functions we take for granted. When one of these areas is injured – the end result of a stroke – a particular function is altered or destroyed. For example, strokes often occur in an area of the brain that controls movement of one side of the body or face.

So how can one lower the risk of having a stroke? The same way one can lower their risk of having a heart attack. Besides living a good lifestyle – being a non-smoker, regular exercise and a healthy diet - you should see your doctor regularly to control the major risk factors: high blood pressure, high cholesterol, and diabetes. Taking an aspirin every day may also help prevent a stroke, but as always you should consult your doctor before starting any type of medication treatment.

Stroke warning signs include the sudden loss of strength or sensation of an arm, leg, or the face; sudden visual changes; sudden dizziness or vomiting; slurred speech, inability to understand what others are saying or to get the right words out; sudden confusion; and sudden severe headaches. If you are unsure about the sudden onset of other symptoms, play it safe and call 911.

Time is of the essence. If any of these symptoms develop, DO NOT WAIT TO SEE YOUR PERSONAL DOCTOR OR WAIT FOR SOMEONE TAKE YOU TO THE HOSPITAL.

Remember, a few minutes could make the difference between regaining normal function and living the rest of your life with permanent damage.

For more information on stroke preventions in English and Spanish, visit www.stroke association.org (1-888-4-STROKE) or http://health.ucsd.edu/specialties/stroke/prevention.htm (1-800-926-UCSD).

Dr. Grunvald is Assistant Clinical Professor, Department of Medicine at the Perlman Internal Medicine Group, UCSD Medical Center.

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