Do You Know You're Having a Stroke?

Tuesday, November 25, 2008

A Mayo Clinic study shows a majority of stroke patients don't think they're having a stroke — and as a result — delay seeking treatment until their condition worsens. The findings appear in the current issue of Emergency Medicine Journal.

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Researchers studied 400 patients who were diagnosed at Mayo Clinic's emergency department with either acute ischemic stroke or a transient ischemic attack (TIA), a temporary interruption of blood flow to part of the brain.

Less than half of the patients — 42 percent — thought they were having a stroke. In fact, most in the study did not go to the emergency room when symptoms appeared. The median time from onset of symptoms to arrival at the hospital was over three and a half hours. Most said they thought the symptoms would simply go away. The delay in seeking medical help was the same among men and women.

When asked how they knew about stroke symptoms, nearly one-fifth said they thought a stroke always came on gradually. Just over half (51.9 percent) said they thought that seeking medical care immediately was important.

Significance of the findings

"Time is crucial in treating stroke," says Latha Stead, M.D., emergency medicine specialist and lead author of the study. "Each individual's medical background differs and affects recovery, but in general the sooner a patient experiencing a stroke reaches emergency care, the more likely the stroke can be limited and the condition managed to prevent further damage and improve recovery." The researchers say their findings clearly indicate that better public understanding of stroke symptoms will lead to a faster response and better outcomes.

What you should know

Strokes can happen quickly or can occur over several hours, with the condition continually worsening. The thrombus or clot that is causing the stroke can frequently be dissolved or disintegrated so blood can again flow to the brain. In such cases, immediate treatment can mean the difference between a slight injury and a major disability. Interestingly only 20.8 percent of the participants knew about such treatment. By use of stents, medications and other technology, physicians can stop a stroke from spreading and greatly limit damage. Stroke symptoms include:

• Sudden numbness, weakness, or paralysis of your face, arm or leg — usually on one side of the body
• Sudden difficulty speaking or understanding speech (aphasia)
• Sudden blurred, double or decreased vision
• Sudden dizziness, loss of balance or loss of coordination
• A sudden, severe "bolt out of the blue" headache or an unusual headache, which may be accompanied by a stiff neck, facial pain, pain between your eyes, vomiting or altered consciousness
• Confusion or problems with memory, spatial orientation or perception

In such cases, a stroke gives no warning. But one possible sign of an impending stroke is a TIA. The signs and symptoms of TIA are the same as for a stroke, but they last for a shorter period — several minutes to a few hours — and then disappear, without leaving apparent permanent effects. You may have more than one TIA, and the signs and symptoms may be similar or different. A TIA indicates a serious risk that a full-blown stroke may follow.

Other Mayo researchers involved in the study were Lekshmi Vaidyanathan, M.B.B.S.; Maria Bellolio, M.D.; Rahul Kashyap, M.B.B.S.; Anjali Bhagra, M.B.B.S.; Rachel Gilmore, M.B.B.Ch.; Wyatt Decker, M.D.; Sailaja Enduri, M.B.B.S.; Shaily Mishra, Ph.D.; Helen Wood, R.N.; Ayman Yassa, M.D.; Ann Hoff, M.D.; and Robert Brown, M.D. Dr. Stead is supported by the Mayo Emergency Medicine Research Career Development Award and Mayo Clinic.

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