Neurologist Robert Brown, M.D., answers the most frequently asked questions about strokes.
Hi, I'm Dr. Robert Brown, a neurologist at Mayo Clinic. And I'm here to answer some of the important question you may have about strokes.
The fast acronym, F.A.S.T., is a good way of remembering stroke symptoms and what to do if you or a friend or loved one experiences those symptoms. F for facial weakness, A for arm weakness, S for speech slurring, and T for time. Time to call 911 should those symptoms occur. Sometimes stroke symptoms may be temporary, lasting only several minutes or hours, and this is called a transient ischemic attack. The symptoms should not be ignored even if they are temporary. The risk of stroke is markedly increased in the days and weeks after those symptoms occur, so seek emergency evaluation to clarify why the symptoms occurred and how best to prevent a future stroke.
An aneurysm is a small saccular-shaped or berry-shaped out-pouching off of an artery in the brain. About two to three percent of the population has a brain aneurysm, and most never cause any symptoms. But on occasion, that aneurysm can rupture, leading to bleeding into and surrounding the brain, a bleeding type of stroke called a subarachnoid hemorrhage. People with that type of hemorrhage typically present with a sudden onset of a very severe headache, unlike anything they've ever experienced before, and they should seek emergency medical care.
The brain cells are affected very quickly after a stroke occurs. In the most common type of stroke, called an ischemic stroke, or cerebral infarction, there's a lack of blood flow to an area of the brain leading the brain cells to begin to die off due to a lack of oxygen and other nutrients. Emergency treatments can sometimes be used to restore the blood flow. Stroke treatments are most effective if they can be used early after stroke symptoms occur.
Most strokes are preventable. And stroke prevention is far more effective than trying to treat a stroke after it has occurred. There are both non-modifiable risk factors, those things we cannot change, and modifiable risk factors, those things that can be changed. Non-modifiable risk factors include age, race, gender, and family history of stroke. Modifiable risk factors include high blood pressure, high cholesterol levels, cigarette smoking, diabetes, obstructive sleep apnea, lack of regular exercise, obesity, heavy alcohol use, recreational drug use, and some types of heart disease.
Every stroke is a little bit different because any area of the brain can be affected by a stroke. Some strokes lead to only mild symptoms, and others are more severe and have a major impact on speech, strength, swallowing, walking, and vision. The patient with a stroke will typically start therapies very early after a stroke, including physical therapy, occupational therapy, and speech therapy. A person can continue to recover from a stroke for many months after a stroke up to a year or even longer. This recovery is a very gradual process. But don't give up. Celebrate the gains from week to week and month to month.
If you have any stroke risk factors, partner with your medical team to control them. If stroke symptoms occur, seek emergency care. Work with your medical team to arrange for the appropriate evaluation to clarify why the stroke happened, and institute strategies to prevent another stroke from occurring in the future. Take your medications as advised. Your medical team will also institute therapies to help you with any deficit that you might have related to your stroke so that you can live your life to the fullest after a stroke occurs. Thank you for your time and we wish you well.