Early warning of stroke - the difference between life, serious disability or death

Strokes can happen to anyone in any age group. It is most prevalent in older Australians due to many age related health issues. A stroke can be life threatening. We must stay vigilant for any signs of stroke in our loved ones and ourselves.

According to the Australian Stroke Foundation, stroke occurs when an artery supplying blood to the brain either suddenly becomes blocked or begins to bleed. This may result in part of the brain dying, leading to a sudden impairment that can affect a range of activities such as speaking, thinking, movement and communication.

The Stroke Foundation says there are two main types of stroke: a blood clot or other particles blocking a blood vessel causes one type (ischaemic stroke, which is also known as cerebral infarction) and the rupturing and subsequent bleeding of a blood vessel causes the other (haemorrhagic stroke). Ischaemic stroke accounts for about 80% of stroke and haemorrhagic stroke accounts for about 20%.

The Australian Institute of Health and Welfare (AIHW), Stroke and its Management in Australia: an update, says there are over 33,000 stroke events each year resulting in over 8,500 deaths. Stroke death rates increased greatly with age, with 81% of stroke deaths occurring among those aged 75 or over. More females (5,000) die from stroke than males (3,500).

The majority of stroke events (70%) are people aged 65 and over. It is estimated that just over a third of Australians with stroke had a disability from their stroke. People with a disability resulting from stroke were much more likely to be profoundly limited (always need help) in core activities (56%). The high proportion of profound limitations will trigger the need for specialised home care which may required for the rest of the persons life. Of people with stroke-related disability, 28% were aged under 65 and 72% were aged 65 and over.

Nan McAdam writing in her elder care blog says, "A stroke can happen very quickly or can be preceded by small TIA's (Transient Ischaemic Attacks) or mini strokes. With a TIA, the symptoms may appear similar to a stroke, but pass quickly, usually disappearing within half an hour. They don't leave outward signs of damage."

"It is important to understand, a TIA can be a precursor to a major stroke. It is vital not to ignore the symptoms. A TIA should be reason to get to a doctor quickly."

A TIA, also called a "warning stroke," signals a high risk of a subsequent, larger stroke.

The most common cause of stroke is high blood pressure. High blood pressure should not be taken lightly. It is important to see a doctor and control our blood pressure with weight loss and medications.

Another cause of strokes is Atrial Fibrillation. This is a condition where the upper chambers of the heart quiver instead of producing a strong muscular contraction of the upper part of the heart. The heart suffering from "Afib" isn't pumping the blood around the body correctly, leaving an opportunity for the blood to pool causing a clot. This clot can become dislodge and flow with the blood stream until it lodges in the brain causing a stroke. A person experiencing Afib has 7 times the chance of stroke. A person with chronic Afib can be given blood-thinning drugs such as Coumadin or Plavix.

It is important when suffering a stroke; the patient should immediately be transported to an emergency room of a hospital. This person should never try to drive themselves to the hospital.

If a person suffers a stroke, it is imperative for them to be treated within the first 3 hours of onset. Most strokes can be reversed if treated within this time period.

People who have suffered a TIA "mini stroke" are at twice the risk of heart attack than the general population, according to research reported in the Stroke Journal of the American Heart Association.

The AHA study included 456 patients (average age 72, 43% men) diagnosed with a TIA between 1985 and 1994. Nearly two-thirds had high blood pressure, more than half smoked, and three-fourths were being treated with medication, such as aspirin, to prevent blood clots. The patients have been monitored every five years since the study began.

In this study, the risk of heart attack among TIA patients was about 1% per year, double that of people who had never had a TIA. This increased risk persisted for years and was highest among patients under age 60, who were 15 times more likely than non-TIA patients to have a heart attack. The study, showed the average length of time between a first TIA and a heart attack was five years.

Nan McAdam has identified 7 stroke indicators we should be watching for? How will we know if a stroke is happening?

  1. Ask them to smile. Watch to see if their smile droops on one side. Sometimes, Bell's Palsy, which is not a stroke, can cause paralysis in facial muscles. It's not a stroke, but only a doctor can tell for certain. Don't risk it … seek an emergency room!
  2. It can come dressed as a speech problem. All of a sudden they aren't making any sense, or they cannot find the words for common everyday things. Ask the person to say a simple sentence, such as "it's raining outside". If this simple sentence isn't spoken coherently, time for transport to an ER.
  3. You may notice a change in their face. Their eye or lip may, suddenly, droop on one side of their body. Be watchful for sudden numbness or weakness of the face, arm, or leg, especially if it happens on one side of the body. Ask your loved one to raise both arms, at the same time. Since a stroke can cause weakness or paralysis on either side, one arm may not want to rise with the other.
  4. Ask them to stick out their tongue. If the tongue is crooked or goes to one side or the other, it could indicate stroke.
  5. Your loved one may experience a sudden onset or complain about feeling dizzy. They may have a loss of balance or coordination. Many times, a stroke can be cloaked in the guise of a fall or a near fall. The person can have a small stroke and lose their balance. Most often, they don't know why they fell.
  6. Watch for a sudden change in vision. Complaints of blurriness and/or difficulty seeing out of either or both eyes.
  7. A loved one may complain about a severe headache for no known reason. Don't give your loved one an aspirin. If the stroke is from a haemorrhage instead of a clot, giving an aspirin will only make the bleed in the brain worse and can cause permanent damage. Only an MRI can determine the cause and location of a stroke.
McAdam says, "Strokes can happen quickly. Sometimes, it's difficult to know if your loved one has experienced a stroke. It's always best to keep in mind, as the old quote says, "it is better to be safe than sorry!"

A good rule of thumb is, "if you don't know, then go."

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