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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. Things will move quickly once you get to the hospital, as your emergency team tries to determine what type of stroke you're having. That means you'll have a CT scan or other imaging test soon after arrival. Doctors also need to rule out other possible causes of your symptoms, such as a brain tumor or a drug reaction. Stroke consultation at Mayo Clinic TestsSome of the tests you may have include:
TreatmentEmergency treatment for stroke depends on whether you're having an ischemic stroke or a stroke that involves bleeding into the brain (hemorrhagic). Ischemic strokeTo treat an ischemic stroke, doctors must quickly restore blood flow to the brain. This may be done with:
The time window when these procedures can be considered has been expanding due to newer imaging technology. Doctors may order perfusion imaging tests (done with CT or MRI) to help determine how likely it is that someone can benefit from endovascular therapy. Other proceduresTo decrease your risk of having another stroke or transient ischemic attack, your doctor may recommend a procedure to open up an artery that's narrowed by plaque. Options vary depending on the situation, but include:
Hemorrhagic strokeEmergency treatment of hemorrhagic stroke focuses on controlling the bleeding and reducing pressure in the brain caused by the excess fluid. Treatment options include:
Stroke recovery and rehabilitationAfter emergency treatment, you'll be closely monitored for at least a day. After that, stroke care focuses on helping you recover as much function as possible and return to independent living. The impact of the stroke depends on the area of the brain involved and the amount of tissue damaged. If the stroke affected the right side of the brain, your movement and sensation on the left side of the body may be affected. If the stroke damaged the brain tissue on the left side of the brain, your movement and sensation on the right side of the body may be affected. Brain damage to the left side of the brain may cause speech and language disorders. Most stroke survivors go to a rehabilitation program. Your doctor will recommend the most rigorous therapy program you can handle based on your age, overall health and degree of disability from the stroke. Your doctor will take into consideration your lifestyle, interests and priorities, and the availability of family members or other caregivers. Rehabilitation may begin before you leave the hospital. After discharge, you might continue your program in a rehabilitation unit of the same hospital, another rehabilitation unit or skilled nursing facility, as an outpatient, or at home. Every person's stroke recovery is different. Depending on your condition, your treatment team may include:
Speech therapy is often a part of stroke rehabilitation. More Information
Treatment outcomesOne way to evaluate the care of patients diagnosed with stroke is to look at the percentage of patients receiving the timely and effective care measures that are appropriate. The goal is 100 percent. The graphs below display the percentage of eligible Mayo Clinic patients diagnosed with stroke receiving all of the appropriate care measures. Stroke Core MeasureSee related graph. Carotid Endarterectomy MortalitySee related graph. Carotid Stenting MortalitySee related graph. Comprehensive Stroke MeasureSee related graph. Comprehensive Stroke – Arrival Time to Skin PunctureSee related graph. Comprehensive Stroke – Post Thrombolysis Revascularization RateSee related graph. Comprehensive Stroke – Timeliness of IV t-PA TherapySee related graph. For additional information and data visit Medicare Hospital Compare. For additional information about quality at Mayo Clinic visit Quality Measures. Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus
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that information as set forth in our notice of privacy practices. You may opt-out of email communications at any time by clicking on the unsubscribe link in the e-mail. Clinical trialsExplore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition. Coping and supportA stroke is a life-changing event that can affect your emotional well-being as much as your physical function. You may sometimes feel helpless, frustrated, depressed and apathetic. You may also have mood changes and a lower sex drive. Maintaining your self-esteem, connections to others and interest in the world are essential parts of your recovery. Several strategies may help you and your caregivers, including:
Communication challengesProblems with speech and language can be especially frustrating. Here are some tips to help you and your caregivers cope with communication challenges:
Preparing for your appointmentA stroke in progress is usually diagnosed in a hospital. If you're having a stroke, your immediate care will focus on minimizing brain damage. If you haven't yet had a stroke but you're worried about your future risk, you can discuss your concerns with your doctor at your next scheduled appointment. What to expect from your doctorIn the emergency room, you may see an emergency medicine specialist or a doctor trained in brain conditions (neurologist), as well as nurses and medical technicians. Your emergency team's first priority will be to stabilize your symptoms and overall medical condition. Then the team will determine if you're having a stroke. Doctors will try to find the cause of the stroke to determine the most appropriate treatment. If you're seeking your doctor's advice during a scheduled appointment, your doctor will evaluate your risk factors for stroke and heart disease. Your discussion will focus on avoiding these risk factors, such as not smoking or using illegal drugs. Your doctor will also discuss lifestyle strategies or medications to control high blood pressure, cholesterol and other stroke risk factors. Jan. 20, 2022 When assessing a patient with a possible stroke What should you check first?Patients with suspected acute stroke should have a rapid initial evaluation for airway, breathing and circulation [Evidence Level A]. A neurological examination should be conducted to determine focal neurological deficits and assess stroke severity [Evidence Level A].
Which of the following most accurately describes a cause of an ischemic stroke?An interruption of blood supply to the brain causes all ischemic strokes.
Which of the following clinical signs is most suggestive of a ruptured aneurysm?A sudden, severe headache is the key symptom of a ruptured aneurysm. This headache is often described as the "worst headache" ever experienced.
What is the name of the condition in which the patient forgets about the injured side?The condition is also known as left side neglect, unilateral neglect or hemispatial neglect. It is one of the oddest symptoms of brain injury and can be one of the most troublesome. “Left neglect” is a term describing a deficit in awareness that occurs following an injury to the brain's right side.
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