Strokes strike nearly 800,000 Americans each year, killing about 140,000
and forever changing the lives of those who survive.
In honor of National Stroke Awareness Month, BCH hosted a free health lecture
in Erie, Colo. BCH interventional cardiologist
Srini Iyengar, MD, and neurologist
Alan Zacharias, MD, described the causes of stroke, warning signs and ways to lower your risk.
What is a Stroke?
“A stroke occurs when there’s a loss of blood flow to brain
tissue, depriving brain tissue of
oxygen and nutrients. Brain cells begin to die within minutes,” said Dr.
Zacharias, who started off the lecture.
He then went on to explain the two broad categories of stroke: ischemic
“An ischemic stroke is the most common type, responsible for more
than 80 percent of strokes. It occurs when a blockage of an artery cuts
off blood flow to a part of the brain,” Dr. Zacharias said.
Ischemic strokes can be caused by:
- Embolism - a blood clot that travels from the heart or blood vessel up
to the brain
- Thrombosis - a blood clot that develops in the blood vessels inside the brain
Dr. Zacharias said that these clots may be caused by fatty deposits (plaque)
that build up in arteries and cause reduced blood flow.
“The other type of stroke, hemorrhagic, occurs when a blood vessel
in your brain leaks or ruptures. Blood spills into or around the brain
and creates swelling and pressure,” stated Dr. Zacharias.
Warning Signs of a Stroke
Dr. Zacharias said, “There are a number of symptoms for stroke.
Any sudden changes can be a stroke.”
The most common sign is sudden weakness of the face,
arm or leg, most often on one side of the body. Other warning signs include sudden:
- changes in speech or understanding speech
- changes in vision
- unsteadiness or loss of coordination
- severe headache
If you think you or someone is having a stroke, immediately call 9-1-1.
Also, check the time so you’ll know when the first symptoms appeared.
“People sometimes experience a transient ischemic attack, or TIA,
which symptoms resemble those found in a stroke but usually last a few
minutes. Even if all symptoms quickly resolve, it's still very important
that you call 9-1-1 and immediately be evaluated by a qualified physician.
A TIA is a warning sign of a possible future stroke and is treated as
a neurological emergency,” said Dr. Zacharias.
Time is of the Essence for Treatment
"Never wait to see if symptoms will go away!" Dr. Zacharias
warned. “You need to act quickly to save yourself or a loved one
from potential disability or death.”
According to Dr. Zacharias, if you suffer an ischemic stroke, doctors work
to restore blood flow to your brain with:
An injection of blood-thinning medication called tissue plasminogen activator (tPA), the gold standard treatment
for ischemic stroke.
Emergency endovascular procedures, which are procedures performed directly inside the blocked blood vessel.
Doctors may insert a catheter through a groin artery and thread it to
your brain to deliver tPA directly into the area where the stroke is occurring.
Or, doctors may use a catheter to maneuver a device into the blocked blood
vessel and pull out the clot.
Other treatments may include surgical procedures that open up a narrowed
artery running along the side of your neck to your brain.
Identifying Your Risk Factors
Dr. Zacharias explained that there are some risk factors for stroke you
control, but it’s important for you to know them.
He said that genetics contributes to about 50 percent of your stroke risk.
“Stroke tends to run in some families. Members of a family might
have a genetic tendency for stroke risk factors such as an inherited predisposition
for diabetes or high blood pressure.”
However, there are risk factors you can control. Dr. Zacharias noted that
some of the most important treatable and modifiable risk factors for stroke are:
- Hypertension (the No. 1 risk factor)
- Cigarette smoking
- Elevated cholesterol
- Physical inactivity
He recommended talking to your
health care provider about how to lower your risk for stroke if you have one of the above risk factors.
Reducing Your Risk from Atrial Fibrillation
Atrial fibrillation (AFib) is a type of irregular heartbeat that affects
about 2.3 million people in the U.S. It occurs when there’s a malfunction
in the heart’s electrical signals, causing it to beat rapidly and
erratically. According to the National Stroke Association, AFib raises
a person's risk for stroke by 500 percent. However, properly treating
AFib can greatly reduce this risk.
Following Dr. Zacharias’ presentation, interventional cardiologist
Srini Iyengar, MD, BCH's structural heart program director, spoke about a new way for
AFib patients to protect themselves from stroke: the
According to Dr. Iyengar, blood-thinning medications, such as warfarin
(Coumadin®), are the most common treatment for preventing AFib-related
stroke. These clot-preventing medications can greatly reduce stroke risk if taken
properly and no side effects are seen.
Yet, more than half of all AFib patients are not prescribed these medications.
For certain individuals, there are barriers to taking a blood thinner,
including dangerous interactions with other medications, dietary restrictions, high
prescription costs and concerns about bruising or excessive bleeding from an injury.
Dr. Iyengar stated because of these concerns, the Watchman procedure could
be an alternative to taking blood-thinning medications for some AFib patients.
Watchman is a one-time procedure performed under
general anesthesia in a catheterization laboratory setting. The procedure usually
lasts about an hour and the patient is typically in the hospital for 24
hours following the procedure. Learn more about Watchman
BCH is a Primary Stroke Center
BCH has been awarded Advanced Certification as a Primary Stroke Center
by The Joint Commission and the American Heart Association/American Stroke
Association. The Joint Commission’s Primary Stroke Center certification
recognizes centers that make exceptional efforts to foster better outcomes
for stroke care. Achievement of certification signifies that the services
provided at BCH have the critical elements to achieve long-term success
in improving outcomes. To learn more about our primary stroke center,
View PowerPoint slides from the lecture on “Reducing Your Stroke Risk.” If you'd
like to schedule an appointment with our lecture presenters, you can reach
Srini Iyengar, MD, at 303-622-3980, or
Alan Zacharias, MD, at 303-857-5867.
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