Stroke, Otherwise Known as a “Brain Attack” - dummies

Stroke, Otherwise Known as a “Brain Attack”

By Sarah Samaan, Rosanne Rust, Cynthia Kleckner

You already know that your brain is pretty impressive. It has billions of neurons, or nerve cells, with literally trillions of connections that allow it to communicate with itself. Your movements, your speech, your senses, and your thoughts all depend on the normal functioning of your brain. Like your heart, it’s constantly on the job and absolutely dependent on blood flow for its life force.

Blood flow to the brain comes largely through the two carotid arteries (one on the right and one on the left), as well as the vertebral arteries, which come up the back of the neck. When the blood supply to part of the brain is cut off, a stroke occurs. Just like a heart attack, if blood flow is restricted long enough, the tissue supplied by that artery dies.

[Credit: Illustration by Kathryn Born]
Credit: Illustration by Kathryn Born

In the case of a stroke, that means the functions of the body or mind controlled by the affected part of the brain are severely — and possibly permanently — limited.

A stroke can be large, involving a major artery, or very small, if a small branch off of a larger blood vessel is affected. Although large strokes tend to be the most devastating, even very small strokes can have profound effects, especially if they involve a crucial segment of the brain that’s involved in coordination of the neurons’ messages.

Strokes may cause paralysis of an arm, leg, or both. Speech may be affected, as can normal thought processes. Sometimes, the thought processes remain intact, but the individual loses the ability to communicate, either verbally or in writing.

Most strokes are caused by the same things that contribute to heart disease: hypertension, diabetes, high cholesterol, smoking, obesity, and a sedentary lifestyle. In fact, hypertension is the leading cause of stroke. That means that most strokes are preventable, but it’s up to you to take control.

Sifting through the facts on strokes

Stroke is the fourth-leading cause of death in the United States and a serious cause of life-changing disability. The World Heart Federation estimates that 15 million people worldwide will suffer a stroke each year.

Although more aggressive treatment of risk factors such as hypertension and cholesterol and fewer smokers mean that strokes are declining in the Western world, it’s estimated that over the next two decades, stroke mortality will triple in the developing world (such as Latin America, the Middle East, and Africa).

There are two general types of strokes, both of which can be equally devastating:

  • Ischemic strokes happen when an artery gets blocked off, or plugged up, by cholesterol plaque or by a blood clot. Nearly 90 percent of all strokes are ischemic.

    Transient ischemic attacks (TIA), sometimes referred to as mini-strokes, are a type of ischemic stroke in which the artery is only briefly blocked. The symptoms are similar to a stroke but typically last less than five minutes. TIAs are often a warning that a full-blown stroke is on the way and should be taken just as seriously as a stroke.

  • Hemorrhagic strokes are caused by the rupture of a blood vessel. In this case, blood leaks into the brain, causing compression and damage to the tissue. Hemorrhagic strokes are usually caused by aneurysms or other malformations of the blood vessels. Although less common, hemorrhagic strokes can be more devastating and account for about 30 percent of all deaths from strokes.

Although most strokes occur in people over 65, more than one in three occur in people who haven’t yet reached Medicare age. The incidence of stroke in men and women under 50 has skyrocketed in the last two decades. This can be directly attributed to poor lifestyle choices, which are epidemic in younger folks. That is to say: Put down the double bacon cheeseburger, people!

The effects of a stroke can be mercifully minor or they may be devastating. Rehabilitation can help tremendously by retraining the healthy parts of the brain to take over the function of the damaged portion. Some people can make nearly miraculous recoveries, while others, generally those who have larger strokes or strokes affecting critical areas of the brain, are permanently and severely disabled. In truth, only 10 percent of people ever fully recover from a stroke.

Acting FAST if you suspect a stroke

If you suspect that you or someone else is having a stroke, the National Stroke Association recommends that you take the FAST test:

  • F for Face: Ask the person to smile. If her face droops, it could be a stroke.

  • A for Arms: Can the person raise both arms? If one seems weaker, it could be a stroke.

  • S for Speech: Can the person repeat a simple sentence? If not or if the speech is slurred or seems strange, it could be a stroke.

  • T for Time: Time is crucial. Call 911 if you suspect a stroke.

Other symptoms that should get your attention include a sudden loss of vision, confusion, difficulty walking, loss of coordination, or a severe headache.