A Better Understanding of Stroke
Every year 700,000 people in the United States experience a new or recurrent stroke. Learn how you can be prepared in case you or a loved one experiences stroke.

“Your brain controls everything you do, and it needs a continual supply of blood flow for energy,” says Lewis Sayre, M.D., emergency physician at Salem Hospital. “Disrupt blood flow, and a stroke can occur. Consequently, you may lose the ability to talk, move or think clearly.”

Types of strokes
The two main types of strokes may share symptoms, but the causes and treatments aren’t the same. Successful treatment depends on differentiating between the two.

Ischemic stroke
Ischemic stroke occurs when a blood vessel in or near the brain becomes blocked. Without blood bringing oxygen and nutrients to brain cells, they may stop functioning and die. Depending on the area of the brain that’s affected, a stroke may impair your ability to speak, walk, see or think clearly. About 80 percent of all strokes are ischemic.

Hemorrhagic stroke
Burst blood vessels account for approximately 20 percent of all strokes. This is a hemorrhagic stroke. When blood spills into or around the brain, it puts pressure on cells in the area. If this pressure isn’t relieved quickly, brain cells may die.

Every minute counts: Signs and symptoms of stroke
Thankfully, fast action can help minimize the damage done by either type of stroke.

“Stroke is a medical emergency,” says Michael Wynn, D.O., a neurologist with Salem Hospital. “Call 911 immediately if you suddenly experience any of the following symptoms.”

• Numbness or weakness in the face, arms or legs—often affecting only one side of the body
• Trouble speaking or understanding what others are saying
• Problems seeing with one or both eyes
• Loss of balance, dizziness or difficulty walking
• Severe headache with no known cause

What causes stroke?
Atherosclerosis is a common cause of ischemic stroke. It occurs when fatty deposits, or plaques, accumulate on blood vessel walls. Eventually, the plaques may build up enough to block blood flow. Or, blood clots may form where the blood vessel narrows. These clots cause most strokes.

An embolism is a clot that usually starts in a larger blood vessel—such as the carotid artery— but clogs a smaller blood vessel. Heart rhythm disorders, such as atrial fibrillation, may cause embolisms to form in the heart. If one of these clots travels to the brain, it can cause a stroke.

For hemorrhagic stroke, high blood pressure, aging, diabetes and smoking can weaken vessels and lead to an aneurysm. This is a ballooning weak spot in the wall that makes the blood vessel more likely to rupture. A head injury also may cause bleeding in the brain and lead to a stroke.

Treatment
Medication can help dissolve clots and restore blood flow to patients suffering an ischemic stroke. This medication, called tPA, can only be given within three hours of the onset of symptoms. The longer it takes to restore blood circulation, the more damage may be done. Aspirin or Coumadin^® are medications often prescribed to prevent strokes.

Sometimes patients with hemorrhagic strokes benefit from surgery. These patients must be seen as soon as possible in order to have any benefit from surgery. Surgery can fix damaged vessels and remove blood in the brain. Medication to help control bleeding may be used, too.

Recovering from a stroke
What the future holds after a stroke depends on which part of the brain was affected and how much it was damaged. About 10 percent of those who survive a stroke regain most or all function. Half can live at home with medical assistance. Another 40 percent need long-term care in a facility. How fully you recover also depends on the type of stroke.

“Support is the main ingredient in stroke recovery,” says Ruby McElroy, a stroke survivor. “My sister has been with me every step of the way, and I thank her all the time.”

Ruby organizes a support group for stroke survivors and caregivers. See the listing of support groups more information.