A stroke is a loss of blood flow to part of the brain. Deprived of oxygen and
nutrients, brain cells start to die within a few minutes, which can cause
lasting brain damage, long-term disability or death.
If you think you or someone else is having a stroke, call 911 right away.
Immediate treatment may save a life and improves the chances of successful
rehabilitation and recovery.
FAST
| What to look for | |
|---|---|
| F — Face | Drooping on one side when smiling |
| A — Arm | Raise both arms; one drifts downward |
| S — Speech | Slurred or strange |
| T — Time | Call 911 |
The first three letters identify a stroke. The fourth is the one that changes
the outcome, and it is the one people hesitate over. Every minute counts.
Other sudden symptoms: numbness or weakness of face, arm or leg — especially
on one side; confusion, trouble speaking or understanding speech; trouble
seeing in one or both eyes; difficulty walking, dizziness, loss of balance or
coordination; a severe headache with no known cause.
Two kinds, and the treatments are opposites
| Cause | Share | |
|---|---|---|
| Ischaemic stroke | A blood clot blocking a vessel in the brain | About 80% |
| Haemorrhagic stroke | A vessel breaking and bleeding into the brain | The rest |
One is treated by breaking up a clot; the other by stopping bleeding. That is
exactly why nobody should be given anything before imaging, and why the
ambulance matters more than the medicine cabinet.
A transient ischaemic attack — a "mini-stroke" — is the blood supply being
blocked briefly. The damage is not permanent, **and a TIA puts you at much
higher risk of a stroke.** It is a warning, not a lesser event.
Risk
The major factors: high blood pressure — the primary risk factor;
diabetes; heart diseases, especially atrial fibrillation, which produces
the clots that cause strokes; smoking, which damages blood vessels and
raises blood pressure; a personal or family history of stroke or TIA; age;
and race and ethnicity — African American and Hispanic people have a
higher risk.
Also linked: alcohol and illegal drug use, too little physical activity, high
cholesterol, an unhealthy diet, and obesity.
Diagnosis and treatment
A provider asks about symptoms and history, does a physical exam checking
mental alertness, coordination and balance, numbness or weakness in face, arms
and legs, and trouble speaking or seeing — then runs tests.
For an ischaemic stroke, treatment breaks up or removes the clot, and
carotid artery disease may need a procedure to open the blocked artery.
For a haemorrhagic stroke, treatment stops the bleeding: first find the
cause, then control it.
- High blood pressure as the cause → blood pressure medicines
- An aneurysm → clipping or coil embolization, surgeries that prevent
further leaking and stop it bursting again - An arteriovenous malformation — a tangle of faulty arteries and veins
that can rupture — → AVM repair, by surgery, by injecting a substance to
block blood flow through it, or by radiation to shrink the vessels
Stroke rehabilitation helps relearn lost skills, aiming at as much
independence and quality of life as possible.
Preventing the next one
Having a stroke increases the risk of having another. Heart-healthy
changes: eating a heart-healthy diet, aiming for a healthy weight, managing
stress, regular physical activity, quitting smoking, and managing blood
pressure and cholesterol. Where that is not enough, medicines control the risk
factors.
*Source: National Institute of Neurological Disorders and Stroke, via
MedlinePlus.*
许可协议： CC0 1.0（公有领域） · 改编自 medlineplus.gov
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