With Strokes, Every Minute Matters

What, exactly, is a stroke? A stroke is a “brain attack” that occurs when a blood vessel that supplies blood to the brain is blocked by a blood clot, or when a weakened blood vessel in the brain bursts. In the past, victims who survived a stroke were often left permanently disabled. New technologies and therapies, however, have made it possible to not just survive a stroke but to fully recover and live an active, fulfilling life.

Stroke is the fifth leading cause of death in the U.S., according to the U.S. Centers for Disease Control & Prevention (CDC), and the leading cause of long-term disability. On average, someone in the U.S. has a stroke every 40 seconds; and someone dies from a stroke every three to four minutes.

Curiously, however, neurologists have noted a significant decrease in the number of stroke cases presenting at hospitals over the past few months. Felipe De Los Rios, M.D., neurologist and medical director, stroke program at Miami Neuroscience Institute, part of Baptist Health, says the number of cases he and his colleagues have seen has dropped at least 40 percent since February.

It’s not that fewer people are having strokes, Dr. De Los Rios explains. He believes more people are simply ignoring their symptoms – perhaps because, in the midst of a global pandemic, they’re avoiding hospitals and possible exposure to the COVID-19 virus.

“People need to understand the risk of not seeking care the minute stroke symptoms appear,” Dr. De Los Rios says. “COVID-19 has a mortality rate of up to eight percent for people age 70 to 79, and up to 15 percent for people 80 and older. By comparison, the mortality rate for stroke victims age 75 and older is around 35 percent within the first 30 days, and close to 60 percent after 24 months.”

Dr. De Los Rios adds that Baptist Health has instituted rigorous patient safety practices and stringent infection control procedures to ensure the safety of patients and staff at all of its facilities throughout South Florida.

What are the risk factors for stroke? There are quite a few, including high cholesterol, smoking, obesity, diabetes and age. But the number one risk factor for stroke is high blood pressure because of the stress it puts on your body’s blood vessels. The CDC says nearly 80 percent of those having a first stroke have high blood pressure.

How can you recognize a stroke?

Stroke symptoms appear suddenly and can include:

• Numbness or weakness of face, arm or leg, especially on one side
• Confusion or trouble speaking or understanding speech
• Trouble seeing in one or both eyes
• Difficulty walking, dizziness, loss of balance or coordination
• Severe headache with no known cause

Dr. De Los Rios recommends that you think F.A.S.T. if you see someone with one or more of these symptoms:

F – Face drooping: Does one side of the face droop or is it numb? Ask the person to smile. Is the person’s smile uneven or lopsided?

A – Arm weakness: Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downwards?

S – Speech: Is speech slurred? Is the person unable to speak or hard to understand? Ask the person to repeat a simple sentence.

T – Time to call 911: When someone suffers a stroke, time is of the essence. If the person shows any of these symptoms, even if this symptom goes away, call 911 and get them to the hospital immediately.

Every minute matters

When you suffer an acute stroke, what happens next could mean the difference between facing a lifetime of disability or walking out of the hospital on your own two feet. Doctors refer to the “golden window” as the period of time – usually less than three to four hours – when a stroke can still be treated before the brain suffers lasting injury.

“Stroke care can be quite complicated and therapies have to be delivered fast,” says Dr. De Los Rios. “As a Comprehensive Stroke Center, Baptist has highly skilled specialists, including neurologists, neurosurgeons and interventional neuro-radiologists, who are capable of managing even the most complex stroke cases.”

When a stroke call comes in from paramedics, the B.E.S.T. (Baptist Emergency Stroke Team) Stroke Team is mobilized so that the patient can be diagnosed and treated immediately upon arrival. Doctors need to know what kind of stroke they’re dealing with before they can treat it.

Ischemic strokes, which are caused by a blood clot blocking blood vessels leading to the brain, thereby cutting off the brain’s oxygen supply, account for roughly 80 percent of all stroke cases. Hemorrhagic strokes occur when a blood vessel in the brain bursts and blood leaks into the brain. These are not as common as ischemic strokes but can be far deadlier.

“The most important thing you can do if someone is exhibiting signs of having suffered a stroke is to call 911 – don’t drive the victim to the hospital yourself,” Dr. De Los Rios advises. “Paramedics are trained to stabilize stroke victims en route to the hospital and will call ahead to alert the stroke team.”

Preventing a stroke

Although you can’t do anything to reverse the aging process, fortunately, you can reduce other risk factors for stroke. High blood pressure and cholesterol can be managed with simple lifestyle changes; if this is not enough, your doctor can prescribe medications that will keep them both at healthy levels. Diabetic? Make sure you take your meds and watch your diet. Are you a smoker? Ask your doctor for advice or visit tobaccofreeflorida.com for strategies on how to quit. Overweight or obese? Losing even just five to ten pounds can help – not just with stroke but with many other health conditions as well.