A stroke, sometimes called a "brain attack," happens when blood flow to an area in the brain is cut off. The brain cells, deprived of the oxygen and glucose needed to survive, die. If not caught early, permanent brain damage and death can result.
Strokes are the fifth leading cause of death in men (and the third most common cause of death in women), yet most guys can't name one stroke symptom. Here's how to recognize and prevent them.
Why Should I Care About Strokes?
If you're like most middle-aged guys, you probably don't spend much time worrying about a stroke. After all, strokes are a risk we associate with later in life -- something to think about after we retire and are fitted with our first pair of dentures.
But maybe we should be a little more concerned. They are indeed more likely in men over age 65, but they can happen at any age. Strokes are also more likely to be fatal and strike earlier in men than in women.
The consequences of a stroke can be devastating. Not only can a stroke kill you, but nonfatal strokes can leave you severely debilitated, paralyzed, or unable to communicate.
However, the news isn't all bleak. About 80% of strokes are preventable. So it's time to improve your odds. If you're at risk, you need to learn the signs of stroke and make some changes in your lifestyle.
Knowing the risk factors and signs of a stroke is the first step in stroke prevention.
How Does a Stroke Happen?
There are two types of stroke:
- Ischemic strokes are similar to a heart attack, except they happen in the blood vessels of the brain. Clots can form either in the brain's blood vessels, in blood vessels leading to the brain, or even blood vessels elsewhere in the body that travel to the brain. These clots block blood flow to the brain's cells, choking off oxygen to a part of the brain. Without oxygen, brain cells first go into shock and then start dying. So the longer you go without stroke treatment, the greater the damage to your brain. Ischemic strokes can also happen when too much plaque (fatty deposits and cholesterol) clogs the brain's blood vessels. These are the most common type of stroke. About 80% of strokes are ischemic.
- Hemorrhagic strokes happen when a blood vessel in the brain breaks or ruptures. The result is blood seeping into the brain, causing damage to brain cells. While less common, these strokes can be more devastating. Although the cause is different from an ischemic stroke, the result is the same: Brain cells can't get the blood they need. More than 60% of people who have a hemorrhagic stroke die within a year, and those who survive tend to be much more disabled. The most common causes of hemorrhagic stroke are high blood pressure and brain aneurysms. An aneurysm is a weakness or thinness in the blood vessel wall.
What Are the Symptoms of Stroke?
The most common symptoms of a stroke are:
- Weakness or numbness of the face, arm, or leg on one side of the body
- Loss of vision or dimming (like a curtain falling) in one or both eyes
- Loss of speech, difficulty talking, or understanding what others are saying
- Sudden, severe headache with no known cause
- Loss of balance or unstable walking, usually combined with another symptom
What Should I Do If I Have Symptoms of a Stroke?
Immediately call 911 if you or someone you know has symptoms of a stroke. Stroke is a medical emergency. Immediate treatment can save your life or increase your chances for a full recovery.
The American Heart Association uses the memory tool known as F.A.S.T. to recognize signs of stroke:
- Facial drooping
- Arm weakness
- Slurring of speech
- Time to call 911
Are Strokes Preventable?
Up to half of strokes are preventable. Many risk factors can be controlled before they cause problems.
Controllable risk factors Include:
- High blood pressure
- Atrial fibrillation
- Uncontrolled diabetes
- High cholesterol
- Heavy drinking
- Being overweight
- Carotid or coronary artery disease
Uncontrollable risk factors include:
- Age (People over age 65)
- Gender (Men have more strokes; women have deadlier strokes)
- Race (African-American people have a higher risk)
- Family history of stroke
Your doctor can evaluate your risk for stroke and help you control your risk factors.
Hemorrhagic strokes are best prevented by controlling high blood pressure. The less pressure there is on the walls of your blood vessels, the less likely they are to burst.
The more common ischemic strokes are caused by blood clots -- the same villains responsible for heart attacks. To decrease the risks, you need to keep your arteries clear of plaque -- the gunk that builds up in them and leads to clotting. Ways to do this include:
- Exercising for at least half an hour on most days of the week
- Eating right, preferably a diet low in saturated fat (such as that in processed meats) and high in fruits and vegetables
- Maintaining a healthy weight
- Not smoking. Smokers are twice as likely to have a stroke.
Low-dose aspirin can reduce stroke risk, although it may not help younger men already at low risk for stroke. Talk to your doctor before starting aspirin therapy.
Sometimes, people experience warning signs before a stroke occurs. These are called transient ischemic attacks (also called TIA or "mini-stroke"), brief episodes of the stroke symptoms listed above. A TIA is when a blockage, caused by a clot, is temporary. These leave no permanent brain damage but do put you at higher risk for a subsequent stroke.
Some people have no warning signs before a stroke, or symptoms are so mild that they are not noticeable. Regular checkups are important in catching problems before they become serious. Report any symptoms or risk factors to your doctor.
How Are Strokes Treated?
Specific stroke treatment depends on the type of stroke. If caught in time, ischemic strokes can be treated with drugs called clot busters (thrombolytics). Clot busters can quickly dissolve the blockage, restoring blood flow to the affected area and preserving brain cells.
Hemorrhagic strokes are hard to treat. Usually, it's necessary to simply watch and wait for bleeding to stop on its own. Occasionally, hemorrhagic strokes can be treated with surgery or other procedures.
The main problem with treating strokes is catching them in time. Clot busters need to be given within a few hours of the first symptoms of a stroke.
As you recover -- and stroke recovery can be slow -- you're likely to need ongoing treatment. The problem is that having one stroke puts you at risk for having more. If you've had an ischemic stroke, your doctor might recommend blood thinners, drugs that reduce your blood's tendency to clot. Stents can also be surgically implanted to open up a clogged artery.