Every year, about 800,000 people in US have a stroke. Stroke is the leading cause of long-term disability in the United States.

There are two major types of strokes: Ischemic stroke and hemorrhagic stroke. Ischemic strokes are about 87% of strokes. They occur when blood supply to the brain is blocked mainly caused by thrombosis and embolism or clots that travel to the brain from another location in the body. On the other hand, hemorrhagic stroke also known as “brain bleeds” is less common and occurs when a blood vessel ruptures within skull not due to trauma and bleeds into the surrounding brain. Aneurysms and chronic high blood pressure are causes of hemorrhagic strokes.

Risk factors of stroke

There are non-modifiable risk factors and modifiable risk factors. Non-modifiable risk factors are advanced age, females and family history of myocardial infarction or stroke. The modifiable risk factors are high blood pressure, diabetes, high cholesterol, obesity, smoking, atrial fibrillation, lack of physical activity, excessive alcohol use, and drug use. Chronic hypertension is the most modifiable risk factor to reduce a stroke.

Recognizing signs of stroke:

• Sudden numbness or weakness in the face, arm, or leg, especially on one side of the body.
• Sudden confusion, trouble speaking, or difficulty understanding speech.
• Sudden trouble seeing in one or both eyes.
• Sudden trouble walking, dizziness, loss of balance, or lack of coordination.
• Sudden severe headache with no known cause.

According to CDC recommendations, If you think someone may be having a stroke, act F.A.S.T. and do the following test:

• F—Face: Ask the person to smile. Does one side of the face droop?
• A—Arms: Ask the person to raise both arms. Does one arm drift downward?
• S—Speech: Ask the person to repeat a simple phrase. Is the speech slurred or strange?
• T—Time: If you see any of these signs, call 9-1-1 right away.

Some patients with ischemic stroke may be candidates to receive a medication called alteplase, a thrombolytic also known TPA or “clot-busting” drug to break up blood clots. This drug can limit brain damage & reduce the risk of disability. On the other hand, surgery or endovascular procedures may be needed to stop the bleeding and save brain tissue in hemorrhagic stroke.

During a stroke, every minute counts and fast treatment is crucial. With stroke time lost is brain lost. Immediate treatment can lessen the brain damage and may minimize long-term effects of a stroke and even prevent death. The stroke treatments that work best are available only if the stroke is recognized and diagnosed within 3 hours of the first symptoms. Intravenous Alteplase tPA maybe given within 4.5 hours of Last Known Well, therefore it is important to note the time when any symptoms first appear.