Do you know the signs of stroke?

When a blood clot cuts off life-giving oxygen to the brain during a stroke, up to two million brain cells can be destroyed per minute.

Ischemic strokes — by far the most common type — strike fast and every minute counts to get care that reduces the risk of lasting disability or death, says vascular neurologist Mohammad Shafie, MD, PhD, associate director of the UCI Health Comprehensive Stroke and Cerebrovascular Center.

“The longer the blockage lasts, the greater the damage,” he says. “That's why it's critical to get medical help as quickly as possible when signs and symptoms appear.

“Delays in getting care when experiencing stroke symptoms reduces a patient’s treatment options and increasing their odds for neurological, cognitive and physical disability.”

That’s why it’s essential to be familiar with physical changes that can signal an ischemic stroke, Shafie says.

BE FAST

The acronym BE FAST can help people recognize the signs of stroke:

• Balance. Does the person have a sudden loss of balance or dizziness?
• Eyes. Has the person lost vision in one or both eyes? Is their vision blurry?
• Face drooping. Does the person’s face look uneven? Does one side of the face droop or is it numb? Ask the person to smile. Is it uneven or lopsided?
• Arm weakness. Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward? This can also show up in the legs.
• Speech. Is the person’s speech slurred? Do they have trouble speaking or seem confused?
• Time. Call 9-1-1 to rush the person to a hospital immediately if they show any of these signs, even if the symptoms go away.

Also be on the lookout for the sudden onset of a headache that many stroke patients have described as the “worst headache of my life.” This is frequently the key symptom of a hemorrhagic, or bleeding, stroke.

Do not take aspirin or ibuprofen, which may worsen the hemorrhage, and call 9-1-1.

"Even if you’re not one-hundred percent sure, call 9-1-1," Shafie says.

“Paramedics will assess the situation and transport the patient to the most appropriate care facility, such as the comprehensive stroke care center at UCI Health — Orange, where our trained stroke specialists can help immediately.”

Clot-busting medicines

If a clot is the cause of the stroke, doctors will determine if the patient would benefit from a drug called tPA, short for tissue plasminogen activator.

This clot-busting medication can help reopen blocked arteries in some people experiencing an ischemic stroke, reducing the severity of the stroke and reversing some of its effects.

“Clot-busting medications given within three to four-and-a-half hours of symptom onset can help prevent lasting disability in up to one-third of patients,” says Shafie.

EVT procedure for large clots

When a clot is too large for tPA to be effective, the alternative is endovascular thrombectomy (EVT). This minimally invasive procedure to surgically remove the clot saves lives and reduces disability. It is considered the gold standard for treating patients with major ischemic strokes that involve large blood vessels in the brain.

Initially, EVT was approved only for stroke patients within a six-hour window after the onset of symptoms. More recent clinical trials have shown that EVT can be performed safely and effectively within 24 hours after symptoms begin.

In an EVT, a thin tube called a microcatheter is inserted in an artery in the patient’s groin and guided by X-ray imaging through the blood vessels to the brain. There, a specialized stent at the tip of the catheter is used to remove large clots and restore blood flow.

“EVT leads to very good outcomes for about half of stroke patients treated in that 24-hour window,” Shafie says.

Reduce your risk factors

People also need to know they can prevent a stroke by lowering their health risks.

“Studies show that up to 90% of first-time strokes can be prevented with risk-factor modifications,” says Shafie.

That means getting care for conditions that elevate a person’s potential for a stroke. These include:

• High blood pressure (hypertension)
• High total cholesterol
• Diabetes
• Obesity
• Smoking
• Atrial fibrillation, a type of heart arrythmia
• Obstructive sleep apnea
• Excessive alcohol use

Shafie encourages everyone — even those without a hypertension diagnosis — to check their blood pressure frequently with a home blood-pressure cuff and talk to their doctor about their readings.

“Getting at least 30 minutes of exercise three or four times a week also has a protective effect against stroke,” he adds.

Expert care gives better outcomes

Expert care makes a substantial difference in better outcomes after a stroke, as well preventing one.

As part of an academic healthcare system, the stroke experts at UCI Health “are actively engaged in the latest translational research and clinical trials aimed at advancing knowledge in the prevention, diagnosis and development of novel therapies to improve the lives of our patients,” says Shafie.

To learn more about UCI Health stroke prevention and treatment services, call 866-STROKE-3 (866-787-6533).

The UCI Health Comprehensive Stroke & Cerebrovascular Center is Orange County’s first Joint Commission-certified comprehensive stroke center. We set the highest standards for providing rapid, quality treatment for patients with acute stroke and complex cerebrovascular diseases, 24 hours a day, seven days a week, 365 days a year.

Ranked as one of the top 100 hospitals nation-wide for stroke care by Healthgrades and a recipient of the American Heart Association’s Gold Health Plus Achievement Awards for eight consecutive years, we have also received the Healthgrades Awards for excellence in stroke care, neuroscience and cranial neurosurgery.