Time and awareness is key to treating a stroke

Nov 15, 2013

Knowing how to recognize the symptoms of stroke can mean the difference between life and death. Lorraine Rapp and Linda Lowen, hosts of WRVO's health and wellness show Take Care, spoke with Dr. Larry Goldstein, professor of neurology and director of Duke University's Stroke Center about what you should do if you suspect a loved one has had a stroke.

Lorraine Rapp: Describe what takes place in the body when a person is having a stroke?

Dr. Larry Goldstein: Stroke is not one disease or one process. As we think about it, there are two major types. There’s what we call an ischemic stroke, and that’s when a blood vessel to or within in the brain is closed off, and what it does is starve that portion of the brain of blood and oxygen, so the brain cells then die. The second major type of stroke is what we call hemorrhagic stroke, and that can occur in two main or different types. One is when there is bleeding within the brain itself, and then the second type is when there is bleeding around the outside of the brain. That type is caused most commonly by a broken aneurism that then leaks around the brain. There’s no way to be absolutely sure, without a brain imaging test, as to what the type of stroke is. One of the things that people think about doing is when they think somebody might be having a stroke, they equate it with a similar process as a heart attack and they give the person aspirin. Well, aspirin affects blood clotting, and if the person is actually having a bleeding kind of stroke, it could actually make things much worse. So, when a the patient gets to a hospital, there’s many things that need to be done and be done very, very quickly, because time saved is brain saved.

Linda Lowen: What are the symptoms that most people should be aware of that herald a stroke?

Dr. Goldstein: Walk, talk, reach, see, feel. So, “walk” is having an abrupt onset of difficulty walking. “Talk”—abrupt difficulties with speech, or understanding speech. “Reach”—problem with the arm; the arm is either weak or numb. “See”—that’s a loss of vision in one or both eyes, or problems seeing to one side. And “feel”—that’s a severe, unusual headache that comes on abruptly in somebody who normally doesn’t get headaches.

Lorraine: Is this hereditary/genetic, does this run in families? And if so, what can a person do to diminish their risk of having a stroke if they know it’s in the family?

Dr. Goldstein: So if you have a first degree relative—a parent, a brother, a sister—that’s had a stroke under age 65, that is also associated with an increased risk. So there are several very important lifestyle things that everybody can do to decrease their stroke risk. One thing is to exercise for at least thirty minutes most days of the week. Diet, having a healthy diet that’s low in sodium and high in potassium and three to five servings of fruits and vegetables daily. Not smoking, and not being exposed to environmental tobacco smoke. Having a lean body weight, the Body Mass Index, which is a measure of height and weight, of less than 25. And also— in people who do drink— for women, no more than one alcoholic drink a day; for men, no more than two. What we found is that people who follow these five healthy lifestyle habits, have an eighty percent lower risk of having a first stroke compared to others who don’t follow those healthy lifestyles.

More of this interview can be heard on Take Care, WRVO's health and wellness show Sunday at 6:30 p.m. Support for this story comes from the Health Foundation for Western and Central New York.