Health Check: Why time is brain when it comes to stroke health and awareness

PARKERSBURG, W.Va. (WTAP) - The month of May is known as National Stroke Awareness Month.

According to the Center for Disease Control and Prevention, every 40 seconds someone in the United States has a stroke. Every three and a half minutes someone dies from a stroke.

“The idea behind this awareness was that despite all the advances that we’ve had in research and treatment for stroke, it continues to remain the fifth leading cause of death in the country,” said Dr. Muhammad Rizwan-Husain, Assistant Professor of Neurology at WVU Medicine Camden Clark Medical Center.

The American Stroke Association defines a stroke as a disease that affects the arteries leading to and within the brain.

Strokes can be caused by a clot obstructing the flow of blood to the brain known as an Ischemic Stroke. A stroke can also be caused by a blood vessel rupturing and preventing blood flow to the brain known as a Hemorrhagic Stroke. A Transient Ischemic Attack or T.I.A. is a “warning stroke” caused by a temporary clot.

“Eighty-five percent of the strokes are due to a blood vessel that’s blocked off, whether it’s a big blood vessel in the neck or the head, or one of the smaller capillaries, and about 15 percent of the time, it’s actually a brain hemorrhage or a bleed. Both are addressed totally differently,” Dr. Rizwan-Husain said.

The most common modifiable risk factors include diabetes, obesity, smoking, high cholesterol, and a lack of exercise. The biggest risk factor however is high blood pressure.

“So you need to keep that in check, checking you have your device at home, to make sure that the medicines that you’re taking, making sure your blood pressure is controlled, it’s not still staying high, despite you being on medications,” Dr. Rizwan-Husain said.

While noting that people who have uncontrollable high blood pressure are at risk of stroke, it is also a modifiable risk factor for cardiovascular disease. Dr. Rizwan-Husain said there’s a big heart-brain connection. Things you would do to have a healthy heart automatically apply to your brain as well. It’s all a part of the same system; therefore, if your heart isn’t doing well, neither is your brain.

Non-modifiable risk factors are advancing age, as most strokes occur above the age of 50, family history, race, gender, and a prior history of a heart attack or stroke.

Dr. Rizwan-Husain discussed the phrase B.E. F.A.S.T. which is an acronym for the warning signs you should look out for if you or a loved one is having a stroke.

B: Balance: Is there a loss of balance or coordination?
E: Eyes: Is the person having trouble seeing out of one or both of their eyes?
F: Face Drooping: Does one side of the face droop or is it numb? Is the person’s smile uneven?
A: Arm Weakness: Is one arm weak or numb? Does the arm drift downward?
S: Speech Difficulty: Is the person’s speech slurred?
T: Time is Brain: Call 911

If you or a loved one are experiencing any of these symptoms, it’s important to recognize them and call 911 and get to a hospital as quickly as possible.

“For every minute that a stroke goes untreated, two million brain cells die,” Dr. Rizwan-Husain said. “And for every one hour that a stroke goes untreated, the brain ages by about three and a half years.”

The golden window to get to the hospital would be between three and a half and four hours after the first sign of a stroke. The shorter the amount of time after the first sign of a stroke, the better shot at a patient not having any long-term effects.

“So once we evaluate the patient, and let’s say we, we know that they’re having a stroke on a quick, very basic neurological exam, we get a CAT scan, then the next thing to confirm is when did that stroke happen?” Dr. Rizwan-Husain said.

The results from a brain scan will determine how the treatment will be conducted.

There is a “clot-busting” medication called thrombolytic that breaks up the blood clots and are used for treating Ischemic and T.I.A. strokes.

For a Hemorrhagic Stroke, an endovascular procedure may be needed to stop the large brain bleed.

“So if they have a big blood clot that’s lodged in one of the carotid vessels that’s in the neck or the brain, we can pull that blood clot out,” Dr. Rizwan-Husain. “And that, again, is very time-sensitive. We can do that up to 24 hours, but we have various imaging techniques to see who’s eligible and who’s not.”

Depending on the side effects of the stroke you could be going to speech, physical or occupational therapy. Recovery time after a stroke is different for everyone. It can take weeks, months, or even years. While some people recover fully, others have long-term or lifelong disabilities.

“The question is ‘will I walk again, will I talk again, will I see again,’ ” Dr. Rizwan-Husain said. “Generally speaking, and this is not for specific strokes, but stroke recovery continues up to several months out. And that’s where I tell patients that you should not give up, you need to get the therapy. Rehab works phenomenally.”

Dr. Rizwan-Husain said it’s important to understand everyone’s brain is different and everyone’s blood vessels are different. There’s no one size fits all. Everyone has different risk factors that will affect their risk of stroke.

“For every specific stroke, you have to identify why they had the stroke,” Dr. Rizwan-Husain said. “So if someone has an irregular heart rhythm called atrial fibrillation, you want to put them on a different medication than aspirin to prevent another stroke from happening. If someone has cancer as a cause of the stroke, then you want to address that a little differently. If someone has a hole in the heart then you want to address that differently. So those are things that we would figure out during their hospital or hospital stay. And so we can address that once they leave the hospital.”

Dr. Rizwan-Husain said some people get scared all the time about getting screened for stroke-like symptoms.

“Someone who’s walking, who’s talking, who’s been independent all their whole life, now suddenly just cannot move an arm just gonna remove a leg cannot understand cannot speak,” Dr. Rizwan-Husain said. “So that is really bothersome for somebody and they’re scared. On that subject, there are some strokes that affect parts of the brain that cause people to be confused. And families might see the loved one and say, well, they’re just confused. I don’t know what’s happening, but they’re actually having a stroke. So whenever you don’t understand what’s happening. You’re better off, it’s safer for the patient, just bring them to the emergency room, and let us evaluate them right away.”

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