TIME IS EVERYTHING
The phrase “Time Is Everything” is no more important than in the diagnosis and treatment of a stroke. The medical term for a stroke is a Cerebral Vascular Accident. There have been great strides in the management of strokes but quick identification is the key for success. Unfortunately, there is often a long delay in recognition that a stroke is occurring which limits how much help can be given. Thus, early recognition and getting to the hospital is essential.
A stroke is a condition in which the blood flow has been altered to part of the brain. The problem is usually a result of one of two processes, hemorrhagic or ischemic. A hemorrhagic stroke is when there is bleeding into the brain causing damage. The ischemic stroke is when a blockage occurs in one of the arteries supplying the brain. Early recognition is important in both types of strokes. However, the biggest change that has occurred in stroke management is early differentiation of the type of stroke and immediate treatment of an ischemic stroke. There are medications available called “Fibrinolytics” when used early on that can actually dissolve the blockage in the artery. If the blockage is removed and blood flow is restored early enough, than the damage to the brain can be limited or actually reversed. However, the time from the onset of a persons symptoms to treatment with a fibrinolytic is limited to within 3 hours. As can be imagined, this is not a long time. From the time a person develops symptoms, gets to the hospital, be evaluated by the physician, to have a CT scan to make sure this not a hemorrhagic stroke, and then begin the medicine would have to be done within 3 hours. However, it can be done with increased awareness of symptoms and having emergency departments more aware and prepared to handle stroke patients quickly. Fortunately, our local hospitals are equipped to handle this situation. Therefore, what we need to learn is warning symptoms of a stroke so if occurs we can get the appropriate help quickly.
A commonly used tool used to assess whether a stroke is occurring is called
The Cincinnati Prehospital Stroke Scale. It is based on 3 physical findings and if any one of these is present, then immediate treatment should be sought.
Facial Droop- when smiling both sides of the mouth should move equally, if one side does not then this is called facial droop.
Arm Drift- with eyes closed hold arms straight out 10 seconds, the arms should move equally or not at all, if one are does not move or one arm drifts, this is abnormal.
Abnormal Speech- try to say “you can’t teach an old dog new tricks”, if you slur the words, uses the wrong words or is unable to speak, this is abnormal.
The signs of a stroke can be many, but if there is any doubt that you are having a stroke, then please be evaluated as quickly as possible. Do not be shy or worry that someone will think you are being silly. There is too much at stake. In addition, one of the biggest causes of a stroke is smoking, so stop now. Here is to your good health.