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Strokes
Strokes
 
By Roland Larrabee, M.D.

A stroke, or cerebrovascular accident (CVA), happens when the blood supply to part of the brain is suddenly reduced or stopped. That part of the brain dies and no longer works. Blood cannot get to your brain when a blood vessel is blocked or bursts inside the brain. This can happen in different ways:
 
  • A blood clot in an artery blocks blood flow to the brain.
  • A fatty deposit called a plaque forms inside a blood vessel, breaks away, and blocks an artery in the brain.
  • An artery in the brain tears or bursts. Blood spills out into the brain. This kind of stroke often happens with no warning. It most often results from high blood pressure. Sometimes it is caused by a blood vessel problem that has been there since birth.
You are more likely to have a stroke if:
  • You have high blood pressure.
  • You have heart disease.
  • You have diabetes
  • You have high cholesterol.
  • You smoke cigarettes.
  • Someone in your family has had a stroke.
  • You are overweight.
  • Your arteries have fatty deposits on the inside.
Every stroke is different. The symptoms you have depend on the part of the brain damaged by the stroke. Symptoms may come on suddenly. Here are some of the warning signs:
  • You may have a severe headache with no known cause.
  • You may feel weak or numb on one side of the body. You may feel tingling in your face, arm, or leg.
  • You may feel dizzy or lose your balance. You may have trouble walking.
  • You may not be able to speak. You may have a hard time understanding what others say.
  • You may be confused or have a change in personality.
  • You may have trouble seeing in one or both eyes or have double vision.
  • You have a hard time moving your muscles. It may be hard to swallow or move your arms and legs.
  • You may lose bowel or bladder control.
  • You may faint.
If you have any of the symptoms of a stroke, call 911 and go to an emergency room right away. Every minute counts. The doctor may give you a medicine to break down blood clots. These medicines must be given within 2 to 4 hours after the stroke started. They can make symptoms go away very quickly and prevent permanent injury. These drugs can also cause serious bleeding, so are not always given.

After a stroke, you need to be watched and cared for. You will likely stay in the hospital for a few days. You will need bed rest. You may need an IV and oxygen. You will need treatment for whatever caused the stroke. Depending on how well you feel and how severe your stroke, you will start a rehabilitation program. The program may start while you are in the hospital or a nursing facility. It may last for weeks or months after you leave the hospital. The program is made up of:

  • Physical therapy. It helps you get back your muscle strength. It teaches you ways to move safely even if your muscles are weak or paralyzed.
  • Occupational therapy. It will help you relearn how to eat, dress, and take care of yourself.
  • Speech therapy. It may help you if have problems relearning to swallow, speak, or understand words.
How long it takes to get better depends on how badly the brain was injured.
  • Some things may get better in a few days or weeks.
  • Other problems may take longer to improve.
  • People can regain strength and their speech can get better up to 1 year after a stroke.
Once your rehab is done, your doctor can tell you better what you can expect.
  • How can I prevent having a stroke?
  • If you have high blood pressure, be sure you take your medicine.
  • If you smoke, quit.
  • Keep your diet low in fat. That will lower the chance of getting fatty deposits in your blood vessels.
  • Exercise every day. Ask your doctor for an exercise program.
  • Keep a healthy weight.
Dr. Larrabee is Associate Director of Family and Community Medicine at the Walter L. Aument Family Health Center, 317 S. Chestnut St., Quarryville.