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Are you at risk of having a stroke? Stroke 101: Know the risks


Amy Lynch for GBMC

May 3, 2019
A stroke is oftentimes thought of as a tragedy that only hits the elderly.

According to the Centers for Disease Control and Prevention, strokes strike 795,000 Americans — and result in 140,000 deaths — annually. Risks do increase with age, but a stroke can affect anyone at any time, and they’re a leading cause of disability in those who survive.

Different strokes

Strokes occur when there’s a sudden interruption in blood flow to the brain. The majority of strokes are ischemic, meaning an artery in the brain becomes blocked by plaque or a clot that develops at the site (thrombotic) or breaks free from elsewhere in the body and travels to the brain (embolic). Hemorrhagic strokes occur when a vessel in the brain ruptures and bleeds, often due to high blood pressure.

Who’s most at risk?

Michael Sellman, MD, chief of neurology at the Greater Baltimore Medical Center’s Primary Stroke Center, says high blood pressure and diabetes are the two biggest concerns that can put patients at risk for stroke.

“We spend a lot of time monitoring and aggressively treating these conditions,” he explains. “High cholesterol/triglycerides, cigarette smoking and heart disease can also raise stroke risks; and in younger populations, cocaine and IV drug use can be a factor.”

It’s unclear whether a direct genetic link exists, although Dr. Sellman says predispositions toward high blood pressure, heart disease and diabetes can play a role in upping chances of a stroke. And if you’ve already had a stroke, you’re at higher risk for a recurrence, particularly within 30 days of the initial event.

Warning signs and symptoms

Stroke symptoms depend on the area of brain that’s affected and can range from subtle to dramatic.

“The most common presenting factor is sudden onset of weakness in the arms, legs or face, notably on one side of the body,” Dr. Sellman describes. “You may suddenly be unable to walk or speak, or you may experience a loss of vision in one eye.”

The National Stroke Association offers an easy way to remember and recognize indications of a stroke called “FAST.”
  • Face droops or is numb.
  • Arm is weak or numb.
  • Speech is difficult or slurred.
  • Time to call 911.
Seek treatment ASAP even if symptoms seem mild or go away after a few minutes. “If you think you’re having a stroke, call 911,” Dr. Sellman urges. “There’s a golden window of opportunity when treatment has the best potential to reverse a stroke. The first three hours are the most crucial, but we can still intervene even up to 24 hours after symptoms appear.”

As a Certified Primary Stroke Center, GBMC has a strong working relationship with EMS, which notifies the hospital of incoming stroke patients before they arrive, giving the care team more time to prepare.

During and after a stroke

Stroke treatment can include infusing medication to break up blood clots and addressing underlying factors like high blood pressure, blood sugar or atrial fibrillation.

“Patients usually need physical, occupational and speech therapy as part of their recovery,” Dr. Sellman adds. “These treatments should be offered in the hospital and continue at a rehabilitation center or at home.”

Depending on the degree of disability following a stroke, patients may need to make modifications at home such as increasing accessibility with ramps or bars. Aspirin therapy routines are recommended to reduce future risk of stroke.

Stroke prevention

Dr. Sellman advises a holistic, long-view approach to maintain healthy blood pressure, weight, cholesterol and blood sugar levels as the best way to lower stroke risks, along with measures to quit smoking and reduce stress.

“All these efforts work together to improve overall well-being,” he says. “There’s no magic pill; it’s up to the patient to make wise lifestyle choices.”
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