THE FACTS ABOUT STROKE

*Hear Dr. Carolyn Brockington, Director, tell you about stroke symptoms and the Stroke Center at St. Luke’s-Roosevelt.

Learn to recognize and defend against stroke--one of America’s most lethal killers
Interrupted blood flow within the brain causes stroke
Recognize the most common signs of stroke
What causes a mini-stroke or transient ischemic attack (TIA)?
What are the key links in the Stroke Chain of Survival?
You can help prevent stroke by controlling these key health care risk factors
Doctors use these key tests to diagnose a stroke and locate its cause


Learn to recognize and defend against stroke--one of America’s most lethal killers
Knowledge is your strongest weapon when it comes to preventing and treating stroke. At Mount Sinai Health System, we are working closely with the American Stroke Association to increase your knowledge of how you can defend against this major cause of death and disability among Americans.

If you or another person is experiencing a stroke, you can reduce its impact by immediately seeking emergency help during the first critical hours after stroke symptoms appear. And, over time, you can lower the possibility of having a stroke by controlling key health care risk factors.

At Mount Sinai Health System, we staff and equip our stroke centers and emergency departments to provide rapid diagnosis, expert treatment and rehabilitation for stroke victims. We are available to help you to recognize, reduce or even eliminate certain stroke risk factors.

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Interrupted blood flow within the brain causes stroke
Stroke is the nation’s third leading killer after heart disease and cancer. Each year about 600,000 Americans suffer a new or recurrent stroke and nearly 170,000 die from stroke.

A stroke occurs when a burst blood vessel or blood clot interrupts the flow of blood within a portion of a person’s brain. This interruption can cause paralysis on one side of the body, memory loss, trouble seeing, speaking or walking, or a combination of these symptoms.

When blood vessel damage or a blockage interrupts blood flow for more than several minutes, the injury becomes more severe as cells die in the stricken region of the brain. Parts of the body controlled by these cells cannot function, which can cause death.

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Recognize the most common signs of stroke
If you notice one or more of the following signs in yourself or another person, immediately call 9-1-1 or your local emergency medical services number. You must get to the nearest hospital emergency department--preferably one that has dedicated stroke care facilities.

While none of these signs occurs with every stroke, and sometimes they are intermittent, you should act quickly when stroke is suspected.

Stroke treatment is most effective during the first three hours or earlier after experiencing symptoms.

The signs of stroke include:
* Sudden numbness or weakness in the face, arm or leg, especially on one side of the body
* Sudden confusion, trouble speaking or understanding
* Sudden trouble with sight in one or both eyes
* Sudden difficulty walking, dizziness, loss of balance or coordination
* Sudden severe headache

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What causes a mini-stroke or transient ischemic attack (TIA)?
A TIA, or mini-stroke, will produce the same warning signs as a major stroke; however, these signs last only a few minutes. TIAs are important stroke warnings. Do not ignore them. Emergency treatment is vital.

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What are the key links in the Stroke Chain of Survival?
You must treat every stroke or TIA as a life-threatening emergency. Time is critical when diagnosing and treating stroke.

To gain the greatest benefit from tPA, a "clot-busting" drug treatment, and other emergency therapy, you must get to a hospital quickly. A doctor should diagnose your stroke and treat you within three hours of the time symptoms began. Emergency room tests will determine if a stroke, a TIA or another medical problem caused your symptoms.

To increase your chances of minimizing a stroke’s impact, take these four steps in the Stroke Chain of Survival within three hours of the onset of symptoms:

1. Rapid recognition and reaction to stroke warning signs. Recognize the warning signs and note the time when they first occur. Call 9-1-1 immediately. Tell the operator you or the person you are with is experiencing stroke warning signs.
2. Rapid start of pre-hospital care. Get an early assessment and pre-hospital care by emergency medical service personnel.
3. Rapid emergency service transport and hospital pre-notification. Tell emergency medical service personnel to take you to a hospital stroke center or emergency department that is equipped and staffed to diagnose and treat stroke. Ambulance personnel will notify the emergency room while in route.
4. Rapid diagnosis and treatment at the hospital. Get a prompt evaluation by a stroke specialist and appropriate treatment to restore blood flow to the brain. Also, be sure to get any follow-on care your stroke specialist recommends.

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You can help prevent stroke by controlling these key health care risk factors
Stroke specialists point out that we can prevent 50 percent to 80 percent of strokes by controlling key risk factors such as
* Cigarette smoking
* High blood pressure
* Diabetes
* Poor diet
* Obesity
* Lack of exercise
* High cholesterol
* Heart disease
* Carotid artery disease

The more risk factors a person has, the greater the likelihood of becoming ill. Modifying these factors can lower stroke risk significantly.

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Doctors use these key tests to diagnose a stroke and locate its cause
When a person is showing symptoms of a stroke or a TIA, the physician conducts various tests to determine the cause of the problem. By identifying the cause and its location, the doctor can provide optimal treatment to prevent future strokes.

· Imaging tests create a picture of the brain similar to X-ray photos. CT scan (Computed Tomography) also uses X-rays to create such pictures. They provide valuable information about a stroke’s cause and the location and extent of brain injury.
· MRI (Magnetic Resonance Imaging) generates a large magnetic field to produce a sharp image of the brain that shows the location and extent of brain injury. Doctors often depend upon MRI to diagnose small, deep brain injuries.
· Electrical tests show the brain’s electrical activity. An EEG (electroencephalogram) records the brain’s electrical impulses. An Evoked Response test measures how the brain handles sensory information related to hearing, body sensations or vision.
· Blood flow tests reveal problems that cause dangerous changes in blood flow to the brain. Ultrasound or Doppler tests provide detailed information about blood flow and the condition of arteries--especially arteries in the neck or at the base of the skull.
· Imaging technology called angiography produces detailed X-ray pictures of blood flow within the brain. The physician obtains such photos by maneuvering a tiny catheter through blood vessels entering the brain, then injecting dye through the catheter into the brain’s bloodstream. X-ray photos track the dye and show how efficiently blood is flowing through the brain.

The physician uses these photos to evaluate the size and location of blockages. This type of test is especially valuable in diagnosing and locating aneurysms and malformed blood vessels and providing information before surgery.

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