Stroke

If you think that you or a loved one is experiencing a stroke, remember to B.E. F.A.S.T.:

• B(alance or coordination loss) — Is the person having any trouble walking or standing? Are they experiencing any dizziness.
• E(yesight trouble) — Is the person experiencing any sudden blurred or lost vision?
• F(ace) — Ask the person to smile. Does one side of the face droop?
• A(rms) — Ask the person to raise both arms. Does one arm drift downward?
• S(peech) — Ask the person to repeat a simple sentence. Are the words slurred? Can the patient repeat the sentence correctly?
• T(ime) — If the patient is exemplifying any of these symptoms, time is important. Call 911 immediately.

The longer you wait to seek emergency medical care, the more brain cells continue to die. The faster medical intervention is received, the better the chance for preserving brain cells and function.

If you believe someone you know is experiencing a stroke, call 911 immediately.

Methodist Healthcare takes pride in the full-service neurological care we offer to the South Texas community, and this expands to our advanced stroke care. We boast four hospitals offering high-quality stroke care, including:

• Methodist Hospital — Comprehensive Stroke Center designated by DNV GL Healthcare, USA, Inc., a Primary Stroke Center designated by The Joint Commission and recognized by the American Heart Association's Get With The Guidelines^®-Stroke program as a Stroke Honor Roll-Silver Plus recipient
• Methodist Hospital Metropolitan — Primary Stroke Center designated by The Joint Commission
• Methodist Hospital Northeast — Primary Stroke Center by The Joint Commission and recognized by the American Heart Association's Get With The Guidelines^®-Stroke program as a Stroke Honor Roll-Elite Gold Plus recipient
• Methodist Hospital Stone Oak — Primary Stroke Center and recognized by the American Heart Association's Get With The Guidelines^®-Stroke program as a Stroke Honor Roll-Elite Gold Plus recipient

When you choose any one of our facilities, you are in the hands of healthcare providers who are experts in stroke care.

The brain needs a constant supply of blood, which carries the oxygen and nutrients it needs to function. Arteries supply blood to specific areas of the brain. A stroke occurs when one of these arteries is blocked or bursts. As a result, part of the brain does not get the blood it needs, so it starts to die.

Several different risk factors contribute to the occurrence of stroke, or brain attack. Fortunately, you can control many of these risk factors, which include:

• Being overweight or obese and physically inactive
• Current vascular disease
• Existing heart disease
• Heart arrhythmia, specifically atrial fibrillation
• High blood pressure
• Tobacco use, including smoking
• Type 1 and Type 2 diabetes

There are three different types of stroke: transient ischemic attack (TIA), ischemic stroke and hemorrhagic stroke.

If an artery leading to the brain, or inside the brain, becomes blocked for a short period of time, the blood flow to an area of the brain slows or stops. This lack of blood and oxygen can cause a transient ischemic attack, or mini-stroke. Symptoms associated with a TIA may include:

• Loss of balance
• Loss of coordination
• Numbness
• Trouble speaking

It is common for these symptoms to last for a very short period of time and then disappear. While TIAs cause no permanent brain damage, they are a serious warning sign of stroke and should not be ignored.

There are two types of ischemic strokes: embolic and thrombotic. In an embolic stroke, a blood clot or plaque fragment forms somewhere in the body—usually the heart or in the large arteries leading to the brain—and moves through the bloodstream to the brain. Once in the brain, the clot blocks a blood vessel and leads to a stroke.

A thrombotic stroke is a blood clot that does not travel but forms inside an artery which supplies blood to the brain. The clot may interrupt the blood flow and cause a stroke.

Strokes caused by a bursting blood vessel in the brain that spills blood into the brain are called hemorrhagic strokes. High blood pressure and brain aneurysms can both cause the blood vessel to be weak and possibly cause this type of stroke. There are two types of hemorrhagic stroke: intracerebral hemorrhage and subarachnoid hemorrhage.

An intracerebral hemorrhage is caused when a burst blood vessel bleeds into the brain. High blood pressure, also called hypertension, is the most common cause of this type of stroke. The bleeding causes brain cells to die and that part of the brain no longer works correctly.

In a subarachnoid hemorrhage a blood vessel bursts in the brain and blood pours into the area around the outside of the brain. This bleeding may increase pressure in the brain, injuring brain cells. This type of stroke has many possible causes, but is usually the result of a burst aneurysm. An aneurysm is a weak spot on the wall of an artery that may balloon out, forming a thin-walled bubble. As it gets bigger, the aneurysm gets weaker and can burst, leaking blood into or outside of the brain.

The goal of treatment is to prevent further brain damage. The treatment plan is based on whether the stroke is caused by blockage of blood flow—ischemic stroke—or if it is caused by bleeding from a burst blood vessel in the brain—hemorrhagic stroke.

If you are having a hemorrhagic stroke, there are several options for treatment:

• Blocking off the bleeding vessels with a balloon or coil
• Medication that prevent or reverse swelling in the brain
• Medications to lower your blood pressure
• Medications to maintain your normal blood clotting
• Surgery to remove the blood in the brain or decrease the pressure
• Surgery to repair the broken blood vessels

If you are having an ischemic stroke,

• Medications that thin the blood pressure (blood thinners)
• Medications to help dissolve blood clots
• Medications to help reduce swelling in the brain
• Surgery to remove the plaque that is causing the blockage in a blood vessel or artery supplying blood to the brain

If you are at an increased risk for stroke, due to heart disease, heart arrhythmia or another high-risk condition, a left atrial appendage closure (LAAC) implant may be a viable option to reduce your risk of stroke, and cause to reduce your long-term use of blood-thinners.

tPA is a clot busting drug approved for use in certain patients having a stroke. The drug must be administered within a three-hour period from onset of symptoms of an ischemic stroke. Timely administration of tPA can reduce loss of physical and mental functioning that strokes can cause.