Q: What is a stroke and could I be at risk?

Ask Our Expert About Strokes

About Our Expert

John Castaldo, M.D. is chief of Neurology and Director of the nationally recognized Stroke Center at Lehigh Valley Hospital and Health Network.

• What is a stroke and could I be at risk?
• How do I know if I’m having a stroke?
• I’ve heard it’s important to arrive at the hospital within an hour if you have a stroke. Is this true and why?
• What happens if I come to Lehigh Valley Hospital with a stroke?
• How can I prevent myself or a loved one from having a stroke?

Q: What is a stroke and could I be at risk?

A: Stroke is a “brain attack”—it affects the brain just like some heart attacks affect the heart.

• The most common type of stroke, an ischemic stroke, is caused by a blocked artery. As fatty deposits, known as plaque, build up in the wall of an artery, blood flow to a part of the brain is reduced. This plaque can also break open or rupture, causing a blood clot to form within the artery, stopping the blood flow to the brain. Ischemia accounts for about 85 percent of all strokes.
• A hemorrhagic stroke is caused by an artery rupture in or near the brain. Brain hemorrhage accounts for about 15 percent of all strokes.
• A mini-stroke, also called TIA (transient ischemic attack), causes stroke-like symptoms when clots form in arteries going to the brain and then break up. A mini-stroke is usually a warning sign that a major stroke is about to occur, and shouldn’t be taken lightly.

There are factors that put you at risk for a stroke. Some you can’t control such as your family history of stroke or heart disease, your age (being older than 55 puts you at risk) and gender. Men have a higher incidence of stroke although more women are likely to die from a stroke. Race also influences your risk. African Americans have a higher risk for stroke than others because they tend to suffer from high blood pressure.

The good news is there are some risk factors you can control:

• high blood pressure
• high cholesterol
• being overweight
• diabetes
• heart disease
• lack of exercise
• smoking
• excessive alcohol consumption
• illegal drug use

Q: How do I know if I’m having a stroke?

A: Strokes can cause:

• Sudden numbness or weakness of the face, arm or leg. This usually occurs down one side of the body and occurs over a few seconds. It is always painless although there may be a sensation of pins and needles tingling.
• Sudden confusion, trouble speaking or understanding.
• Sudden trouble seeing in one or both eyes.
• Sudden trouble walking, dizziness, loss of balance or coordination.
• Sudden severe headache with no known cause.

Sometimes the warning signs only last for a short time and can disappear just as quickly as they appear. If you or someone you know is experiencing any of these symptoms, take an aspirin and call 9-1-1 immediately.

Q: I’ve heard it’s important to arrive at the hospital within an hour if you have a stroke. Is this true and why?

A: It is very important that you get to the hospital quickly. Time is brain, and the longer you wait before getting to the hospital, the less chance there will be for survival without permanent disability. If you think you are having a stroke, call 9-1-1 because they begin care on the way to the hospital.

Too few stroke victims recognize the symptoms soon enough to get to a hospital and receive the clot buster tPA, the only drug approved for stroke treatment by the Food and Drug Administration. Most of the brain damage from a stroke occurs during the first hour, damage that may not be reversible if you don’t get prompt treatment.

It’s important to go to a hospital that specializes in treating a stroke, too. Lehigh Valley Hospital and Health Network (LVHHN) was the first hospital in the region to be certified as a Primary Stroke Center by the Joint Commission on the Accreditation of Healthcare Organizations, the same organization that surveys and accredits hospitals.

All three hospitals within LVHHN have a special Stroke Team available 24-hours-a-day to care for stroke patients, using the latest and most effective technology and treatments. We are also the only hospital in the region able to administer tPA (which we give to patients within three hours of the start of their stroke) anytime of the day or night.

Q: What happens if I come to Lehigh Valley Hospital with a stroke?

A: Once you are in the ER . . .

• A physician will assess your condition and neurological tests will be performed.
• Blood will be drawn and analyzed.
• You will be examined by a stroke specialist.
• You will undergo a CT scan to determine the type of stroke you’re having and which treatment will be right for you.
• You may receive clot buster therapy, like tPA to dissolve the clot in your brain.
• You may undergo cooling therapy to lower your body temperature and reduce the swelling in your brain and prevent more extensive damage.
• A clot retriever may be inserted into your brain to remove the clot from your artery.
• Depending on your condition, you either will stay in the neuro ICU or be sent to the neuroscience medical-surgical unit, where specially educated nurses will monitor your recovery.
• Your rehabilitation needs will be assessed, and you may need to undergo physical, occupational and/or speech therapy in a hospital setting or at home.

Q: How can I prevent myself or a loved one from having a stroke?

A: Although there are certain risk factors you can’t change, there are some that you can. If you don’t smoke and you eat a low-fat, high fiber diet and exercise at least five days a week for 30 minutes, you can greatly reduce your chance of having a stroke. There are other things you can do: 1) Under the advice of your doctor, take an aspirin a day to prevent ischemic stroke and heart attack; 2) Ask your doctor about medications to lower your blood pressure to the proper level and the use statins to lower your cholesterol if it is too high.

ARTICLE TOOLS: