Your Health Matters
By Claudia Parks, R.N.

The Greeks had a word for it- apoplexy, meaning "struck down." The word was an apt description of an occasional dramatic event: a man or woman suddenly falling to the ground, as if pole axed or clubbed down, lying there paralyzed unconscious, and perhaps dead. Today we commonly call such an event a stroke. Some doctors use the term cerebrovascular accident (CVA).

Not all or most strokes are immediately fatal. They range from transient "little strokes" that may not even be recognized, to massive strokes that are quickly lethal. In between are hundreds of variations. There are probably as many as three million Americans have some trouble from some type of stroke each year. About 900,000 fall into the serious category.

We are more vulnerable to strokes as we get older. Although the peak incidence is at about 60 years of age, the groundwork is usually laid much earlier, and strokes are not uncommon in forties and younger persons.

In most respects, protective and preventive measures against strokes are the same as those against heart attacks. Most of the risk factors are similar if not identical. The main difference is that heart attacks affect vessels that serve the heart, while strokes result from damage to vessels that supply blood to the brain.

TYPES OF STROKE: (1) Occlusive stroke or ischemic stroke. By far, the most common type of stroke is the one in which there's obstruction of an artery supplying blood and oxygen to a part of the brain. This sudden blocking comes about in two ways: a clot (thrombus) occurs, or an embolus lodges, obstructing blood flow. An embolus is a particle of material moving in the bloodstream. It may consist of a piece of clot that has broken off from the main thrombus. (2) Hemorrhagic stroke. The other major mechanism of stroke is a leakage or rupture of an artery that spills blood into areas of the brain. Hemorrhage (bleeding) most often occurs inside the brain and is a devastating disorder. This condition is often caused by the bursting of an aneurysm, which is a ballooned out portion of an artery- causing a weakness in the artery wall.

Two primary factors figure prominently in the background of stroke patients: atherosclerosis (the buildup of fatty plaque in the arteries- making the surface rough and apt to cause clot formation) and hypertension (high blood pressure).

Warning Episodes. About 10 percent of strokes are preceded by TIAs (transient ischemic attacks), often called ministrokes. This is a temporary interruption of blood flow to the brain. These ministrokes can occur days, weeks, or even months before a major stroke. They frequently last less than 5 minutes, with symptoms similar to those of a full-fledged stroke. Signs of little strokes may appear before age 40. These do not invariably end in a catastrophic stroke, but they may indicate incipient or impending stroke. Prompt medical attention at this point can often prevent a major stroke. Some warning signs are: (1) sudden temporary weakness or numbness of the face or an arm or leg (2) Temporary loss of speech or trouble in speaking (3) An episode of double vision (4) Temporary dimness or loss of vision, particularly in one eye (5) Unexplained dizziness or unsteadiness, or momentary blackout (6) Confusion or personality changes. These symptoms depend on the parts of the brain affected by an insufficiency of blood- parts that can be identified by careful diagnosis.

Symptoms of acute stroke: (1) Sudden paralysis, numbness or weakness of the face, arm or leg, especially on one side of the body (2) Severe headache with no obvious cause (3) Blurry or decreased vision (4) Difficulty speaking or understanding speech (5) Dizziness or loss of balance (6) Lack of coordination (7) Nausea and vomiting. As soon as you notice any of these warning signs- call 911 and get to the hospital fast.

PREVENTION: (1) Don't ignore TIAs (2) Control your blood pressure. Hypertension (140/90 mm/hg or higher) can lead to stroke. Ask your physician about dietary changes and medication. (3) Check your cholesterol. A total cholesterol level of more than 200mg/dL is a major risk factor for stroke. (4) Kick the habit. Smoking doubles your risk. (5) Keep your weight down. Excess weight, especially in the midsection, is a major risk factor. (6) Know your family history. Your chance of stroke is higher if it runs in your family. (7) Limit alcohol to one drink a day. (8) Stay active. Regular physical activity helps prevent stroke. MORE INFORMATION: www.strokeassociation.org 1- 800-STROKES

Claudia Parks, RN is a former doctor's office and emergency room nurse and retired as an educator from Fulton County Schools. She writes Your Health Matters as a public service; the information here is designed to help you make informed choices about your health. It is not intended as a substitute for the advice of your physician. Claudia and her husband make their home in the beautiful north Georgia Mountains near Blairsville. Claudia can be reached at yhm@windstream.net