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Doc Talk: Go to the ER immediately if you have stroke symptoms

  • Published Friday, Dec. 27, 2013, at 8:11 p.m.
  • Updated Monday, Dec. 30, 2013, at 10:40 a.m.


There are two very important things to know about strokes that could save your life or prevent permanent disability. First, learn the symptoms of a stroke. Secondly, call an ambulance if you – or someone you know – have symptoms.

Many people ignore stroke symptoms, believing they are not important or will go away. Even if the symptoms do go away, you might be having a problem in your brain that could mean a stroke will occur soon. Strokes are rarely painful, which is part of the reason why many people hesitate to seek immediate care.

Most strokes occur when a blood clot blocks an artery in the brain, causing the death of brain cells that are not getting enough blood. If treated quickly with a drug called tPA, the clot might dissolve and the brain could recover. But every minute the stroke goes untreated means more brain damage is occurring.

Symptoms vary according to which area of the brain is affected. Stroke symptoms can include a sudden disability or change in behavior. The symptom could be a loss of the ability to speak, walk, swallow, move a limb or one side of the body or face, loss of the ability to see out of one eye or loss of vision in a part of one’s field of vision. Symptoms could also include confusion, dizziness, the loss of comprehension of language or awareness of one’s surroundings and unusual behavior. Sometimes a family member or friend will simply tell me the stroke victim “isn’t acting like himself.” A headache or nausea might accompany other symptoms.

Sudden onset of any loss of sensory function or motor function, or sudden onset of dizziness, should be assumed to indicate a stroke. Just to be sure, go to the emergency room.

If the symptoms come and then go, they may be caused by a TIA, or transient ischemic attack. A TIA is like a temporary stroke, in which the clot dissolves by itself and brain function is restored. However, a TIA indicates that a stroke might occur soon, so it’s important to go to the emergency room regardless.

If the drug tPA is administered intravenously within 3 or sometimes 4.5 hours of the onset of symptoms, the patient might recover. In some cases, tPA can be injected directly into the clot, using a special procedure that involves threading a catheter through an artery directly to the clot. In either case, fast treatment is the most important factor in preventing further brain damage.

After treatment, the physician will try to find the origin of the clot so future strokes can be avoided. A blood clot may originate in the heart or in a narrowed artery. It might be the result of faulty heart rhythm or excessive blood clotting. The doctor may prescribe medication or recommend a procedure to reduce the possibility of having another stroke.

Strokes, which are the third leading cause of death in the United States, can occur at any age but are most common in people over the age of 50. They are nearly always preventable. The primary risk factors are smoking, high blood pressure, diabetes, high cholesterol, obesity and a family history of heart disease or stroke. Talk with your doctor about your personal risk of stroke and ways to reduce the risk.

And remember, if symptoms appear, go to the emergency room immediately.

Calvin Olmstead is a neurologist and medical director of stroke services at Wesley Medical Center.

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