Brain attack warning: You could be having a stroke

One of the biggest fears in my patient population is having a stroke. All of us have seen a person with massive weakness or paralysis on one side of his or her body or whose speech has been destroyed by a brain attack.

The cause of a stroke should always be identified. Atrial fibrillation may be the cause in patients with heart rhythm problems. Other common causes are uncontrolled high blood pressure, blockage in a neck artery (carotid bruit) and poorly controlled diabetes. Less common causes include conditions such as vasculitis, cerebritis, brain aneurysms, arteriovenous malformations, and others.

Symptoms occur suddenly. Drooling and arm or leg weakness are common signs. The patient doesn’t respond appropriately. He may be confused with slurred or no speech. Sudden disorientation is another sign that a person could be having a stroke. These symptoms may last for a minute or longer, and they may persist. If they last for less than five minutes, they are called a transient ischemic attack (TIA). It is possible to have recurrent TIAs. If the symptoms last longer than 24 hours, the patient has had a stroke.

When stroke symptoms happen, the clock starts ticking. The longer you wait to call 911 for help, the less time there will be for a stroke team of specially trained physicians and nurses to aggressively treat the problem as soon as the patient arrives at the hospital. Time is critical. A rapid response is necessary to get more blood and oxygen to the affected area of the brain to minimize damage.

Stroke treatment may include the use of a powerful clot-breaking drug called tissue plasminogen activator (tPA). Heparin and other drugs that inhibit blood clotting (“blood thinners”) may be used. Surgery may be needed to remove blood clots or repair torn or broken blood vessels.

If you have symptoms similar to those of a stroke, or if you have a heart rhythm problem, it is extremely important to discuss these with your doctor. If the symptoms occur suddenly and unexpectedly, do not wait. Calling 911 could make the difference between leading a normal lifestyle and having a permanent neurologic disability.

A brain attack can cause devastating long-term effects. Risk factors must be identified and treated to reduce the possibility of stroke. Uncontrolled high blood sugar (glucose) levels, high blood pressure, smoking and blocked arteries all contribute to stroke and heart and vascular disease. If you are at risk, do not wait to get these problems addressed. It is a matter of life, death and potential long-term disability.

James A. Smith is a vascular and internal medicine physician with Kansas Vascular Medicine. He is board certified by the American Board of Vascular Medicine and the American College of Osteopathic Internists.

This story was originally published May 1, 2017 at 1:26 PM with the headline "Brain attack warning: You could be having a stroke."