Stroke

What is a stroke?

Arteries are blood vessels that carry blood from your heart to the rest of your body. Most strokes happen when an artery that carries blood to the brain becomes blocked. When brain cells that aren’t getting enough blood die, part of the brain is injured.

If you have a stroke, you may lose the ability to do something that is controlled by the injured part of your brain. For example, you could lose the use of an arm or leg, or the ability to speak.

The damage can be temporary or permanent. Doctors have found that if you get treatment right away after stroke symptoms start, there is a better chance to get the blood moving to your brain and prevent more damage.

Symptoms of Stroke

How do I know if I’m having a stroke?

If you have any of the following symptoms, call for emergency help immediately:

• Sudden weakness or numbness of the face, arm, or leg on one side of your body
• Sudden dimness or loss of vision, particularly in one eye
• Trouble talking or understanding what others are saying
• Sudden severe headache with no known cause
• Sudden unexplained dizziness
• Falling or unstable walking

The sooner you get help, the more doctors can do to prevent complete or permanent damage to part of your brain.

Another warning sign of a stroke is called a transient ischemic attack (TIA). A TIA is a “mini-stroke” that can cause the symptoms listed above. It may only last a few minutes, but you should not ignore it. People who have a TIA are at greater risk of having a stroke later. Call your doctor immediately if you think you are having a TIA.

How can I tell if someone else is having a stroke?

One way to tell if another person might be having a stroke is the F.A.S.T. test.

• F is for Face drooping.Does one side of the face droop when the person tries to smile?
• A is for Arm weakness.When the person raises both arms, does one arm drift downward?
• S is for Speech difficulty.Can the person repeat a simple sentence (for example, “The sky is blue.”) correctly? Is his or her speech slurred?
• T is for Time to call for emergency help.It’s important to get help immediately if a person has any of these symptoms.

Causes & Risk Factors

What are the risk factors for stroke?

Some risk factors for stroke can be changed, treated, or controlled. High blood pressure is the biggest risk factor for stroke that you can control. Others include the following:

Some risk factors for stroke can’t be changed. Your risk of having a stroke is higher if you:

• Smoking
• Uncontrolled diabetes
• High cholesterol level
• Are older than 55 years
• Have a family history of stroke
• Are black
• Are female
• Have had a previous stroke or transient ischemic attack

After I have had a stroke, am I more likely to have another one?

Yes. People who have had a stroke are more likely to have another stroke. The risk is especially high during the year after your first stroke.

What are the complications of a stroke?

The following are the most common effects of stroke:

• Weakness or paralysis on one side of the body
• Problems with speech and language
• Poor balance or clumsy movement
• Ignoring or being unaware of one side of the body
• Trouble swallowing
• Problems with bladder or bowel control
• Problems with memory, thinking, or problem solving
• Poor vision and/or changes in vision
• Numbness

Is it normal to have emotional changes after a stroke?

Brain injury and loss of function from a stroke can lead to emotional changes. Soon after the stroke, you may have trouble controlling your emotions. Your moods may change more quickly than they did before the stroke. For example, you may suddenly start crying or laughing for no reason. Usually this gets better over time.

It is understandable if you feel depressed, sad, or frustrated as you get used to the changes caused by a stroke. These reactions are common after a stroke, and they can be treated. It is important to talk to your doctor about how you are feeling so that he or she can help.

What about driving a car again after a stroke?

You should not make the decision on your own to start driving after a stroke. Your doctor can advise you if it is safe for you to drive again. Having a stroke can affect your mobility, vision, and thinking. Your reaction time may be slower. These changes can make driving a car unsafe for you and for other people on the road.

If your doctor says that it is safe for you to drive again, contact your state’s department of motor vehicles. Ask about the rules for people who have had a stroke. You may have to take a driving test or a class. Driver training programs are often available through rehabilitation centers.

It can be challenging if you can’t drive after having a stroke. Other options for getting around include public transportation, specialized vans, taxis, and rides from friends and family members. Community resources such as senior citizen groups and local volunteer agencies may also be able to help.

Prevention of Stroke

What can I do to reduce my risk of having a stroke?

Ways you can reduce your risk of having a stroke (or another stroke) include the following:

• If you are a smoker, stop smoking.
• Reduce the amount of alcohol you drink.
• Control your blood pressure.
• Control your cholesterol levels.
• If you have diabetes, control your blood sugar level.
• Get regular physical activity.
• Maintain a healthy weight.

You should have regular checkups so that your doctor can help you manage health conditions that increase your risk of having a stroke (for example, high blood pressure). Ask your doctor for advice on making lifestyle changes to decrease your risk of stroke. Support from family members and friends can also help you make these changes.

Talk to your doctor about whether taking aspirin in low doses would help reduce your risk of stroke or transient ischemic attack. Aspirin can help keep your blood from forming clots that block your arteries. If taking low-dose aspirin is right for you, it is important to follow your doctor’s instructions so that you get the most benefit with the fewest side effects.

Portions of this article were developed in cooperation with the American Heart Association.

Treatment

What is stroke rehabilitation?

Stroke rehabilitation can be an important part of recovery after a stroke. It helps build your strength, coordination, endurance, and confidence. A main goal of stroke rehabilitation is to help you learn how to live with the effects of the stroke so you can be as independent as possible. It may include physical therapy, occupational therapy, speech therapy, and swallowing therapy.

Your doctor will decide what kind of rehabilitation will be helpful for you. Rehabilitation can begin right after the stroke is over and your condition is stable. In many cases, it starts in the hospital as soon as 24 to 48 hours after a stroke. Most people need to continue rehabilitation for months or years after a stroke.

What can I do to help a loved one recover from a stroke?

Your loved one who has had a stroke will need your help and support. Some places offer classes for stroke survivors and their families. You may be able to go to some of your loved one’s rehabilitation sessions. This is a good way to learn how stroke rehabilitation works and how you can help your loved one get better. Find out what he or she can do alone, what he or she can do with help, and what he or she can’t do at all.

Let the rehabilitation staff know what activities your loved one enjoys. Help your loved one practice the skills learned in stroke rehabilitation. For example, avoid helping your loved one do things that he or she is able to do alone. Practicing skills will build your loved one’s confidence.