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Classification and external resources

CT scan slice of the brain showing a right-hemispheric ischemic stroke.
ICD-10 I61.-I64.ner
ICD-9 434.91
OMIM 601367
DiseasesDB 2247
MedlinePlus 000726
eMedicine neuro/9 emerg/558 emerg/557 pmr/187
MeSH D020521

A stroke is an event which damages part of the brain. This can happen if an artery that feeds blood to the brain gets clogged, or if it tears and leaks.

Strokes are often called a brain attack because of the similarities it has to a heart attack. A heart attack is when there is a lack of blood flow to the heart and a stroke is when there is a lack of blood flow to the brain. There are two types of strokes. One is when there is a blood clot blocking the artery. An artery is a type of tube that takes blood to different parts of your body. The other type of stroke is when a blood vessel bursts and there is blood moving around freely in the brain. A blood vessel is another type of tube that carries blood to your body.[1]

A stroke, or cerebrovascular accident (CVA), is the rapid loss of brain function(s) due to disturbance in the blood supply to the brain. This can happen because of ischemia (lack of blood flow) caused by blockage (thrombosis, arterial embolism), or a haemorrhage (leakage of blood).[2]

As a result, the affected area of the brain cannot work properly. Symptoms might include: hemiplegia (an inability to move one or more limbs on one side of the body), aphasia (inability to understand or use language), or an inability to see one side of the visual field.[3]

A stroke is a medical emergency. It can cause permanent damage. If it is not quickly treated, it may lead to death. It is the third most common cause of death and the most common cause of disability for adults in the United States and Europe.

Strokes happen on both the left and right side of the brain. When a stroke happens on the left side of someone’s brain, it affects the right side of the body. It can also cause problems with the patient’s speech and language. If a stroke affects the right side of the brain, it affects the left side of the body. It also changes patient’s spatial (relating to space) perceptions. Getting a stroke on the right side of the brain can also cause people to not acknowledge their illness. Patients behave impulsively and neglect the side of their body.[4]

A simple video explanation of a stroke.

Factors that increase the risk of a stroke include old age, high blood pressure, a previous stroke, diabetes, high cholesterol, smoking, atrial fibrillation, migraine with aura, and thrombophilia (a tendency to thrombosis). Of those factors, the most easy to fix are high blood pressure and smoking.

How are Strokes Identified?[change | change source]

Pre-Hospital[change | change source]

The Cincinnati Prehospital Stroke Scale was designed to help "pre-hospital" medical professionals (like EMTs) identify a possible stroke before the patient gets to the hospital.[5] It tests three basic signs. If any of these signs are not normal, the patient may be having a stroke and should be transported to a hospital as soon as possible.[5]

  1. Facial droop: Have the person smile or show his or her teeth.
    • Normal: Both sides of face move equally
    • Abnormal: One side of face does not move as well as the other (or at all); part of the face looks like it is drooping
  2. Arm drift: Have the person close his or her eyes and hold his or her arms straight out for about 10 seconds.
    • Normal: Both arms move equally or not at all
    • Abnormal: One arm does not move, or one arm drifts down compared with the other side
  3. Speech: Have the person say, "You can't teach an old dog new tricks," or some other simple, familiar saying.
    • Normal: Patient uses correct words with no slurring
    • Abnormal: Patient's speech is slurred, patient uses incorrect words, or is unable to speak

About 72% of patients who cannot do one of these three tasks normally are having an ischemic stroke. More than 85% of patients who cannot do all three tasks are having an acute stroke.[6]

"Spot a Stroke"[change | change source]

The "Spot a Stroke" campaign, created by the American Heart Association and the American Stroke Association, teaches everyday people how to recognize a stroke. The Spot a Stroke campaign teaches the basic tests from the Cincinnati Stroke Scale, using the acronym FAST:[7]

  • F: Face - Facial Droop. Is one side of the face drooping or numb? Ask the person to smile. Is the person's smile uneven?
  • A: Arm - Arm Weakness. Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
  • S: Speech - Speech Difficulty. Is speech slurred? Is the person unable to speak or hard to understand? Ask the person to repeat a simple sentence, like "The sky is blue." Is the sentence repeated correctly?
  • T: Time - Time to Call 911. If someone shows any of these symptoms, even if the symptoms go away, call 9-1-1 and get the person to the hospital immediately. Check the time so you'll know when the first symptoms appeared.

In the Hospital[change | change source]

Once the patient is in the hospital, doctors can find out for sure whether they are having a stroke by looking at their brain with special scanning machines, like an MRI or a CT scanner.[8]

Prevention[change | change source]

Strokes can kill. To prevent a stroke, doctors advise people to:

  • Control your blood pressure
  • Stop smoking
  • Exercise at least once a week
  • Stay at a healthy weight
  • Do not drink too much
  • Get regular checkups[4]

Statistics[change | change source]

  • 795,000 people in the United States get a stroke each year
  • One out of four people who have a stroke die (137,000 deaths from stroke per year)
  • Currently, 3 million people in the US have disabilities from strokes
  • In US, strokes cost $57.9 billion per year (damage and loss of work)
  • ⅔ of stroke happen in people 65 and up
  • Strokes affect men more than women
  • Women more likely to die from stroke than men
  • Strokes are more common in African Americans
  • Strokes are more likely to be fatal in African Americans
  • Stroke rates in older adults are declining but rates in younger people are rising (scientists think that it’s related to obesity)
  • Physical therapy can help patients
  • Some people are in a wheelchair after getting a stroke
  • 10% of survivors suffer no long term disabilities
  • 10% of survivors suffer from so many disabilities that they have to stay in 24 hour care[4]

References[change | change source]

  1. Stroke; Overview. N.p.: GALE Cengage Learning, n.d. Health and Wellness Resource Center. Web. 22 Feb. 2016.
  2. Sims NR, Muyderman H (September 2009). "Mitochondria, oxidative metabolism and cell death in stroke". Biochimica et Biophysica Acta 1802 (1): 80–91. doi:10.1016/j.bbadis.2009.09.003. PMID 19751827.
  3. Donnan GA, Fisher M, Macleod M, Davis SM (May 2008). "Stroke". Lancet 371 (9624): 1612–23. doi:10.1016/S0140-6736(08)60694-7. PMID 18468545.
  4. 4.0 4.1 4.2 Blaser, Larry. "Stroke." The Gale Encyclopedia of Science. Ed. K. Lee Lerner and Brenda Wilmoth Lerner. 5th ed. Farmington Hills, MI: Gale, 2014. Student Resources in Context. Web. 22 Feb. 2016.
  5. 5.0 5.1 Hurwitz AS, Brice JH, Overby BA, Evenson KR (2005). "Directed use of the Cincinnati Prehospital Stroke Scale by laypersons". Prehosp Emerg Care 9 (3): 292–6. doi:10.1080/10903120590962283. PMID 16147478.
  6. American Heart Association (2011). Advanced Cardiovascular Life Support Provider Manual. USA: First American Heart Association Printing. pp. 137. ISBN 9-781616-690106.
  7. "Spot a Stroke". American Stroke Association. 2015.
  8. "How is a Stroke Diagnosed?". American Heart, Lung, and Blood Association. 2015-10-28. Retrieved 2015-10-27.

More reading[change | change source]

  • J.P. Mohr et al. (2004). Stroke: pathophysiology, medical diagnosis, and management. New York: Churchill Livingstone. ISBN 0-443-06600-0.
  • Perry, Thomas and Miller Frank (1961). Pathology: a dynamic introduction to medicine and surgery. Boston: Little, Brown and Company.

Other websites[change | change source]