Stroke Awareness Month

May is National Stroke Awareness Month and a great time to educate and inform the public about the number five cause of death and the leading cause of disability in the United States.

What is a stroke?

A stroke is brain damage due to leak-age or disruption of the blood supply to the brain. There are two types of strokes. Eighty-seven percent of strokes are caused by a blockage in a blood vessel supply-ing the brain, called an ischemic stroke. The other type of stroke is a hemor-rhagic stroke, which is caused by a bleed.

What are some medical conditions that can increase the risk of stroke ?

High blood pres-sure, high cholesterol and diabetes can cause narrowing or weaken the vessels to a point that they may shut down,, heighten-ing the chances of having a stroke. Sleep apnea can cause low oxygen levels and el-evate the blood pres-sure or disrupt the heart rate, which may lead to a stroke. Atrial Fibrillation can be a risk for forming a blood clot in the heart, which may travel up to the brain and cause a stroke.

What are some be-haviors that decrease the risk of stroke?

Eighty percent of stroke can be pre-vented with a healthy lifestyle, specifically:

* Don't Smoke - Smoking decreases oxygen levels in the blood, and the nico-tine may raise the heart rate, blood pressure and make the blood more prone to clotting.

* Limit Alchohol - Excessive alcohol use may affect your heart which could increase the chances of experi-encing a stroke.

* Maintain a Healthy Weight - Obesity and a sedentary lifestyle increase the risk of stroke by elevating many risk factors and increasing inflammation throughout the body.

What are the warning signs of a stroke?

The abbreviation, BE FAST, is often used to remember the warning signs of stroke and when to immediately call 911.

* Balance difficulties

* Eyesight changes

* Face droops

* Arm weakness

* Speech difficulties

* Time to call 911

What is a tPA and when can it be adminis-tered?

Recombinant tissue plasminogen activator (tPA) is often referred to as the "clot buster medi-cine" that may be given to try and restore blood flow to the brain in the setting of acute ischemic stroke. This medicine is approved by the Food and Drug Administration (FDA) for administra-tion up to three hours from symptoms onset, and in a select popula-tion, it is recommended for use in a four-and-a-half-hour time frame from symptoms onset.

What other procedure can be done?

A mechanical throm-bectomy is a procedure for ischemic stroke dur-ing which a small cath-eter is introduced into the blood vessels at the groin or the wrist and threaded up to the site of the blockage in the brain. The blockage is then removed, restoring blood supply to the brain. This procedure is considered for patients having a moderate or severe stroke due to a blockage in a large blood vessel within 24 hours from symptoms onset.

What do people need to know in terms of mi-nority health and stroke?

According to the United States Depart-ment of Health and Hu-man Services Office of Minority Health, African American men are 70% more likely to die from a stroke than non-His-panic whites. African American women are twice as likely to have a stroke as compared to non-Hispanic white women.

These numbers are very concerning. It is very important for phy-sicians and other health care providers to be aware of the disparities in stroke care and out-comes. Several large research projects are looking at the potential causes and ways to fix this major public health problem. Some of the strategies can include better access to primary care for early treatment of risk factors and stroke prevention, edu-cation, early recogni-tion and early interven-tions.

research is be-ing done here locally on stroke?

There is local in-volvement in multiple national clinical trials for stroke. Some excit-ing trials include the utilization of a blood clot-busting medica-tion outside of the four-and-a-half-hour time frame and the use of neuroprotective agents/strategies in pa-tients with strokes. Cur-rently, local patients are being recruited for a study utilizing stem cells for patients with moderate to severe strokes.

On a national level, There continues to be extensive research, and promising results, for example on neuroprotective medi-cations which can limit brain injury if admin-istered quickly after the onset of a stroke. Another frontier of re-search is stroke recov-ery where there may be a role for stem cells or magnetic stimula-tion. Stroke research is exciting and holds great promise, but as the old saying goes, 'prevention is better than cure.'